Medical Negligence 1 and 2 Flashcards Preview

Year 2: Medical Ethics & Law > Medical Negligence 1 and 2 > Flashcards

Flashcards in Medical Negligence 1 and 2 Deck (28)
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1
Q

GMC guidance includes advice about what?

A
  • Ethics
  • Professionalism
  • Professional Governance
  • The Law as it affects and governs medical practice
  • Confidentiality
  • Consent
  • Negligence
  • Record Keeping
  • Risk management, audit, peer review
  • Clinical governance
  • Referral of patients
  • Dealing with criticism and complaints
  • Working with colleagues, team working
  • The duty to report
  • The duty of candour
  • Continued professional development
  • Self-appraisal and staying healthy
2
Q

Summarise the GMC guidance to doctors?

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
3
Q

What is the relevance of understanding legislation when working as a doctor?

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
4
Q

What are the difference ways that a complaint can be made?

A
5
Q

Why might patients make a local complaint?

A
  • Error
  • Grief
  • Poor understanding/poor explanation
  • Unrealistic expectations
  • Failure to appreciate needs/wishes of patient
6
Q

In regards to a local complaint, what do doctors have a legal responsibilityt to do?

A

Have a legal and professional responsibility to reply

GMC states:

“… you have a professional responsibility to deal with complaints constructively and honestly.You should co-operate with any complaints procedure which applies to your work.You must not allow a patient’s complaint to prejudice the care or treatment you provide or arrange for that patient …

When appropriate you should offer an apology.”

7
Q

What are some examples of employer disciplinary procedures?

A
  • Terms and conditions of service
  • Appraisal
  • Job planning
  • Time keeping
  • Absence
8
Q

What are some potential reasons why litigation (civil claims) are more common in the USA than the UK?

A
  • No well-developed free socialised health care system (i.e. NHS) therefore damages necessary to cover subsequent medical expenses
  • Jury involved – someone to blame
  • Contingency Fee system for lawyers
  • Public Expectation
  • UK NHS Complaints Procedures permit interaction and explanation for patients without need to sue
9
Q

What are most cases of litigation due to?

A

Most cases of litigation are due to poor communication between doctor and patient

10
Q

Describe the process of a complaint to the GMC?

A
  • Anyone can make a complain
  • Complain is considered by case workers
  • May be passed onto Case Examiners to investigation your “honesty and probity” if they are in question
  • Cases heard by the Medical Practitioners Tribunal Service (MPTS)
  • Various sanctions can be imposed
  • All parties have a right to appeal
11
Q

Complaints made to the GMC are heard by who?

A

Medical Practitioners Tribunal Service (MPTS)

12
Q

What must investigations into the GMC be related to, at what time, and where?

A
  • Can be unrelated to medicine
  • Incidents can have occurred at any time
  • Incidents can have occurred anywhere
13
Q

What are some examples of potential GMC cases?

A
  • Manner and attitude
  • Dishonesty
  • Sexual impropriety
  • Criminal convictions
  • Health issues
    • Drink driving
    • Abuse of drugs
    • Mental health
  • Significant performance issues
14
Q

What are examples of types of criminal allegations made against doctors?

A
  • Indecent assault
  • Prescription fraud
  • Manslaughter
  • Murder
  • Deception offences
15
Q

What is the difference between civil law and criminal law?

A
  • Civil law is concerned with the right and property of individual people or organisations, which may not always be protected by criminal laws
  • Criminal law relates to offences that negatively affect society as a whole, rather than just one person
16
Q

What are 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
17
Q

Who are criminal proceedings usually brought by?

A
  • Crown Prosecution Service (CPS) in the name of the Crown
18
Q

What are some examples of criminal law cases?

A
  • Burglary, theft, arson and criminal damage
  • Assault, sexual assault and battery
  • Murder
  • Fraud, money laundering and drug dealing
19
Q

Who are criminal law cases heard by?

A
  • Heard in a Magistrates Court of the Crown Court
20
Q

What does medical negligence lead to?

A

Leads to prosecution, civilly or maybe criminally

21
Q

What is medical negligence?

A

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

22
Q

What can individuals do in response to medical negligence?

A

Individuals can sue in civil courts for compensation, in the UK courts do not grant punitive damages (ie money fined by way of punishment)

Monetary award reflects the financial loss (occasioned by inconvenience or injury) suffered by the patient and not the degree of negligence exhibited

Settlement can take place “out of court” or may proceed through the civil courts before a judge (in Scotland, the court of Session)

23
Q

What must be demonstrated to fulfil the definition of medical negligence in legal terms?

A
  1. A legal duty to provide care and skill, which in legal terms is a contract
    1. Express contract
    2. Implied contract
  2. Reasonable care and skill
    1. A mistake made by the practitioner must be an error which no competent doctor in that field would have made
  3. Actual damage must have occurred as a direct result of the lapse (ie causation)
    1. To prove causation the puruer must show that, on the balance of probabilities the alleged negligence caused the damage
24
Q

What are some possible examples of loses due to medical negligence leading to compensation?

A
  • Loss of earnings
  • Expenses incurred
  • Impaired enjoyment of life
  • Permanent incapacity
  • Procreative incapacity
  • Pain and suffering endured
  • Death
25
Q

What is the procedure upon complaint of negligence?

A
  1. Aggrieved patient states his complaint to solicitor, who if he believes allegations have substance represents the complaint to the doctor in writing, demanding reward for damages
  2. Doctor immediately puts the affair to their legal representatives (Defence Organisation, Health Authority etc)
  3. Thereafter lines of action includes
    1. No case to answer
    2. “Res ipsa loquitur”, negligence is self evident
    3. Neither of the above, legal debate in court
26
Q

What are some lines of defence against medical negligence?

A
  • Deny the charge
  • True facts but not the pursued doctors fault, or vicarious liability (where a person can be held liable for the actions of another person – such as Health Board can be responsible for the actions of the doctor)
  • Patient took a risk (consented to procedure)
  • Contributory negligence (claimants own negligence contributed to their loss or damage)
27
Q

What is vicarious liability?

A

Where a person can be held liable for the actions of another person – such as Health Board can be responsible for the actions of the doctor

28
Q

What are some strategies for avoiding/minimalising the 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