Negligence Flashcards
What is the process of a complaint?
Local complaint -> disciplinary action (employer) -> civil claim -> medical council -> criminal prosecution
Why might a patient complain?
Error Grief Poor understanding/explanation Unrealistic expectations Failure to appreciate needs/wishes of patient
What do you have legal obligation to do with complaints?
You have legal and professional responsibilities to reply
What does the GMC say about dealing with complaints?
Professional responsibility to deal with complaints constructively and honestly
Should co-operate
Don’t allow patients complaint to prejudice care or treatment
When appropriate, offer apology
What are disciplinary procedures of employers?
Terms and conditions of service Appraisal Job planning Time keeping Absence
Why is there less litigation in UK than US?
UK NHS Complaints Procedures permit interaction and explanation for patients without need to sue
If complaint made to GMC who is it passed to?
Medical Practitioner’s Tribunal Service (MPTS)
What can GMC cases include?
Manner and attitude Dishonesty Sexual impropriety Criminal convictions Health issues - drugs/alcohol Significant performance issues
What are types of criminal allegations made against doctors?
Indecent assault Prescription fraud Manslaughter Murder Deception offences
What is civil law?
Concerned with rights and property of individual people or organisations, which may not always be protected by criminal laws
What are examples of civil law cases?
Family disputes
Personal injury cases
Breach of contract
Employment law
What is criminal law?
Offences and breaches that negatively affect society, not just one person
What happens if a person breaches criminal law?
Subject to criminal prosecution by the state
Who brings criminal proceedings in the name of the crown?
Crown Prosecution Service (CPS)
How can medical negligence can be defined?
A lack of reasonable care and skill as a result of which the patient suffers
Can the patient sue for medical negligence?
Yes - patients have right to certain standards of service and if negligent in delivery of that service can be demonstrated, the individual may sue in the civil courts for compensation and be awarded damages
What is monetary aware for negligence?
Will reflect financial loss suffered by patient, not degree of negligence exhibited (reason for lapse is immaterial)
What must be demonstrated in order to be medically negligent?
- Legal duty to provide care and skill - contract
- Reasonable care and skill - concept of “accepted Medical Practice”
- Actual damage must have occurred as a direct result of lapse
What did the Hunter v Hunley 1955 case in Scotland say?
A mistake made by practitioner must be an error which no competent doctor in that field would have made
What did the Bolam v Friern case in 1957 say?
That a doctor who had acted in accordance with a practice accepted at the time as proper by a ‘responsible body of medical opinion’ skilled the particular form of treatment was not guilty of negligence
For negligence what must pursuers prove?
They have suffered a loss of some form
What are examples of losses leading to compensation?
Loss of earnings Expenses incurred Impaired enjoyment of life Permanent incapacity Procreative incapacity Pain and suffering endured Death
What are the lines of action after patient states complaint to solictor and doctor has legal representatives?
No case to answer
‘Res ipsa loquitur; negligence is self evident
Neither of the above; legal debate; court
What are lines of defence in medical negligence?
Deny charge
True facts but not the pursued doctor’s fault or vicarious liability
Patient took risk - consented procedure
Contributory negligence
What is vicarious liability?
Where a person can be held liable for the actions of another person (e.g. Health board held responsible for actions of doctor)
What is element of mens rea?
Recklessness
What is contributory negligence?
Claimant’s own negligence contributed to their loss or damage
What are strategies for avoiding/minimalising the risk of complaints of negligence?
Join medical defence organisation Seek advice early Maintain good records Delegations Comments about colleagues Courtesy and hostility Report early to Defence organisation
Who is the GMC regulated by?
Professional Standards Authority
What is the GMC’s statutory responsibility?
To produce the Medical Register
What is the GMC’s responsibility?
To oversee and certify the appropriateness of medical education, ensuring doctors are fit to practice by publishing its ethical and professional guidance
