Thu 25 Oct 2018

Clinical Negligence Conference

Earlier this month, I attended the Inspire MediLaw Clinical Negligence Conference in Edinburgh.  There were a number of highly experienced medical experts and Advocates who spoke throughout the day on a variety of topics including GP negligence, Plastic Surgery negligence and common claims which arise following negligent emergency treatment, specifically those relating to treatment of cauda equina,  scaphoid injury, headaches and deep vein thrombosis.

There was a particular focus on cancer treatment with several clinicians speaking about the effect of delays in diagnosis of cancer and the consequences of errors in interpretation and misdiagnosis in radiology.

Lauren Sutherland QC led a discussion on the importance of Multi Disciplinary Team meetings (MDTs).  In MDTs, clinicians of different specialisms come together to discuss patients' treatment options.  One of the issues raised about these meetings was their lack of transparency as patients are not present for these discussions.  The concern for patients is what they should do if they are not content with the decision which has been made in their absence. There was discussion of the practicalities of arranging for patients to be present at this meeting, however, it was evident this would be a difficult task to arrange given the number of cases which are discussed at such meetings and also the health of the patient may preclude them from attending.  Despite these issues, all were in agreement that MDTs remain an invaluable forum for discussing patients treatment options across specialisms. 

Isla Davie, Advocate, spoke about delay in diagnosis of cancer cases.  The law is continuing to evolve in this area and Isla gave a helpful overview of recent case law in addition to guidance on valuing these types of claims.  Isla spoke about two categories of cases and there is an important distinction to be made between the two.  The first category are cases where the delay in diagnosis has resulted in the patient losing the chance of being cured.  In these cases, it will be possible to prove that had the diagnosis been made earlier, the patient would likely have been cured (i.e. a likelihood of above 50%).   However, the second category of case is more complicated.  Those are cases where the delay in diagnosis has led to a reduction in the chance of a patient being cured, but even if there had been no delay in diagnosis, it was unlikely the patient would have been cured (i.e. the likelihood of being cured would have been below 50%, say 45%, if diagnosed when it should have been, and reduced further to say 20% as a result of the delay in diagnosis).  In this second category of cases, it is important to obtain medical evidence to support a claim for (1) any reduction in life expectancy; (2) any additional pain and suffering the patient has experienced as a result of the delay; and (3) any psychiatric damage to the patient as a result of the late diagnosis and perhaps additional treatment required, and also as a result of the belief that the delay may have led to a different outcome.

It was an informative and thought provoking day. In dealing with my cases, I regularly have discussions and meetings with medical experts, usually in the context of seeking their opinion on a specific issue or failing relating to a particular case.  So, I found it incredibly helpful to listen to medical experts speaking about what their job entails on a daily basis together with the process of how they go about diagnosing and treating their patients.  Several experts also discussed how things can go wrong and common issues to look out for.  This experience will undoubtedly assist me with knowing the issues to be alert to in the future.

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