MEDICAL NEGLIGENCE by Michael A. Jones B.A., LL.M., Ph.D., Solicitor of the Supreme Court Professor of Common Law ofth.e University of Liverpool Contributing Editor: - Muiris Lyons, LL.B., LL.M. Solicitor of the,supreme Court Partner and Head of Clinical Negligence Department, Stewarts Law LLP SWEET & MAXWELL feffil THOMSON REUTERS
...CONTENTS. :...-.--.. PAGE Preface.... - v... vii Preface t o first edition... *... -;., x i Abbreviations... s i xix Table of,cases.... ( : xxv Table of Statutes cvi Table of S t a t u t o r y I n s t r u m e n t s ' : ' ' '. ' c x v Table of Civil Procedure Rules.. cxix Table of Practice Directions..., ' cxxi Table of Pre-Action Protocols-. ' cxxii Table-of National-Legislation.... cxxiii Table of European and International Conventions and Treaties. cxxiv Table of European Directives... cxxv... P A R A 1. MEDICAL NEGLIGENCE IN CONTEXT 1-001 1. Medical accidents and claims data a malpractice crisis? v... 1-007 2. Defensive medicine-...; :... v. : 1-020 3. No-fault compensation 1-026 4. Making Amends,. 1............ 1-061 5. The NHS. Redress Act 2006...'...-..,.., 1-081 6. Human Rights.-....,..,...,../..'. 1-088 2. THE BASIS.OF. LIABILITY. r...,,.-l...-. 2-001 ' 1. CONTRACT..,.:...;...;.,.:...:... 2-003 ; r 1. Reasonable care ^...-...-.. 2-010 2. Express and implied)warranties.:...v...:...: _..-.. ;...:..'."..'." 2-01.4 2. TORT...'..'.:;,..'...,. ;..' 2-022 1. Duty, of care -..,.,.:.. 2-024 2. Duty.to the patient...-..:. - 2-028 3. Duty, to third parties, 2-071 4. Psychiatric harm... :..;....:..;...;..; ' 2-147 5. Duty owned by third parties to prevent harm., ; by a doctor.;..;...:.:...-.... 2-205
xiv CONTENTS 3. STANDARD OF CARE GENERAL PRINCIPLES 3-001 1. The Basic Principle 3-004 2. Common professional practice 3-015 3. Experimental or novel techniques.< 3-056 4. Keeping up to date 3-066 5. Errors of Judgment 3-071 6. Unforeseeable harm 3-075 7. Degrees of Risk 3-077 8. Specialists '. 3-088 9. Inexperience.- 3 094 10. Alternative medical practice. 3-110 11. Emergencies 3 111 12. The consequences for other cases the Compensation Act 2006.- 3-115 13. Policy and defensive medicine ' ' 3-117 14. Proof of Breachi..., '.. 3-128 4: STANDARD OF CARE SPECIFIC INSTANCES : 4-001 1. FAILURE TO ATTEND OR TREAT 4-004 2. ERRORS IN DIAGNOSIS '. 4-010 1. Failure to take a full medical history -4-011 2. Wrong diagnosis -.-. 4-018 3. Failure to spot something "serious" ' -...;-....... 4-025 4. Failure to revise initial diagnosis :...;.'..-. 4-026 5. Failure to arrange for tests for diagnosis 4-030 6. Failure to consult or refer patient to a specialist 4-034 7. Overtesting...; ' 4-039. 3. FAILURES OF ADVICE AND COMMUNICATION' 4-040 1. Failure to warn about.'risks...'. -. 4-041 2. Failure to give proper instructions to-the patient....;. =.- 4-051 3. The mariner- in which information is communicated to the patient ;...'. '...-, 4-057 4. Failure to communicate with other health professionals 4-058 5. Medico-legal reports...i.;...