Surgeon learns the importance of belonging to an MDO when a patient complaint is investigated by the GMC

Mr H, a consultant orthopaedic surgeon, was made aware of a patient complaint regarding the outcome of hip surgery.

The patient had alleged that Mr H was negligent when performing the operation, resulting in a significant leg length discrepancy which was impacting on her quality of life and her self-image. Mr H had performed the operation in a private hospital – the procedure was technically complicated as it was a repeat procedure for a patient with a congenital hip abnormality. He had also followed the patient up as an outpatient.

Mr H called the Medical Protection advice line to find out how to best proceed following confirmation that the General Medical Council (GMC) would be investigating the matter.

Expert opinion

A medicolegal consultant (MLC) was assigned to the case and initially discussed the complaint with Mr H. He recalled the patient well, and had reviewed the medical records.

Mr H explained to the MLC that the operation was technically challenging. He had warned the patient of the possibility of leg length discrepancy during the consent process. He did not feel that there were any specific operative concerns. The MLC then explained the GMC investigation process to Mr H, reassuring him that as a single clinical incident the case was unlikely to proceed past the initial stages of an investigation. She advised Mr H that the GMC would likely seek an expert opinion to comment on the standard of his care.

The MLC advised that he should not make any comment at present and suggested that he should complete relevant CPD and reflection while waiting to hear back from the GMC. These steps would be likely to protect his position and show that he had approached the issue in an appropriate way, even if ultimately he had not done anything wrong.

Outcome

Six weeks later, the GMC sent a copy of the expert report to Mr H and the MLC. The report concluded that there were no concerns regarding his clinical care, but his record keeping was noted to be “below, but not seriously below” the expected standard.

The MLC reassured Mr H that it was unlikely that the case would be taken further and suggested that he complete the online module on record keeping available via the Medical Protection online learning platform, as this will be helpful during any discussion of the case at his next appraisal.

As anticipated, the GMC closed the case with no further action.

Learning points

• Appropriate record keeping is recognised as an important component of professional standards, helping healthcare professions to give a logical account when their decision-making is called into question. High quality record keeping should be part of routine practice, in order to best protect and defend your professional position, as well as ensuring safe continuity of care.
• Completing the relevant CPD and demonstrating that you have reflected on the adverse incident sufficiently can go a long way in supporting your case, should you be called up in front of the GMC.