Obstetrics and Gynaecology Claims – How Clinicians Can Help Counsel And Expert Witnesses

An estimated 85% of Obstetricians and Gynaecologists in the UK will face litigation within their lifetime. Although 70% of claims are successfully defended, this is a shocking figure and one that places intense pressure on already overstretched doctors and consultants. The questions that spring from this knowledge are, “What makes Obstetrics and Gynaecology so litigious?” and “If a negligence claim is brought, how can the Defendant assist their Solicitor and any Obstetrics and Gynaecology Expert Witnesses’ called to give evidence?”

gynaecology clinical negligence claims

Why are Obstetricians and Gynaecologists vulnerable to clinical negligence claims?

Healthcare professionals have a duty of care to patients, and if this duty is breached (for example, the wrong organ is removed or the incorrect medication prescribed) and this breach caused the patient harm, the healthcare professional could be sued. Although NHS vicarious liability covers negligence claims (meaning the clinicians themselves cannot be sued), Coroner’s Inquiries are not covered; therefore, Obstetricians and Gynaecologists require additional indemnity and medicolegal protection. It is also the case that, although most successful claims are settled out of court, the investigation process can take up to three years. It is difficult to imagine how stressful this must be and the mental and physical toll a negligence claim takes on a medical professional and their family.

In their 2019 article titled Medicolegal Issues In Gynaecology, Holly Vickers and Swati Jha comment that gynaecology and obstetric cases are being increasingly scrutinised because often patients are relatively young and fit, their procedures elective, and therefore, they do not expect complications and adverse effects as a result of these treatments.

At the coal face of medicine are General Practitioners (GPs), typically the first to see a woman experiencing pain or symptoms. Delayed or misdiagnosis is a common cause of gynaecology and obstetrics negligence claims. Take ovarian cancer as an example. If doctors can diagnose ovarian cancer at the earliest stage, nine out of 10 women will go on to live for five years or longer. However, only around one in 10 will survive as long if it progresses to stage four.

A recent report by Target Ovarian Cancer has revealed that more than a quarter of women with ovarian cancer saw their GP three or more times before getting a referral for tests. Researchers also found that almost a third had waited for longer than three months after first going to see their GP before being given the correct diagnosis. In addition, 14% of women polled said they were not given their diagnosis in private, meaning others could listen in on these most sensitive of conversations.

Neglecting to provide a patient with all the relevant information is also an area where the risk of a claim looms large, especially in elective procedures. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 20 provides that healthcare professionals must disclose to the patient any incidents that have occurred during their treatment, regardless of whether the patient requests this information. Clinicians must inform the patient of adverse events, offer an apology, and an explanation for what went wrong. The CQC clarifies in its guidance that apologising is not an admission of guilt. Patients who have suffered medical negligence often seek answers about what went wrong and an apology for their pain and loss. Providing this at the outset can mitigate the risk of a claim being brought.

How can Obstetricians and Gynaecologists assist in defending claims of clinical negligence?

One of the most important steps an Obstetrician or Gynaecologist must take to protect themselves against future clinical negligence claims is to document everything. This includes recording every conversation, treatment decision, and follow-up care and consultations. This helps solicitors, expert witnesses, and the Court understand the context in which the alleged negligence took place and the Obstetrician’s or Gynaecologist’s actions.

Another factor to observe is that good medical practice is defensible, and the best way an Obstetrician or Gynaecologist can avoid negligence claims is to keep within the limits of their expertise and competence. And when delegating, clinicians must ensure their colleagues are competent to complete the task.

Finally, an obstetrician or gynaecologist should ensure that an adequate risk analysis and evaluation is undertaken and, most importantly, that the evaluation is documented before treatment or a procedure begins.
It may seem excessive to rigorously record everything relating to a particular patient, but the fact is that if a medical professional is sued, the more details their counsel and expert witnesses have, the more likely a positive outcome can be achieved.

How can Expert Court Reports Ltd help?

Our Obstetrician and Gynaecology experts deliver timely, rigorous, evidence-based assessments to courts and tribunals. If you would like to find out more about how our Obstetrician and Gynaecology Experts can assist in complex personal or medical negligence claims or defence, please call us on 01865 587865, email office@expertcourtreports.co.uk, or request a call by completing our online form.