Things to do and not to do to prevent Medical Negligence! - Dr Venkatesh Karthikeyan

1. PRECAUTIONS AGAINST
NEGLIGENCE
Dr Venkatesh Karthikeyan,
VMCH&RI,
Madurai.
Mail : 4852012@gmail.com

2. NEGLIGENCE
Negligence is something that :
• one is not supposed to do (Commission) or
• Failing to do something that one is supposed to do (Omission)

3. PRECAUTIONS AGAINST NEGLIGENCE
Things not to do Things to do

4. Things not to do

5. • No female patient should be examined
unless a third person is present.
*Third person (female attender) should not be the patient’s relative .

6. • Do not leave a patient unattended during labour and other emergencies.
• This may lead to DERELICTION i.e., failure on the part of the doctor to
maintain applicable standard of care and skill.
• Patient must not be abandoned. Make next best alternative.

7. • NEVER GUARANTEE A CURE
• Instead make statements like “I will try my level
best” , “I will do to the best of my ability”.
• Avoid over – confident prognoses and promising too much to
the patient.

8. • Do not make a statement constituting or admitting fault on
your part.
• Accepting the fault never becomes protective.

9. • No procedure should be undertaken beyond one’s skill.
• Seek consultation where necessary.
• Transfer the patient if the facilities are inadequate to handle his
problem.

11. • Do not order a prescription over telephone
• May lead to misunderstanding of drug name and dosage
• Chlorprenaramine : Avil
• Chlorpromazine : Anti - psychotic

12. • Do not CRITICISE the professional ability of another doctor,
especially in presence of patient.
• Talk to the doctor directly or report to the State Medical
Council.

13. Things to be DONE

14. • Obtain Informed consent* of the patient.
*Permission granted in full knowledge about possible consequences.

15. • Keep full, accurate and legible medical records.

16. • Confirm diagnosis by laboratory investigations
*In suspected cases of cancer, all laboratory investigations should be
done without delay to establish early diagnosis.

17. • Keep yourself informed of technical advances and use of
standard procedures of treatment.
Eg. : Prophylactic lignocaine for ventricular premature complexes.
Anaphylxis : IV addrenaline
CPR : Intracardial adrenaline
Now, IM Adrenaline due to arrythmias whe givn through other
routes.

18. • Proper instructions should be given to the patient and proper post
operative care should be taken

19. • Exercise care in the selection of assistants and entrusting
of duties to them.
• Eg: Typhoid - Chloramphenicol

20. • Drugs should be identified before being injected or used
otherwise.

21. • Establish good rapport with the patient.
• So that, patient will believe in the doctor.
• Better follow up.
• So that he will feel comfortable
• Better practice.

22. TO DO
• Obtain informed consent of the patient.
• Establish good rapport with the patients.
• Keep full, accurate and legible medical records.
• Confirm diagnosis by laboratory investigations.
• Seek consultation where necessary.
• Transfer the patient if facilities are inadequate to handle the problem.
• Drug should be identified before being injected or used otherwise.
• Keep yourself informed of technical advances.
• Exercise care in selection of assistants.

23. NOT TO DO
• Do not leave a patient unattended during labour
• No female patient must be examined unless a third person is present
• No experimental method should be adopted without consent of the patients.
• No procedure should be undertaken beyond one’s skill.
• NEVER GUARANTEE A CURE.
• Do not abandon a patient.
• Avoid over confident prognoses and promising too much to patient.
• Do not admit your fault to the patient.
• Do not criticize or condemn the professional ability of another doctor,
especially in presence of the patient.

24. Thank you!