Where cardiologists go wrong
Clinical negligence claims notified by Medical Defence Union cardiology members are analysed by Dr Claire Wratten, who advises on cutting risk.
Of the MDU’s consultant cardiologist members, around one third have needed to seek our assistance in the last ten years with a wide range of matters.
These include GMC complaints, coroner’s inquests, employers’ disciplinary processes and clinical negligence claims in both NHS and independent practice.
However, claims against cardiologists are less common compared to some other specialities – such as orthopaedic surgery – but the size of damages awards and claimants’ solicitors’ legal costs can be considerable.
This article explores medical negligence claims brought against cardiologists working in independent practice over a recent ten-year period.
Reasons for claims
The reasons for cardiology claims range from incorrect or inadequate treatment to procedural complications. Themes of cardiology claims include:
Incorrect treatment
Nearly 20% of notified cardiology claims related to alleged incorrect or inadequate treatment.
The conditions affected were wide-ranging and covered both outpatient and inpatient care.
Examples of cases involving outpatient care include incorrect advice given to a patient with valvular heart disease resulting in premature death, misinterpretation of exercise tolerance tests and inadequate treatment of ischaemic heart disease.
Cases involving inpatient care included inadequate cardiac monitoring resulting in delayed detection of cardiac arrest.
Delayed diagnosis or treatment
Seventeen per cent of cardiology claims notified to the MDU were due to an alleged delay in diagnosis or treatment.
These included delays related to cardiac conditions such as bacterial endocarditis and coronary artery disease, and delays for unrelated conditions including malignancies and berry aneurysm.
Angiography
Complications following angiography featured in 15% of claims. The complications were sometimes relatively minor, such as pseudo-aneurysm at the site of femoral artery puncture or complications following use of radial artery access.
In other cases, the consequences were much more serious, such as stroke following angiography.
Ablation & transoesophageal echocardiography
A further 15% of claims followed ablation for arrhythmias. The concerns raised by patients included burns, a stroke following ablation, postoperative infection and cardiac tamponade.
Drug reactions
Just over 10% of claims involved drug reactions, including complications following treatment with gentamicin and amiodarone, as well as adverse reactions to
flecainide.
Other claims alleged vasovagal episodes due to cardiac medication.
Pacemaker insertion
Just under 10% of claims were brought following complications associated with pacemaker insertion. The concerns raised included unnecessary pacemaker insertion, concerns about the lack of an adequate consenting procedure and faulty devices.
It can be very distressing to find out a patient is bringing a claim against you. While claims numbers have remained steady in recent years, the cost of claims has spiralled.
This is not due to clinical standards but to a deteriorating legal environment which the MDU is campaigning to reform.
You can find out more at www.themdu.com/faircomp.
Dr Claire Wratten (right) is senior medical claims handler at the Medical Defence Union
