COMPLAINT


CALLING HALT


BACKGROUND A specialist registrar – Dr J – is to perform a flexible sigmoidoscopy on a 52-year-old male patient who has presented with a positive bowel screening test. Mr B is prepped for the procedure but is very nervous. Dr J explains what is involved and obtains consent. The patient has not requested sedation and during the procedure he complains of extreme discomfort. Dr J reassures the patient but halts the procedure in the descending colon as Mr B is too uncomfortable to proceed. The segment of colon viewed is found to be “clear”. Mr B later writes to the hospital


complaining of “rough treatment” by Dr J. He also claims that the doctor carried on with the procedure despite his demand to stop. Dr J is contacted by the hospital complaints officer and asked to provide a statement in response to a number of specific questions.


ANALYSIS/OUTCOME MDDUS assists Dr J in responding to the questions. He is asked if the patient’s informed consent was given to the procedure. In his answer Dr J makes reference to a signed consent form along with a patient information leaflet which he ran through with Mr B prior to the procedure. A review of the nursing notes


also documents that the patient did not request sedation for the agreed procedure. Nursing documentation graded the


KEY POINTS ●Medical consent is not a one-off decision but always ongoing and can be withdrawn at any time. ●Ensure all relevant treatment discussions with patients including consent are properly documented.


patient’s comfort level from 0-1 (none to mild discomfort) but Dr J acknowledges that Mr B grew more vocal about his extreme discomfort and this was when he halted the procedure. However, at no time before that did Mr B call for him to stop. Dr J states that his usual practice if a patient asked him to ‘stop’ would be to pause and explain the clinical necessity of what he was doing and carry on only if the patient then verbally consented. In this he is again backed up by the nursing documentation. The matter is resolved with no further


action.


ADVICE/GDC GDC WITNESS


BACKGROUND A dentist – Mr H – has been requested by the GDC to attend as a witness at fitness to practise proceedings involving another dentist. He has already provided a statement in regard to the case but GDC lawyers are insisting Mr H attend the hearing in person. It is expected to last five days. The GDC has offered to pay his expenses but not loss of earnings. The dentist asks MDDUS if he is allowed to refuse.


ANALYSIS/OUTCOME A dental adviser responds stating that it would be prudent to “engage with your


professional regulator on a voluntary basis” but that having to take five days off might be considered unreasonable. Mr H is advised to contact the GDC legal team and attempt to narrow the timeframe.


KEY POINTS ● Witnesses can be compelled to attend GDC hearings but this power is rarely necessary. ●Engage with the regulator to narrow the potential timeframe for attendance.


Most individual witnesses in a GDC


hearing are generally needed for less than a day. Five days is a relatively narrow timeframe for a hearing but if a witness is timetabled to attend on a certain day and things have moved quicker than expected the Practice Committee can simply adjourn or use the additional time to read other evidence. Should a witness refuse to attend, the


GDC does have the power to issue a formal witness summons. However, this is rarely used and registrants are best advised to engage pragmatically with the regulator to seek a narrower timeframe for attendance.


MDDUS INSIGHT / 17


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