Medical Negligence Flashcards
(28 cards)
Cassidy v Ministry of Healthcare
it was decided that once they undertake the task they come under a duty of care - whether NHS or Private it doesn’t matter.
Barnett v Chealsea and Kensignton
A duty of care is imposed on the doctor once she has assumed responsibility for the patient’s key.
3 men drank tea laced with arson, doc told men to go home and consult GP in the morning but they all die before then. the doc in the case assumed responsibility by giving advice even though he did see them.
In A and E as soon as a patient walks through the door W/O hindrance, the duty of care is assumed - ths apples to ambulances. Kent V Griffith - unless the ambulance has been called to a more urgent issue on their way to original call.
Darnley V Croydon
the receptionist told patents waiting time is 4-5 hours, so patient left and decided not to wait, he collapsed and suffered bleeding in his brain and was left paralysed. f he would have waited he would have been treated and recovered. The judge used Caparo to help determine if there was proximity.and harm was foreseeable but it would be unfair to impose liability on the receptionists providing info on waiting time.
providing waiting time is a courtesy,.
Also, policy argument if liability was imposed hospitals would tell the receptionist to not provide waiting time this info is helpful patients.
Organisational Issues - Wilsher v Essex
The health authority owed patients a duty of care to provide properly skilled medical staff and an adequately equipped hospital - issues with such a duty - is scarce resources in hospitals. Courts are reluctant to interfere with policy decisions about the allocation of resources.
Organisational issues - Bull v Devon
It was found that a duty of care can exist with relation to organisation. However, they distinguished between hospitals duty to provide adequate care and its freedom to choose how to organise services within the limited finds available.
What are the issues of proximity ?
Thake v Maurice - Proximity - Wife of patient conceived after her husband had a vasectomy. As a wife of the patient, she was an identifiable person. The doctor should have kept her in mind.
Goodwill V Pregnancy Advisory Service- No proximity - 3 years later after her partner’s vasectomy Mrs Goodwill conceived. Courts dismissed her claim because at the time the doc was treating the patient, Mrs goodwill was not an identifiable person.
ABC V Goerges Healthcare NHS Trust - t s impossible for a doc to owe a duty of care to someone who is not their patient
BREACH OF DUTY - BOLAM - THE FACTS
John Bolam was a patient with psychiatric harm he was advised to have electroconvulsive therapy - he wasn’t told about the risk of fractures and or given muscle relaxant. He consequently dislocated his hip joint and suffered a fracture to his pelvis.
What did Justice Mcnair say in Bolam?
He defined negligence as the failure to do an act which a reasonable person in the circumstances would do. When you have a special skill the standard would be that of the ordinary skilled man professing to have the same skill.
What was the principle formed in Bolam
A doctor cannot be negligent if he acts according to a practice accepted as proper by a responsible body of medical men skilled in the art. Just because another doctor has a different opinion does not automatically mean that the doctor has been negligent.
What are the 4 key words of Bolam, identify the descriptive and the normative words. What is the issue with the descriptive words?
ordinary (Descriptive words - what do other doctors do), reasonable, responsible and respectable (Normative words- what ought to have been done. )
Just because something is ordinary doesn’t make it reasonable, responsible or respectable.
Maynard v Midlands Regional Authority
Negligence is not established by preferred one respectable body of distinguished professional opinion to another also professionally distinguished.
whitehouse v Jordan
an error of judgement is not negligence. The Hol ‘ it is not necessarily negligence’
What happens if the d canot get anyone to agree with them
Its up to the D to show why his actions were not negligent - he has to shift the burden of truth. As well as showing the damage did not result from his breach his duty
Clark v Maclenann
gynaecologist performed an operation to restore the bladder to its correct position, this was performed 4 weeks postpartum - this was not reasonable practice. Normal practice is to wait at least 12 weeks postpartum. As a consequence, the lady bleeds internally and suffered untreatable damages.
Just because there is not a body to support the D - it does not equal an automatic breach
Wilshire and V Essex health Authority
Premature baby - over oxygenated due to false reading by JD. senior registrar failed to identify the mistakes and even made the same mistake. The baby was left blind. The JD absolved himself from all duties because of he asked a senior to check his work
According to wilsher, what standard should we hold inexperienced staff to ?
Post standard - it doesn’t matter who you are what matters is the role you are performing - that is the standard the individual will be held to.
other standards include General - everyone held to the same standard and individual - based on the qualifications the individual has
Does the extra qualification allow for the standard of care to be raised -
FB V Rana - no
Bolitho Facts
Baby Bolitho was not attended to by the paediatrician after having 2 episodes of violent coughing. During his 3rd episode, he suffered a cardiac arrest and then brain damage. D accepted a breach of duty by not attending to baby Bolitho.
The principle: bringing other bodies to verify is not enough - it has to be a responsible body of medical men. the judgement highlighted the normative words.
A logical basis is required otherwise a judge hold the opinion that the body of opinion is not reasonable or responsible
Marriot v West Midlands
Mr Marriott had suffered a head injury and had been conscious for 20 - 30minutes his GP attended to him but did not think there was anything wrong. In this case, it was blatantly obvious that a doctor should be concerned about the symptoms reported by someone who recently suffered an head injury
Mulholland V meadway NHS foundation trust
Green J held that that the practioners in a busy A and E did not have the luxury of time. And in such circumstances - not negligent.
What is the standard of care in emergencies ?
off duty doctors are not under a legal duty to offer assistance, if however they come upon a medical emergency and fail to assist - it could lead to disciplinary action by the GMC. you need to take in surrondngs an context when considering the standard of care.
What is the standard of care when it come to alternative medicine
Shakoor v Situ
-the standard of care in that art is what the reasonable alternative practitioner would do.
what is the but for test
But for the D’s negligence, the claimant wouldn’t have suffered this injury
Barnett v Chelsea and Kensington Hospital management
- there may be more than one possible cause of the patients injury
- It is not always possible to be certain what the outcome would have been if the patient had been properly treated.
Wilsher v essex
- There way at least 5 reason for martin wilshers blindness - one was the negligent over oxygenation - HOL they failed to prove that it was the excess oxygen that caused his injuries
What is a loss of a chance
A doctors breach of duty derives the patient of the opportunity of recovery
