Legal action involving doctors, either as defendants or expert witnesses, has greatly increased over the past decade and few can now remain aloof from this aspect of their profession. Written by doctors (including five Council Members of the Medical Defence Union of Great Britain) and lawyers, this practical guide offers clear and comprehensive advice to all concerned.
Part I
discusses how to write medical reports, especially when consent is required or confidential information is involved.
Part II
covers contentious issues in various clinical specialties which repeatedly arise in litigation; well-known examples are cases involving whiplash injuries or perinatal brain damage. In
Part III
lawyers discuss the medico-legal problems of the solicitor's role, court testimony and medical negligence. This book is a valuable reference to all members of the medical profession. Lawyers, officials and others outside the medical profession who come into contact with medical litigation but have limited medical knowledge will find much helpful information.
Auflage
Sprache
Verlagsort
Verlagsgruppe
Zielgruppe
Für Beruf und Forschung
Research
Illustrationen
Maße
Höhe: 24.2 cm
Breite: 17 cm
Gewicht
ISBN-13
978-3-540-19677-8 (9783540196778)
DOI
10.1007/978-1-4471-1863-3
Schweitzer Klassifikation
I: The Writing of Reports and Related Problems.- 1 The Medico-legal Consultation.- Arranging to See Patients.- Accompanying Persons.- The Consultation.- The History.- Examination.- Further Investigations.- 2 Medico-legal Reports.- Obtaining Additional Information.- Compiling the Report.- The First Page.- The Accident.- Present Complaints.- Past History.- The Examination.- The Opinion.- Occupation.- Sport and Social Activity.- Prognosis.- 3 Consent and Confidentiality.- Consent.- General Principles.- Age of Consent.- Intimate Samples.- Implied and Express Consent.- Oral and Written Consent.- Obtaining Consent.- Emergencies and Consent.- The Mental Health Act 1983 and Consent to Treatment.- Sterilisation: Medical and Social Grounds.- Consent to Abortion and Contraception.- Girls under 16 Years of Age.- Consent and Research, Clinical Trials.- Consent and Jehovah's Witnesses.- Consent and Radioisotopes.- Consent Forms.- Consent to Post-mortem Examination and to Removal of Human Tissue.- Surgical Implants.- Confidentiality.- Venereal Disease.- The General Rule and Exceptions.- Some Practical Problems.- Death and Confidentiality.- Confidentiality and Non-medical Staff.- Fitness to drive.- Non-accidental Injury to a Child.- The Occupational Health Physician.- Non-clinical and Administrative Medical Officers.- AIDS: HIV Status.- Audit.- II: The Most Contentious Problems in the High-Risk Specialities.- 4 Anaesthesia.- Cerebral Damage.- Hypoxaemia.- Failure of Oxygen Delivery.- Consequences of Cerebral Hypoxaemia or Ischaemia.- Prevention.- Conclusion.- Anaphylaxis.- Incidence.- Prevention.- Awareness During Anaesthesia.- Spontaneous Recall.- Prevention of Spontaneous Recall.- 5 General Surgery.- What is General Surgery?.- General Causes for Claims.- Inadequate Experience.- Night and Weekend Cover.- The Acute Abdomen.- Missed Diagnosis.- Post-operative Complications.- Gastroenterology.- Oesophago-gastro-duodenoscopy.- Endoscopic Retrograde Cholangio-pancreatography.- Colonoscopy.- Laparoscopy.- Missed Carcinoma.- Common Bile Duct Injuries.- Impotence after Rectal Excision.- Incontinence after Anal Procedures.- Surgery for Obesity.- General Advice.- Vascular Surgery.- Varicose Veins.- Nerve Damage.- Arterial Injury.- Endocrine Surgery.- Thyroid.- Other Endocrine Problems.- Breast.- Missed Carcinoma.- Breast Screening.- Mastectomy.- Reconstructive Breast Surgery.- Salivary Glands.- Parotid Surgery.- Spleen.- Skin and Superficial Swellings.- Neurofibroma.- Undiagnosed Melanoma.- Lymph Node Biopsy.- Local Anaesthetic Overdose.- Inguinal Hernia Repair.- Testicular Atrophy.- Vasectomy.- Miscellaneous Problems.- 6 Dermatology.- The Medical Report.- Occupational Dermatitis.- Nomenclature.- Clinical Considerations.- Evidence in Favour of Occupational Dermatitis.- Patch Testing.- Constitutional Factors in Workers with Dermatitis.- Prognosis of Industrial Dermatitis.- Treatment.- Prevention of Industrial Dermatitis.- The Management of Skin Diseases.- Errors of Diagnosis: the Circumstances.- Negligent Treatment: Some of the Circumstances.- Degrees of Medical Responsibility.- The Cosmetic Factor.- Avoiding Medico-legal Actions.- Child Abuse and the Dermatologist.- 7 Ear, Nose and Throat.- Personal Injury and the Otolaryngologist.