-..-...' : 4-066 4. ERRORS IN TREATMENT.4-068 1. Operations., :... 4-073 ' - 2. Causing or failing to prevent infection'..'... :.:?...-..-..: : 4-095 3. Miscalculating drug reactions 4-107 4. Injections..-...-... : 4-112 5. Failure to monitor treatment.:.:......:.; 4-117 -' 6. Lack, of resources v<.-.v... 4-119 5. MENTAL HEALTH,..;..,.. 4-129 1. Failing to control the patient,.*..'...:. * 4-130.'. 2. Negligent certification 4-148 3. Procedural bars 4-149
CONTENTS XV 5. CAUSATION AND REMOTENESS OF DAMAGE 5-001 1. CAUSATION IN FACT 5-004 1. The "but for" test '.,,. 5-004 2. Proof of causation. 5-018 3. Exceptions to the requirement to satisfy "but for" causation." ' 5-026 4. Loss of a chance. 5-076 2. CAUSATION IN LAW 5-105 1. Successive sufficient causes 5-107 2. Intervening Acts 5-110 3. REMOTENESS OF DAMAGE 5-135 1. Manner of the occurrence 5-137 2. Type of harm 5-140 3. Extent of the harm..' :..; :.'. 5-147 4. The "eggshell skull" rule : 5-149 5. Claimant's impecuniosity : 5-159 i 6. CONSENT TO TREATMENT, 6-001 1. Battery.. 6-003 2. Consent as a defence to battery : 6-008 3. Forms of consent 6-016 4. Consent must be valid '. 6-026 5. Children 6-053 6. Adults who lack capacity to consent.to treatment 6-075 7. Emergency (temporary incapacity), : 6-124 8. Refusals of consent 6-132 7. INFORMED CONSENT 7-001 1. THE DUTY OF DISCLOSURE-.- 7-004 1. The "prudent" doctor standard 7-004 2. The standard applied,in other jurisdictions 7-018 3. What must be disclosed voluntarily? 7-032 4. Asking questions 7-048 2. CAUSATION : 7-054 1. Battery and causation 7-054 2. Causation in negligence 7-056 -3. SPECIAL CASES 7-079... 1. Research 7-079 2. Transplantation -. 7-112 3. Omission to warn about risk of sterilisation failing... 7-122 8. CONFIDENTIALITY 8-001 1. THE LEGAL DUTY TO RESPECT CONFIDENCES 8-005 2. SCOPE OF THE DUTY OF CONFIDENCE- EXCEPTIONS TO THE RULE ; 8-023 1. Consent by the patient 8-024 2. Sharing information with others providing care 8-025
XVI CONTENTS 3. Medical emergency 8-027 - 4. Children.and other.patients who may lack (' competence to consent : 8-028 5. Abuse.or. neglect...;.. / ;... 8-029 6. Statutory obligations 8-030 7. Clinical audit '.-. 8-031 8. Medical research,.epidemiology, financial audit or '. administration :...;:, 8-032 9. Disclosure to a court or. in connection with litigation 8-035 10. Disciplinary proceedings -..:...-......;... 8-038 11. Disclosure in the public interest.!....8-041 3. DAMAGES... ; [.. 8-055 9. LIABILITY OF HOSPITALS AND CONTRIBUTION ' 9-001 1. VICARIOUS LIABILITY. 9-002 2. DIRECT LIABILITY 9-016 1. Organisational errors 9-017 ' 2. Non-delegable Duty -. :. 9-026 ' 3. JOINT LIABILITY AND. CONTRIBUTION 9-042 4. NHS INDEMNITY :.-.:.....< 9-057 10. DEFECTIVE PRODUCTS :. 10-001 1. CONTRACT.-*,...-... 10-005 2. TORT :...; :. : 10-009 1. Manufacturers'duty.:..."...;, ;...>...-...'... 10-009 2. Intermediate inspection 10-023 3. What is "defective"? 