CASE studies
These studies are based on actual cases from MDDUS files and are published in Summonsto highlight common pitfalls and encourage proactive risk management and best practice. Details have been changed to maintain confidentiality
CHAPERONES: CROSSING THE LINE
BACKGROUND: Miss A suffers from gynaecological problems and has been seen several times in the course of the past year by her GP, Dr F, for drug treatments. Each time she is seen by Dr F he administers the drug treatment and then carries out an internal examination – all without a chaperone present. Miss A becomes concerned at both the frequency of the internal
examinations and at Dr F’s conduct during the examinations. She feels it is unnecessary to undergo so many examinations and believes Dr F has inappropriately touched her during them. She discovers that a patient has complained about him previously for similar conduct and the practice had agreed to have a chaperone present for future intimate examinations carried out by Dr F. Miss A is concerned by the fact she had never been offered a chaperone for her consultations with Dr F. She raises a claim against Dr F who is a member of another medical defence organisation. She also raises a claim against Dr F’s former practice partners Dr
H and Dr P, alleging they negligently failed to act on a previous complaint against Dr F which then allowed him to inappropriately examine Miss A. Dr H is an MDDUS member but Dr P is a member with another medical defence organisation.
ANALYSIS/OUTCOME: MDDUS defends Dr H against the allegations of negligence and agrees to share any costs with Dr P’s MDO. An expert legal opinion is sought and concludes that while a charge of negligence is unlikely to be established against the practice partners, they could be held vicariously liable for Dr F’s inappropriate conduct towards Miss A. This is in light of the fact that his inappropriate behaviour towards Miss A occurred during the ordinary course of business in the surgery and also because the partners had previously been aware of a complaint about Dr F’s behaviour. GMC guidance Raising concerns about patient safetyclearly states
that doctors “must protect patients from risk of harm posed by another colleague’s conduct, performance or health”. It explains that if doctors have good reason to think patient safety may be “seriously compromised”, they should “put the matter right if that is possible.” It goes on to say that doctors who have a management role have
a duty to “respond promptly and professionally to incidents and complaints”, adding: “Do not delay [reporting concerns] because you yourself are not in a position to put the matter right.”
20 SUMMONS
GMC guidance Maintaining Boundariesalso emphasises that medical professionals “must protect patients from risk of harm posed by another colleague’s conduct… and take appropriate steps without delay so that [any] concerns are investigated and patients protected where necessary.” MDDUS continues to defend Dr H but eventually Miss A decides to no longer pursue her case against him.
KEY POINTS ● Offer a chaperone for intimate examinations, even when doctor and patient are of the same gender, in line with GMC guidance Maintaining Boundaries.
● Chaperones need not be medically qualified but should respect patient dignity and confidentiality.
● Be aware of the duty to protect patients where there is a suspicion of inappropriate/unprofessional behaviour in a
colleague. Practice partners may be held vicariously liable for a colleague’s wrongful actions.
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