- Otological Aspects.- Noise Induced Hearing Loss.- Head Injury and Deafness.- Trauma and Facial Palsy.- Ototoxicity.- Trauma and the Nose and Paranasal Sinuses.- Trauma and the Throat and Neck.- Informed Consent and Ear, Nose and Throat Surgery.- Ear Surgery.- Thyroid Surgery.- Tonsillectomy and Adenoidectomy.- Endoscopy.- Nasal and Sinus Surgery.- 8 Neurology.- Head Injury.- Concussion.- Post-traumatic Epilepsy.- Brain Damage.- Neck Injury.- Root Damage.- Cervical Spinal Cord Injury.- Peripheral Nerve Injury.- Cranial Nerve Damage.- Traumatic Peripheral Mononeuropathies.- Psychiatric and Psychological Aspects of Organic Brain Injury.- Stress Reactions.- Post-concussional Syndrome.- Focal Brain Damage.- General Damages.- 9 Neurosurgery.- Head Injury.- Review of Essential Documents.- The Opinion.- Additional Recommendations.- Medical Negligence.- Children, Neurosurgery and the Law.- Non-accidental Injury.- 10 Obstetrics and Gynaecology.- Obstetric Brain Damage Claims.- Perinatal Asphyxia and Cerebral Palsy.- The Statute of limitations.- Defence.- Impacted Shoulders.- Multiple Pregnancy.- Prenatal Diagnosis.- Advice on Avoiding litigation in Obstetrics.- Evaluation of Quantum for Brain Damage.- Gynaecological Problems.- Failed Sterilisation.- Complications of Abortion.- Surgical Complications of Hysterectomy.- The Misdiagnosis of Cancer.- Contraceptive Problems.- Conclusions.- 11 Orthopaedics.- Repetitive Stress Injury.- Those Cases with a Definite Pathology.- Work-related Upper limb Disorders.- Malingering.- Anterior Knee Pain (Chondromalacia Patellae).- Relationship to Osteoarthritis.- Relationship to Trauma.- Summary.- Whiplash Injuries of the Neck.- Cervical Spondylosis.- Radiographic Changes.- Mechanism of Injury.- Osteoarthritis and Trauma.- Epidemiology.- Joint Incongruity.- Aggravation of Osteoarthritis.- 12 Litigant's Backache.- Presentation.- Accoutrements.- Gait.- History.- Examination.- Comment on Examination.- Radiographic Examination.- Summary.- Appendix. Examination Techniques and Tests.- 13 Paediatrics.- Advising Parents After a Tragedy.- What Was the Cause?.- Could It Have Been Avoided?.- Was Anyone at Fault?.- Was It Negligence?.- Problems of Causation When Child Is Injured.- Cause: Unknown.- Incorrect Presumption of Cause.- Inadequate Evidence.- Circumstances Long Passed.- Delayed Outcome.- Multiple Causes.- Fault.- Duty of Care.- Omission: A Service That Is Not Good Enough.- Making a Mistake.- Experience and Training.- Negligence and Consequence.- Shared Responsibilities: Parents as Partners.- Quantum: Assessing the Future.- 14 Psychiatry.- Some Legal Principles.- Law of Torts.- Liability.- Compensation for Pain, Suffering and "Psychiatric Injury".- Psychiatric Injury: Some Special Problems.- Causation and Vulnerability.- Pre-existing Conditions.- Problems of Defining Illness Boundaries.- Lack of Objective Validation and Malingering.- "Functional" Disorders and "Hysteria".- Common Psychiatric Disorders in a Medico-legal Setting.- Post-traumatic Stress Disorder.- Post-concussional Syndrome.- Other Psychiatric Sequelae of Head Injury.- Preparing a Medical Report.- Appearing in Court as an Expert Witness.- III: Legal Advice for Doctors Involved with Medico-Legal Problems.- 15 The Solicitor's Problems.- Instructing the Doctor.- Reports from the Treating Doctor.- When Should the Doctor Be Instructed?.- The Doctor's Role.- Choosing the Doctor.- What Investigations May the Doctor Undertake?.- Access to Medical Records.- Disclosure of Medical Evidence.- Joint Examination and Reports.- Provisional Damages.- Arrangements for Attending Court.- 16 Counsel's Advice to the Medical Expert.- Preliminary Considerations.- Keep Within Your Expertise.- Are You Adequately Instructed?.- Are You Sufficiently Informed?.- The Golden Rules.- Be Independent.- Always Have in Mind the Trial.- The Medical Report: Achieving Clarity of Communication.- Layout.- Subject Headings.- The Medical Expert as Witness.- The Trial.- The Subpoena.- Arrangements for Attendance.- Pre-trial Conference.- Preparation.- Patience and Discretion.- Giving Evidence.- Other Evidence.- 17 The Legal Basis of Medical Negligence.- The Duty of Care.- The Breach of the Duty of Care.- Negligence Versus Error of Clinical Judgement.- The Patient Must Suffer Damage.- The Damage Must Flow from the Breach of the Duty of Care.- Novus Actus Interveniens.- Contributory Negligence.- "Res ipsa loquitor", the Facts Speak for Themselves.- Damages.- Special Damages.- Who Is Sued?.- Medical liability and Indemnity.
