Clinical Negligence

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  • Created by: AlexW3
  • Created on: 12-12-23 20:43
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  • Clinical Negligence
    • Defendants
      • Patients encouraged to through hospital / GP complaints procedure
        • Will bring things to light that may be used in litigation
        • May get an apology
        • Encouraged by Civil Procedure Rules
      • NHS hospital
        • Claim against trustor appropriate Health Authority in tort
      • Private hospital
        • Claim against the hospital and / or consultant in tort
      • Nurses
        • Claim against employers in tort
          • Vicarious liability
      • GP's
        • Claim against GP and / or partnership
          • Partners are jointly and severally liable
      • Locum
        • Stand-in doctor
        • Claim against Locum
          • Unless it can be proved that the GP practice that hired the Locum was negligent
            • Parties injured by patients
              • Selwood v Durham CC
    • Duty of Care
      • Can a duty be owed to a 3rd party?
        • Unless it can be proved that the GP practice that hired the Locum was negligent
          • Parties injured by patients
            • Selwood v Durham CC
        • Policy issues and confidentiality
        • Genetic diagnoses
      • Who owed a cuty?
        • All those involved in the care of the patient
          • Inexperience is not a defence
            • Wilsher  v Essex AHA
          • Receptionists have a duty to inform patients about likely wait times
            • Darnley v Croydon Health Services NHS Trust
        • Direct vs  Vicarious liability
          • V - failure of the organisation
          • D - Trusts are vicariously liable for their staff
      • When does a duty begin / end?
        • Duty ends when the treatment ends or patient / Dr dies
        • Duty is continuous
          • Follow up
        • Duty begins as soon as patient presents to A&E
          • Or when the treatment begins
      • One or multiple duties?
        • One duty, which covers?
          • Duty to disclose risks
            • Does not involve clinical expertise
          • Duty to provide post-op care
          • Duty to treat
          • Duty to diagnose
      • What is the nature / scope of the duty?
        • Duty = provide treatment to a reasonable level of skill
        • Did health carer guarantee a specific result?
        • NHS or private?
    • Standard of care
      • Bolam v Friern HCC
        • Standard = ordinary skilled man
          • Objective
            • What would reasonable and responsible group of clinicians have done?
            • Meiklejohn
              • World renowned expert
            • Wilsher
              • Inexperience
                • Judged against the norm
                  • World renowned expert
                  • Not expected to be experts
      • Accepted Medical Practice
        • A doctor is not negligent if he has acted in accordance with an accepted practice
        • Must be a current practice
    • Breach
      • Logical = Reasonableness??
      • Departure from accepted practice
      • When the practice itself is negligent
      • Hucks v Cole [1993]
        • Courts will examine situations where risks of 'great danger' are knowingly taken
          • Can the risks be easily avoided?
      • Bolitho v City and Hackney Council [1997]
        • Medical opinion must have a 'logical basis'
          • Experts must have considered comparative risks and benefits
            • Reached a defensible conclusion
      • Montgomery v Lanarkshire Health Board [2010]
        • The position that there was no need to intervene was defensible
      • Courts will rarely conclude that views genuinely held by a competent medical expert are unreasonable

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