CONFIDENTIALITY: A MOMENTARY OVERSIGHT
BACKGROUND: Mr T visits his practice asking for written confirmation proving that he is a registered patient. He requires the documentation for a government application relating to the immigration status of him and his wife. The practice manager, Ms L, is busy and Mr T is in a hurry so, to save time, she prints off consultation summaries which are then stamped with the official practice stamp and signed. Later that day Mr T returns to say he would rather not use these documents as they contain some sensitive information. Ms L then agrees to write a letter on practice headed notepaper to confirm that Mr and Mrs T are both registered patients. Two days later a letter of complaint arrives from Mrs T alleging the practice breached confidentiality by disclosing parts of her medical records to Mr T without her consent. Amongst the information given to him was a note of an abortion she underwent three years ago which her husband was unaware of. Mrs T states that her husband has previously been abusive towards her. She fears knowledge of the termination will prompt a violent reaction from him and she has been forced to flee the marital home and stay with a friend. She has also suffered considerable stress and anxiety that has apparently sparked other health problems. An MDDUS adviser assists the practice in responding to the complaint. However, a short time later a letter of claim arrives from solicitors representing Mrs T. They are seeking
compensation in relation to the breach of confidentiality and the subsequent problems it caused both for Mrs T’s health and personal circumstances.
ANALYSIS/OUTCOME: MDDUS reviews with Ms L the sequence of events that led to the confidentiality breach. The manager admits that she failed to follow protocol in responding to Mr T’s request, mainly due to a very busy workload and the fact the patient was also in a hurry. She accepts she had not stopped to double check the information that was printed and given to Mr T which she blames on a “brief lapse in concentration”. She emphasises that the practice has learned valuable lessons from the incident and that measures have been taken to avoid a repeat of the error. MDDUS discusses the matter with Mrs T’s solicitors and they
agree to a small settlement, in recognition of the distress and anxiety caused by the breach.
KEY POINTS •
Ensure appropriate data protection protocols are in place for handling access to records requests.
• Carefully check records before disclosure, respecting rules on third-party information.
• Don’t be tempted to take shortcuts when disclosing patient information, even during busy periods.
TREATMENT: ERRONEOUS EXTRACTION
BACKGROUND: A 15-year-old boy – Jake – is referred by an orthodontist to his regular dentist – Dr G – with a treatment plan involving lower and upper fixed appliances (braces). The treatment also required a number of extractions including UL6, UR6, LL6 and LR5. Dr G carries out the extractions in two separate appointments without incident. Two months later Dr G is informed by the orthodontist that he has removed LL7 in error. Checking the notes again the dentist subsequently discovers that Jake had attended another dentist in the practice – Dr K – six months previous complaining of pain in LL6. In consultation with the orthodontist Dr K had extracted LL6. It now was clear that Dr G had
removed LL7 in error, mistaking the tooth for LL6. He arranges a meeting with Jake and his parents and apologises for the error. Five months later the practice receives a letter of claim alleging clinical negligence against Dr G in the removal of LL7. The letter states that in addition to the unnecessary pain and suffering, the error has meant that Jake’s orthodontic treatment instead of taking 16 months will now extend to 30 months. The claim also details the eventual need for an implant replacement for LL7, with periodic renewal of a crown in future.
SUMMER 2015
ANALYSIS/OUTCOME: Two expert reports are commissioned by solicitors representing the claimants – one from an oral surgeon and the other from a consultant orthodontist. In his opinion on the case the oral surgeon states that Dr G should have realised that at age 15 there should be two molar teeth in each quadrant unless there had been previous extractions. He concludes that it is apparent the patient records had not been adequately checked, as this would have revealed the previous extraction – and this clearly amounts to negligence. The orthodontist in his report challenges the claim that the extraction of LL7 will affect the boy’s orthodontic treatment stating it should not necessitate prolonged wearing of the brace.
MDDUS negotiates a settlement on behalf of Dr G significantly below the valuation claimed by the claimant
solicitors, reflecting the fair costs of remedial treatment.
KEY POINTS • • •
Ensure you carefully check notes before any extractions. Use only one form of notation when referring to teeth.
Ensure you have correct clinical documentation to hand before carrying out treatment.
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