Medical negligence Flashcards

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1
Q

What is the GMC’S statutory responsibility?

A

is to produce the Medical Register – its membership

The GMC is responsible for overseeing and certifying the appropriateness of medical education

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2
Q

What are some topics the GMC guidance includes? (9)

A
Ethics
Professionalism
Professional Governance
The Law as it affects and governs medical practice
Confidentiality
Consent
Negligence
Record Keeping
Team working
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3
Q

What does the GMC guidance basically mean? (8)

A
Putting patients first
Being honest
Having the knowledge to practise medicine legally
Knowing one’s limitations
Being knowledgeable and keeping up to date
Treating people with dignity
Treating people consistently
Being able to admit you are wrong
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4
Q

What Relevance Does Legislation have to Working as a Doctor?(7)

A
Working legally and lawfully
Duty of care to the patient
Working with proper skill and attention
Risk versus benefit analysis
Working in a patient’s best interests
Working within one’s own capabilities
Achieving expected outcomes
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5
Q

What is the Quintuple Jeopardy? - complaint list

A
Local Complaints
Disciplinary action - employer
Civil claim 
Medical Council
Criminal prosecution
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6
Q

What are local complaints?

why might a patient complain?

A

Lowest level - Patients have a right to complain, (error, grief poor explanation, unrealistic expectations, failure to meet wishes of patient)

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7
Q

with local complaints what must you do ?

A

reply - the first response back is crucial

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8
Q

Disciplinary action - employer? what are the procedures

A
Terms and conditions of service 
Appraisal 
Job planning
Time keeping
Absence
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9
Q

Civil claim? why are there differences between the UK and U.S

A

NHS - care regardless of income or insurance
Jury involved – someone to blame
UK NHS Complaints Procedures permit interaction and explanation for patients without need to sue

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10
Q

general medical council - complaints - what is the process?

A

At the GMC the complaint is considered by case workers

May be passed onto Case Examiners - investigate if your “honesty and probity” are in question

Cases heard by the Medical Practitioners Tribunal Service (MPTS)

Various sanctions can be imposed

All parties have a right of appeal

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11
Q

What can some GMC cases include? (6)

A
Manner and attitude
Dishonesty
Sexual impropriety
Criminal convictions
Health issues – drink driving/abuse of drugs/mental health
Significant Performance issues
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12
Q

Criminal prosecution? types of criminal prosecution?

A
Indecent assault
Prescription fraud
Manslaughter
Murder
Deception offences
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13
Q

What is civil law?

A

concerned with the rights and property of individual people or organisations, which may not always be protected by criminal laws.

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14
Q

What does civil law dispute?

A

settles disputes between individuals and organisations, and it often involves compensation being awarded.

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15
Q

Examples of civil law cases?

A

Family disputes, such as divorce, dissolution of civil partnerships, children’s issues and childcare arrangements
Personal injury cases, such as road traffic accidents, medical and clinical negligence and slips, trips and falls
Breach of contract or promise, such as cases where money is unpaid or a contract isn’t honoured
Employment law, for example where an employee suffers discrimination

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16
Q

What is criminal law?

A

relates to offences and breaches that negatively affect society as a whole, rather than just one person - can get criminal prosecution from the state

17
Q

Crown court in scotland - 2 types?

A

Sheriff - not usually a jury, lesser crimes/shorter punishment - theft, assault - 4 year prison sentences
High court - jury, judge can hand out large sentences

18
Q

What can medical negligence be defined as?

A

a lack of reasonable core and skill as a result of which the patient suffers

19
Q

The monetary award will reflect what?

A

financial loss (occasioned by inconvenience or injury) suffered by the patient and not the degree of negligence exhibited, the reason for the lapse being immaterial

20
Q

What are the 3 main components of medical negligence

A

legal duty - contract
reasonable care and skill
actual damage

21
Q

Legal duty- what does this mean?

A

to provide care and skill i.e. a professional relationship, which in legal terms is a contract
Express contract
Implied contract

22
Q

Reasonable Care and Skill - basically means what?-

A

The concept of accepted medical practice - an error that no other competent doctor would make

23
Q

the 2 medical negligence cases?

A

Hunter v Hanley 1955

Bolam V Friem 1957

24
Q

Actual damage?

A

must have occurred as a direct result of the lapse ie causation
The negligence has caused the Damage!!!!

25
Q

Medical negligence - examples of losses leading to compensation? (7)

A
Loss of earnings
Expenses incurred
Impaired enjoyment of life
Permanent incapacity
Procreative incapacity
Pain and suffering endured
Death
26
Q

Procedures Upon Complaint of Negligence - STEPS (4)

A
  • complaint to solicitor - looks into allegations and if there is substance will represent complaint to doctor in writing
  • Doctor - legal representatives (Defence Organisation, Health Authority etc)
  • no case, some negligence (self-evident)
  • neither of above - civil court
27
Q

Medical negligence - lines of defence (4)

A

Deny the charge
True facts but not the doctors fault
Patient took a risk - consented procedure
Contributory negligence - claimant’s own negligence contributed to loss or damage

28
Q

What is vicarious liability

A

Vicarious liability - where a person can be heldliablefor the actions of another person (e.g. Health Board can be held responsible for the actions of the doctor

29
Q

What is involuntary manslaughter?

A

causes death but without intent to kill  This charge does not exist in Scotland – ? Involuntary culpable homicide – homicide in the course of lawful conduct

30
Q

What does gross negligence manslaughter mean?

A

breached duty of care with foreseeable serious risk of death ensuing and actions or contributions caused or significantly contributed to death of the victim

31
Q

Strategies for avoiding/minimal risk of complaints of negligence

A
  • Join a medical defence organisation (MDDUS, MDU, MPS)
  • Seek advice early
  • Maintain good records
  • Delegation
  • Comments about colleagues
  • Courtesy and hostility
  • Report early to Defence Organisation