10-028 4. Warnings '' '40-03'6 5. Failure to warn and causation.-. 10-043 6. Continuing duty '..-...-.;... ' 10-051 7. Common practice... -. ;..;;.::.:-... : 10-055 8. Proof.'...:. : i 10-058 9. Causation in fact,...:. -10-062 3. CONSUMER PROTECTION ACT 1987 10-066 1. Claimants....:..-..:.-......-;...':..'.:-. -10-069 2. Defendants, 10-070 3. Products :,..,.:...-. 10-076 4. Defects :.-....- ; 10-078 ' 5. Types of loss :...:.-....10-094 6. Causation '." '..^ ;,... 10-096 7. Defences 10-099 11. DEFENCES AND LIMITATION.,.....:. :... 11-001 1. DEFENCES ;.. ;... ' 11-002 1. Contributory negligence." >......./ - 11-003 2. Volenti non fit injuria..:.. 11-014 - 3. Illegality::...:...:: ; -..-...- '.11-016
CONTENTS xvii. 2. LIMITATION...: 11-020 1. Personal Injuries and.death.....: ;....:.-....'.... 11-023..,-.-2. Commencementof.the Three-Year-Period...; 11-034 '.--'..' 3. Court's.discretion...V. -. :... 11-095 ' 4. Death,.-.,: : 11-116 - -- 5. Persons under, a-disability '. 11-120.'' ' 6. Deliberate.Concealment.>.'...-.'..:::'....- 11-122 '-"'.: ' 7. Defective Products ' 11-126 '8. Latent damage., ;.-.'. 11-129 ' : ' 9. Contribution.Proceedings :.:>.}:...:....' 11-132 "- - 10. New claims.in.pending, actions ; ; 11-134 11. Burden of proof.,..'... - ' 11-140 12. Issuing the Claim Form 11-142 3. DISMISSAL FOR WANT OF PROSECUTION 11-147 12. DAMAGES.:, -.:..:.:,..-...: ', 12-001 1. INTRODUCTION '..' 12-001 r: - 1. What is personal injury?."...-..'...;.'.-... 12-002 -- 2. GENERAL PRINCIPLES 12-006 1. Types of damages 12-006 2. The form of the award: lump sum or periodical payments 12-015 1 3. Interest 12-055 4. Mitigation of damage?. 12-058 3. PERSONAL INJURIES: PECUNIARY LOSSES 12-062 1. Medical and other expenses 12-063 2. Loss of Earnings..- 12-079 3. Deductions 12-097 4. PERSONAL INJURIES: NON-PECUNIARY LOSSES 12-121 1. Pain and suffering 12-122 2. Loss of Faculty and Amenity 12-124 5. WRONGFUL BIRTH 12-127 1. McFarlane: The healthy child the mother's claim... 12-130 2. The disabled child 12-134 3. The disabled parent 12-148 4. Loss offertility 12-150 5. Wrongful life 12-151 ; 6. DEATH,... 12-152 1. Survival of actions 12-153 2. Fatal Accidents 12-155 13. PRACTICE AND PROCEDURE 13-001 1. INTRODUCTION 13-001 2. COMPLAINT : 13-004 3. FUNDING 13-014 1. Private 13-015 2. Insurance.- 13-017
xvni CONTENTS 3. Public. Funding 13-020 4. Conditional Fee Agreements ;. ; 13-028 4. ACCESS TO HEALTH RECORDS ; 13-031 1. Data Protection Act 1998 : >. 13-032 2. Access to Health Records Act 1990 13-043 3. Access to Medical Reports Act 1988 13-049 4. Using medical records.in evidence ;..-..; ". 13-052 5. DISCLOSURE AND THE PROTOCOL 13-053 1. Pre-Action Disclosure.' 13-054 2. Post-Action Disclosure :.*.... 13-071 3. Privilege,,..-.... 13-075 6. THE ROLE OF EXPERTS..-. ;... 13-097... PAGE Appendix 1: NHS-Indemnity. 1124 Appendix 2: Pre-Action Protocol for the Resolution of. Clinical. ; * Disputes.... 1143 Glossary of medical terms _.,. - 1166 Index... - 1181