Negligence

Question 1

What is the process of a complaint?

Answer 1

Local complaint -> disciplinary action (employer) -> civil claim -> medical council -> criminal prosecution

Question 2

Why might a patient complain?

Answer 2

Error
Grief
Poor understanding/explanation
Unrealistic expectations
Failure to appreciate needs/wishes of patient

Question 3

What do you have legal obligation to do with complaints?

Answer 3

You have legal and professional responsibilities to reply

Question 4

What does the GMC say about dealing with complaints?

Answer 4

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

Question 5

What are disciplinary procedures of employers?

Answer 5

Terms and conditions of service
Appraisal
Job planning
Time keeping
Absence

Question 6

Why is there less litigation in UK than US?

Answer 6

UK NHS Complaints Procedures permit interaction and explanation for patients without need to sue

Question 7

If complaint made to GMC who is it passed to?

Answer 7

Medical Practitioner’s Tribunal Service (MPTS)

Question 8

What can GMC cases include?

Answer 8

Manner and attitude
Dishonesty
Sexual impropriety
Criminal convictions
Health issues - drugs/alcohol
Significant performance issues

Question 9

What are types of criminal allegations made against doctors?

Answer 9

Indecent assault
Prescription fraud
Manslaughter
Murder
Deception offences

Question 10

What is civil law?

Answer 10

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

Question 11

What are examples of civil law cases?

Answer 11

Family disputes
Personal injury cases
Breach of contract
Employment law

Question 12

What is criminal law?

Answer 12

Offences and breaches that negatively affect society, not just one person

Question 13

What happens if a person breaches criminal law?

Answer 13

Subject to criminal prosecution by the state

Question 14

Who brings criminal proceedings in the name of the crown?

Answer 14

Crown Prosecution Service (CPS)

Question 15

How can medical negligence can be defined?

Answer 15

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

Question 16

Can the patient sue for medical negligence?

Answer 16

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

Question 17

What is monetary aware for negligence?

Answer 17

Will reflect financial loss suffered by patient, not degree of negligence exhibited (reason for lapse is immaterial)

Question 18

What must be demonstrated in order to be medically negligent?

Answer 18

1. Legal duty to provide care and skill - contract
2. Reasonable care and skill - concept of “accepted Medical Practice”
3. Actual damage must have occurred as a direct result of lapse

Question 19

What did the Hunter v Hunley 1955 case in Scotland say?

Answer 19

A mistake made by practitioner must be an error which no competent doctor in that field would have made

Question 20

What did the Bolam v Friern case in 1957 say?

Answer 20

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

Question 21

For negligence what must pursuers prove?

Answer 21

They have suffered a loss of some form

Question 22

What are examples of losses leading to compensation?

Answer 22

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

Question 23

What are the lines of action after patient states complaint to solictor and doctor has legal representatives?

Answer 23

No case to answer
‘Res ipsa loquitur; negligence is self evident
Neither of the above; legal debate; court

Question 24

What are lines of defence in medical negligence?

Answer 24

Deny charge
True facts but not the pursued doctor’s fault or vicarious liability
Patient took risk - consented procedure
Contributory negligence

Question 25

What is vicarious liability?

Answer 25

Where a person can be held liable for the actions of another person (e.g. Health board held responsible for actions of doctor)

Question 26

What is element of mens rea?

Answer 26

Recklessness

Question 27

What is contributory negligence?

Answer 27

Claimant’s own negligence contributed to their loss or damage

Question 28

What are strategies for avoiding/minimalising the risk of complaints of negligence?

Answer 28

Join medical defence organisation
Seek advice early
Maintain good records
Delegations
Comments about colleagues
Courtesy and hostility
Report early to Defence organisation

Question 29

Who is the GMC regulated by?

Answer 29

Professional Standards Authority

Question 30

What is the GMC’s statutory responsibility?

Answer 30

To produce the Medical Register

Question 31

What is the GMC’s responsibility?

Answer 31

To oversee and certify the appropriateness of medical education, ensuring doctors are fit to practice by publishing its ethical and professional guidance