Medicolegal Issues in Obstetrics and Gynaecology

374 Pages·2018·6.98 MB·English

by  Swati Jha

Medicolegal Issues
in Obstetrics
and Gynaecology
Swati Jha
Emma Ferriman
Editors
123
Medicolegal Issues in Obstetrics
and Gynaecology
Swati Jha • Emma Ferriman
Editors
Medicolegal Issues
in Obstetrics and
Gynaecology
Section Editors
Robert Burrell
Danny Bryden
Janesh Gupta
Raj Mathur
John Murdoch
Editors
Swati Jha Emma Ferriman
Department of Obstetrics and Department of Obstetrics and
Gynaecology, Jessop Wing Gynaecology, Jessop Wing
Sheffield Teaching Hospitals NHS Trust Sheffield Teaching Hospitals NHS Trust
Sheffield, UK Sheffield, UK
ISBN 978-3-319-78682-7 ISBN 978-3-319-78683-4 (eBook)
https://doi.org/10.1007/978-3-319-78683-4
Library of Congress Control Number: 2018940256
© Springer International Publishing AG, part of Springer Nature 2018
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This book is dedicated to my Father who introduced me to
Pandora’s box and made me the Doctor I am today and my
Mother who gave me the values by which I live my life.
Swati Jha
Preface
The UK is experiencing a dramatic increase in medico-legal claims. The four
main reasons for litigation are accountability, the need for an explanation,
concern with standards of care and compensation. However the decision to
take legal action is determined not only by the original injury but also by a
failure to provide information, an explanation and an apology. Insensitive
handling of an injury and poor communication after the original incident
increases the risk of litigation and erodes the patient-doctor relationship.
Doctors almost never deliberately cause harm to patients; however increas-
ingly claims are being prosecuted successfully.
Medicine has always been an imperfect science and as humans we will
make mistakes. Whereas the principle of “Six Sigma” can be applied to cer-
tain areas of medical practice, surgery involves so many variables that it
would be impossible to apply those principles. It is also true that a single
failure rarely leads to harm but in complex systems, which is what surgery
involves, it is usually the Swiss cheese model of accident causation that
results in suffering for the patient. Unfortunately this is also what often results
in successful litigation.
Obstetrics and gynaecology in particular has always had a reputation for
being a highly litigious specialty. However for all those in the practice of
obstetrics and gynaecology, we are in the specialty because we enjoy it and
have chosen it in spite of it being a litigious specialty and have obviously not
been deterred by this fact. Awareness of issues related to litigation however
makes us more aware of how best to avoid injury and harm to our patients and
at the same time protects us from accusations of clinical negligence.
The aim of this book is to highlight minimum standards relating to the
management of different conditions in the practice of obstetrics and gynaeco-
logy. We also highlight clinical governance issues and common causes of liti-
gation. A section on how to avoid litigation is provided in each chapter
followed by a case study. This should be of use to clinicians and lawyers alike
and raise awareness of how to avoid facing clinical negligence claims in our
day-to- day practice.
Sheffield, UK Swati Jha
vii
Contents
Part I General
Swati Jha and Robert Burrell
1 Ethics in Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Kate F. Walker and James G. Thornton
2 Why Doctors Get Sued . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Eloise Powers
3 Consent After Montgomery: Clinical Considerations . . . . . . . . 15
Helen Bolton
4 Consent After Montgomery: Legal Considerations . . . . . . . . . . 19
Elizabeth Thomas and Bertie Leigh
5 Duty of Candour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Helen Bolton
6 Leading Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Fiona Paterson
7 The Claim Journey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Karen Ellison and Emma Ferriman
8 GMC Referral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Katherine Sheldrick and Angela Pilling
9 Report Writing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Eloise Powers and Sallie Booth
10 Being an Expert Witness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
John Reynard
11 The Obstetrician/Gynaecologist in Coroner’s Court . . . . . . . . . 55
A. R. W. Forrest
12 Intimate Examinations and Chaperones . . . . . . . . . . . . . . . . . . 61
Janesh K. Gupta
ix
x Contents
Part II Anaesthesia in Obstetrics and Gynaecology
Swati Jha and Danny Bryden
13 Pain Relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Jeremy P. Campbell and Felicity Plaat
14 Regional Anaesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Sujata Handa and David Bogod
