Learning from Dermatology Cases: Minimise the Risk and Protect Your Medical Indemnity

In dermatology, as with all specialties, a patient may be dissatisfied with the outcome of care or treatment they have received, leading to a complaint or clinical negligence claim. Such actions cause significant stress for the clinician, — and demonstrate precisely why having reliable medical indemnity insurance for doctors is so important. We hope that sharing our experiences with dermatology cases will assist you in enhancing patient safety and reducing your risk profile

Case Study

Mrs M consulted Dr A, a consultant dermatologist, regarding treatment for hirsutism. Various types of treatment were discussed and the patient agreed to commence a course of intense pulsed light technology (IPL). Dr A discussed the risks and benefits of the intervention, including special precautions before and after treatment. He completed a consent form, which stated the following:

• the success of the treatment was not guaranteed
• the results from the treatment vary considerably
• there may be short-term side effects such as reddening, mild burning or blistering, hypo-pigmentation or hyperpigmentation as well as rare side effects such as scarring.

Mrs M signed the consent form and was provided with a copy.

Following the completion of the course of treatment, Mrs M appeared satisfied with the results. Dr A kept concise and detailed notes in Mrs M’s medical records of all the consultations.

Six months later Dr A received a letter of complaint from Mrs M stating that she was dissatisfied with the results of the IPL and requestedcompensation. She alleged that the IPL laser system used was substandard and had caused facial burns.

Dr A was surprised by Mrrs M’s allegations as she had not communicated any dissatisfaction with the results of the treatment during the consultations or experienced any complications or discomfort whilst undergoing treatment. Dr A recalled informing the patient that multiple sessions would be required and that each patient’s response to treatment varied. Dr A stated that he had followed the British Medical Laser Association treatment guidelines and ensured that the machine was regularly maintained and had a quality assurance programme in place. He thought that the result of the treatment was positive and that Mrs M had been pleased with the result at the final consultation.

Dr A contacted the PMP medicolegal helpline team, who then assisted him in preparing an appropriate response, which led to a successful resolution of the complaint.

Key Learning Points

Dr A had a consistent consent process explaining the risks, benefits, and alternatives of the proposed treatment. He had taken time to discuss the intervention with the patient and provided evidence of the process on a consent form and contemporaneous notes in the patient’s medical record. In essence, he had practiced in accordance with the GMC’s consent guidance.

Inadequate informed consent is frequently identified as a contributory factor in a patient’s dissatisfaction with the care provided, which ultimately has the potential to lead to litigation. Dr A’s detailed, contemporaneous records assisted him in responding effectively to the complaint from Mrs M. Good medical records are a vital component of providing high-quality patient care and are often viewed as a reflection of the standard of care provided.

In Summary

If you are involved in a patient safety incident, receive a complaint, or become aware of a claim or potential claim, you must complete a claims notification form as soon as possible so our claims team can review the matter promptly.

If you require advice or guidance relating to the situation, please contact the PMP medicolegal helpline. Our experienced team is available 24 hours a day, seven days a week to provide immediate support and assistance.