By Alicia Hayes, Legal Adviser, Medical Protection
Our member, Dr J, was a consultant in emergency medicine and first contacted Medical Protection in late 2019. He was called to an inquest involving the death of a 19-year-old, who died of injuries suffered in a road traffic accident. On the day of the accident, Dr J was working a shift as a pre-hospital physician with the ambulance service who responded to the incident.
The accident itself took place in mid-2016. Dr J was one of the first doctors who arrived in an ambulance to treat the two patients following the collision. There were delays in getting an ambulance or doctor to the scene due to bad weather and the rural location of the accident.
At the inquest, the family of the 19-year-old felt that Dr J’s care at the scene was substandard. They suggested the decision he took to intubate, administer drugs and stabilise her at the scene – all of which took up time – before she was taken to hospital caused her death. They alleged that she should have been taken as soon as Dr J got there, especially given the delay getting there in the first place. Dr J was of the view the deceased would have died on the way to hospital if he had not stabilised her condition and intubated her, given her very serious injuries.
The coroner decided to instruct an expert to comment on the care. Unfortunately, she chose to instruct someone who was not suitably or equally qualified to our member. He was a hospital grade doctor, who no longer practised emergency medicine. He was not a consultant and had no pre-hospital experience or expertise. He made several criticisms of Dr J’s care. As a result of this expert report, Dr J contacted Medical Protection for assistance and we arranged legal representation on his behalf.
Following our written submissions, we successfully managed to have the first expert report excluded on the basis that he was not a suitably qualified expert to comment. The coroner accepted without question that he was not of the same level or expertise as Dr J. A new expert was instructed, with the same level of qualifications and expertise, and he was not critical at all of Dr J and in fact confirmed that the treatment he gave the girl at the scene meant she made it to hospital alive, so that emergency surgery to save her could be attempted. In his view her injuries were so grave, she was never going to survive the injuries, but Dr J gave her a chance.
The coroner returned a verdict of Road Traffic Accident. This conclusion was the best possible outcome for Dr J as it meant the coroner was satisfied no acts or omissions on anyone’s part caused or contributed to the death. This also meant a civil claim by the family would unlikely be successful and that Dr J would not have to self-refer to the Medical Council. Dr J was very relieved by the outcome and grateful for our support, commenting we “went the extra mile” and “delivered more than just a service; one which feels like it’s personal and human”.
How Medical Protection assisted
Medical Protection was able to provide full support to Dr J with separate legal representation – a legal adviser and barrister – over the course of the three parts of the hearing, and two preliminary hearings.
We were successful in having the first expert report excluded and in having the coroner instruct a suitably qualified expert to comment on Dr J’s care. This was crucial as it would have been very unfair had the criticisms of the unqualified expert been allowed to stand, and potentially influence the outcome. The law is very clear on this point. Only those with similar expertise or qualifications are entitled to comment on care of fellow professionals. This led to achieving the ultimate outcome, which was the fair and correct one in the circumstances. Unfortunately, the family never accepted that the first expert was not suitably qualified to comment. Their view was that the inquest was a “whitewash” and they also voiced their dissatisfaction and upset at the outcome, which was difficult for Dr J as, though he was vindicated by the expert, the family never accepted that. The words of the first expert could never have been unheard.
This case illustrates how much Medical Protection can support members, even where they have done nothing wrong. In the main, members might think they need us most when there has been an error of some kind, but in this case the family were already convinced that their daughter did not receive the correct treatment, and that the long delay in getting to her caused her death, which was not the case. That meant the member needed a large amount of assistance with various aspects, including having to be separately represented.
The fact of the matter was her injuries were incredibly serious and ultimately fatal, but the family did not accept this. This problem was compounded by the fact the coroner instructed an expert who was not suitably qualified. This demonstrates how important it is to ensure the correct experts are instructed from the outset.