15 General Anaesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Samuel Hird and Rehana Iqbal
Part III Obstetrics
Emma Ferriman and Swati Jha
16 Prenatal Screening and Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . 85
Emma Ferriman and Dilly Anumba
17 The 20-Week Anomaly Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Emma Ferriman and Dilly Anumba
18 Induction of Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Myles J. O. Taylor
19 Diabetes in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Alexander M. Pirie
20 Cardiac Disease in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Philip J. Steer
21 Pre-eclampsia and Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . 109
Alexander M. Pirie
22 Umbilical Cord Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Susana Pereira and Edwin Chandraharan
23 Fetal Growth Restriction (FGR) . . . . . . . . . . . . . . . . . . . . . . . . . 121
William L. Martin
24 Placenta Praevia, Placenta Accreta and Vasa Praevia . . . . . . . . 127
Jeremy Brockelsby
25 CTG Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Vikram Talaulikar and Sabaratnam Arulkumaran
26 Operative Vaginal Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Stephen O’Brien, Mohamed ElHodaiby, and Tim Draycott
27 Caesarean Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
James Johnston Walker
28 Shoulder Dystocia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Tim Draycott and Jo Crofts
Contents xi
29 Vaginal Birth After Caesarean Section, Uterine Rupture . . . . . 163
Kara Dent
30 Sepsis in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Derek J. Tuffnell
31 Twins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Mark D. Kilby and Peter J. Thomson
32 Vaginal Breech Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Simon Grant and Emma Ferriman
33 Maternal Collapse in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . 185
Peter Brunskill and Emma Ferriman
34 Postpartum Haemorrhage and Retained
Products of Conception Postnatal . . . . . . . . . . . . . . . . . . . . . . . . 191
Stephen O. Porter
35 Perineal Trauma and Episiotomy . . . . . . . . . . . . . . . . . . . . . . . . 199
Dharmesh S. Kapoor and Abdul H. Sultan
Part IV General Gynaecology
Swati Jha and Janesh Gupta
36 Abdominal Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Thomas Keith Cunningham and Kevin Phillips
37 Diagnostic and Operative Laparoscopy . . . . . . . . . . . . . . . . . . . 213
Andrew Baxter
38 Diagnostic and Operative Hysteroscopy . . . . . . . . . . . . . . . . . . . 217
Ertan Saridogan
39 Endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Alfred Cutner
40 Ectopic Pregnancy and Miscarriage . . . . . . . . . . . . . . . . . . . . . . 225
Andrew Farkas
41 Ovarian Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Swati Jha and Ian Currie
42 Laparotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
James Campbell
43 Urological Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Christopher R. Chapple
44 Bowel Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Janesh K. Gupta and Tariq Ismail
45 Vascular Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Jonathan D. Beard
xii Contents
Part V Urogynaecology
Swati Jha
46 Vaginal Repair and Concurrent Prolapse
and Continence Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Philip Toozs-Hobson
47 Midurethral Synthetic Slings . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Swati Jha
48 Colposuspension and Autologous Fascial Sling . . . . . . . . . . . . . 269
Andrew Farkas
49 Vaginal Mesh Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Mark Slack
50 Vaginal Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Swati Jha and Linda Cardozo
51 Laparoscopic Prolapse Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Simon Jackson
52 Acute Urinary Retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Mark Slack
53 Obstetric Anal Sphincter Injury [OASI] . . . . . . . . . . . . . . . . . . 291
Swati Jha and Abdul Sultan
Part VI I nfertility, Subfertility and the Menopause
Swati Jha and Raj Mathur
54 Fertility Testing and Treatment Decisions . . . . . . . . . . . . . . . . . 297
Ying Cheong and Rachel Broadley
55 Assisted Conception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Raj Mathur
56 Gamete Donation and Surrogacy . . . . . . . . . . . . . . . . . . . . . . . . 307
Sharon Pettle and Hannah Markham
57 Termination of Pregnancy (Abortion) . . . . . . . . . . . . . . . . . . . . . 313
Swati Jha and Lesley Regan
58 Hormone Replacement Therapy (HRT) . . . . . . . . . . . . . . . . . . . 317
Nick Nicholas
59 Long-Acting Reversible Contraception . . . . . . . . . . . . . . . . . . . 325
Raj Mathur and Swati Jha
60 Sterilisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Janesh K. Gupta