CONTENTS IN THIS ISSUE


IN 2004 a 69-year-old patient named Mary McClinton was admitted for treatment of a brain aneurysm at Virginia Mason Medical Center in Seattle. During a diagnostic procedure an antiseptic solution was mistakenly injected into the patient’s femoral artery. It later emerged that the hospital had recently changed its standard antiseptic from a brown iodine-based liquid to a colourless solution which looked identical to the marker dye used in vascular procedures. Rather than going on the immediate defensive the hospital


took the unusual step of making a public explanation of what went wrong and apologising to the McClinton family. This mea culpa was product of a policy of openness and a safety culture at the centre which has since been heralded around the world. So it was no coincidence that in March of this year Health


Secretary Jeremy Hunt used the occasion of a speech at the Seattle hospital to launch plans to introduce a duty of candour along with other steps to reduce avoidable medical harm. On


page 12 of this issue, solicitor Majid Hassan looks at plans for a statutory duty of candour and how these might be implemented. Our Q&A on page 10 features Professor Steve Field, currently CQC chief inspector of general practice but also a key figure in NHS reform in England. The importance of having a chaperone policy for all patients – no matter what gender – is highlighted in our advice feature on page 14. And on page 16 Professor Mark Strachan discusses why diagnosis in cases of diabetes is not always straightforward. Page 18 features a tale from the First World War of a


French-American dental surgeon who reputedly treated a toothache suffered by General Douglas Haig and earned a footnote in the history of the Royal Army Dental Corp – not to mention doing pioneering work in facial reconstructive surgery. And on page 9 medical ethicist Deborah Bowman offers an alternative summer reading list.


Jim Killgore, editor 12 A QUESTION OF CANDOUR 14 CHAPERONE ESSENTIAL Not all healthcare 14


organisations have established chaperone policies despite the risks both to doctors and patients


16 CLINICAL RISK REDUCTION


Professor Mark Strachan highlights some pitfalls for the unwary in diagnosing diabetes


18 THE GENERAL’S TOOTHACHE Jim Killgore recounts the 16


curious tale of a flamboyant dentist, his motor car and the eventual establishment of the Royal Army Dental Corps


Editor:


Jim Killgore Associate editor: Joanne Curran


‘Courtyard’ by Jean Irons Oil on canvas; 1999; 182 x 182 cm


Art in Healthcare (formerly Paintings in Hospitals Scotland) works with hospitals and healthcare communities across Scotland to encourage patients, visitors and staff to enjoy and engage with the visual arts. For more information visit www.artinhealthcare. org.uk Scottish Charity No SC 036222.


Editorial departments: MEDICAL Dr Jim Rodger DENTAL Mr Aubrey Craig LEGAL RISK


Simon Dinnick Peter Johnson


Please address correspondence to:


Summons Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA


jkillgore@mddus.com


Design and production: CMYK Design 0131 556 2220 www.cmyk-design.co.uk


Solicitor Majid Hassan looks at


Government plans for a statutory duty of candour in healthcare


REGULARS 4 Notice Board


6 News Digest 8 Risk: What don’t you know? 9 Ethics: A good read 10 Q&A: Steve Field 20 Case studies: Untreated diabetes, Instrument failure, Out-of-date consent


22 Addenda: Counting swabs, Hirtz’s compass, Crossword and Vignette: Archibald Young, surgeon and expert on war wounds


Printing and distribution: L&S Litho


Summons is published quarterly by The Medical and Dental Defence Union of Scotland, registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. • Tel: 0845 270 2034 • Fax: 0141 228 1208


Email: General: info@mddus.com • Membership services: membership@mddus.com • Marketing: marketing@mddus.com • Website: www.mddus.com The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Memorandum and Articles of Association.


The opinions, beliefs and viewpoints expressed by the various authors in Summons are those of the authors alone and do not necessarily reflect the opinions or policies of The Medical and Dental Defence Union of Scotland.


SUMMER 2014 3


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