Turning a blind eye
A delay in sharing an urgent result with a patient results in a loss of vision
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Diathermy Drama
Minor surgery to remove a skin tag is complicated by an unexpected event
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A hidden problem
Mr T, a 40-year-old accountant, attended a private health check under his employer’s healthcare scheme. Blood and protein were noted on urinalysis and his eGFR was found to be 45 ml/min/1.73 m2. He was asked to make an appointment with his GP and was given a letter highlighting the abnormal results to take with him.
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A friend in need
Ms N, a 33-year-old female accountant, presented to Mr X, a consultant orthopaedic surgeon, with severe lower back pain radiating to both legs.
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A complicated claim
Mr A, an orthopaedic surgeon, was approached by a claimant’s solicitors to provide an expert report on behalf of their client.
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No news is not always good news
Child J, a one-week-old baby girl, was noticed to have a clicking right hip when she was seen by the community midwife. A referral to the orthopaedic clinic was requested and Child J was reviewed by orthopaedic junior doctor, Dr M, three weeks later. Dr M confirmed that there was no relevant family history and examined Child J.
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Reported abuse
Mrs X asked her GP to refer her eightyear-old daughter, Child F, to be assessed by a consultant psychiatrist in child and adolescent mental health. The GP referral letter stated that Child F had reported to her teacher that her father frequently touched her genitalia.
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Back to basics
Mr B, a 42-year-old builder, attended his GP, Dr S, with a three-week history of back pain and left sided sciatica. Dr S found nothing of concern on further questioning or examination, so made a referral for physiotherapy and recommended ibuprofen.
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Lost in translation
Mrs S, a 27-year-old Romanian woman who lived with her husband in the UK, became pregnant and presented to her local GP surgery to commence antenatal care. Mrs S did not speak English and usually brought a family member with her to interpret.
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We need to talk about death
Mrs S was a 36-year-old patient diagnosed with a benign giant cell tumour of the sacrum. She was seen by Mr A, consultant in orthopaedic oncology, and listed for resection of the lesion.
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Repeating the risk
Mrs L, a teacher, was first prescribed the oral contraceptive pill microgynon by her GP, Dr G, when she was 17. Her blood pressure was taken and recorded as normal. At this time, no other mention was made in the records of her risk profile or family history.
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Poor notes, fatal consequences
Mrs Y, a 39-year-old chef, opted to M see consultant obstetrician Mr B for private antenatal care. It was her first pregnancy and other than a BMI of 30 she had no pre-existing medical problems.
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Elbow Arthroscopy radial nerve injury
Mr P, a right-handed project manager, developed a stiff right elbow following a previous injury, and had reached the limit of his progress with physiotherapy. X-rays showed degenerative changes and he was referred to an orthopaedic consultant, Mr A, who diagnosed osteoarthritis of his elbow.
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Failing to act on tonsillar cancer
Mr K was a 36-year-old man who ran a pub. Mr K smoked and drank heavily. Mr K’s dentist had noticed a painless swelling on the right side of his neck during a routine check-up and asked him to see his GP.
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Death by Diarrhoea
Mrs B was a 27-year-old secretary with a ten-year-old daughter. She had just enjoyed a trip to Pakistan where she had been visiting relations. Three days after her return she developed profuse, watery diarrhoea.
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An essential guide to consent - Voluntariness
Patients overtly coerced into undergoing treatment they do not want can rightly claim that their “consent” was not given freely and is therefore not valid. Cases of overt coercion are rare, but there are circumstances in which patients may feel that they have been covertly pushed into accepting treatment they would prefer not to have had. For example, in some circumstances patients may find it very difficult to say “No” to the proposed treatment, or to challenge the doctor’s assumption that they would have no objections to going ahead.
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Learning From Events
With more than 300 million patients consulting with primary care teams annually it’s unfortunately inevitable that a proportion will suffer some form of unintentional harm, mostly of low to moderate severity. Research has suggested that around 1-2% of consultations in primary care are associated with an adverse event. The cost of harm – to patients, to those working in healthcare, and to productivity – is significant.
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MEMBERSHIP LEVELS
It costs your practice nothing to set up a Practice Xtra group – it’s just a way of bringing all our GPs together into a single group while continuing to provide world-class defence, advice and support to them. You can choose from two levels of benefits to reward this cooperative approach. This level depends on how many GPs there are in your practice and how many are Medical Protection members.
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Championing change
Whether it’s a revised piece of GMC guidance, or a Bill going through the Scottish Parliament, we use our expertise to inform debates about changes that could affect your practice.
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Getting the most from your membership
Your eligibility for assistance You must be a member of MPS at the time of the event in order to be entitled to request assistance. The event must not predate the point you joined or rejoined MPS. You must have paid the correct subscription rate and abide by the terms of membership, as laid out in the Memorandum and Articles of Association and associated guidance documents, and it is important to be aware of them. You must inform us if the scope of your practice changes. Withholding information or providing false or misleading answers is likely to adversely affect entitlement to the benefits of membership and, in certain circumstances, membership may be terminated.
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Careers - Core skills series: Communication
In this series we explore the key risk areas in general practice
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