When asked to attend adverse event meeting

Business Dilemmas

Dr Kathryn Leask

How should this consultant prepare for a meeting following an adverse incident? Dr Kathryn Leask gives her response

 

         

           

               

Dilemma 1

Can you help with this meeting?

Q I have been asked to attend a meeting following an adverse incident involving a medication error (I work as a consultant cardiologist). 

I have put my account of the event in writing based upon my recollections and the appropriate records, but I was wondering if you could offer further advice in this area? 

AFirstly, it is important not to jump to conclusions about the purpose of the meeting. 

And remember that you have a professional duty to be open and honest when things go wrong and to learn lessons from any incident. 

It’s also advisable to contact your medical defence body for advice.

 

The check list below will help you to prepare in advance. It is important to do this, even if there are no obvious concerns about your role in the incident.

1. Establish what process or policy is being followed, who will be present at the meeting and if you can bring a trusted colleague for support.

2. If you do feel that your care could have been better, then be prepared to demonstrate that you recognise this and what remediation you have undertaken – or plan to – to address this. 

Including mention of reflection and remediation in adverse incident statements or at meetings is not always necessary, but it can help you pre-empt any recommendation about steps you should take to improve your practice.

3. Ensure you have seen the relevant medical records, where applicable, so you are familiar with the original documentation about the event in question.

4. Consider drafting a statement, even if one has not been formally requested. Aim to create an aide memoire for the meeting that includes a full chronology and everything you would want to say about your role in events. 

This way, you are less likely to leave the meeting feeling that key points were omitted from your evidence or that you didn’t make yourself clear. You can find our guide on writing reports at www.themdu.com/guidance-and-advice/guides/writing-a-report-or-statement.

5. Listen carefully to each question and only answer if you fully understand. You can ask for clarification if the question is unclear.

6. Take your time and consider your answer before speaking.

7. When you have answered a question, it is appropriate to stop talking and wait for the next question. Don’t be tempted to fill any silences.

8. If you don’t know something, it is fine to say so.

9. Do not speculate about what might have, should have, or could have happened, or not happened.

10. Do not comment on the actions or omissions of other people or go outside of your own area of expertise.

11. While the purpose of adverse incident investigations is to fact-find and not to apportion blame, if you do feel uncomfortable with the questions you are being asked, you can ask for a copy of the questions to take away. 

This will allow you to seek support and get advice before you answer them. You can offer to reply to these in writing later.

12. Be mindful of the relevant GMC guidance when answering questions. It is important to be honest, take reasonable steps to check any information is accurate and that no relevant information is omitted.

13. Ask to see a copy of any report or statement that is prepared based on your answers so that you can check this is factually correct and your responses have not been misunderstood.

Your account will be relied on, so try to give an accurate report of your involvement in the incident, as the information could be used in processes such as a coroner’s inquiry or GMC investigation. 


Insurer wants details of my care for a dead patient

Dr Kathryn Leask

A consultant requests help to respond to a request for information from an insurance provider. Dr Kathryn Leask gives her advice.

 

 

 

 

Dilemma 2

Why has insurer asked for data?

QI am an interventional radiologist and have been contacted by a patient’s private medical insurance company asking for details of their care and the reasons why specific decisions about their treatment was made. 

Unfortunately, the patient died three weeks after treatment following a deterioration in their condition. The insurer has asked about the decision-making process including timings. 

It has also asked for some audit information about my practice. While I have no concerns about the care I provided and the family of the patient have not raised any issues, I am concerned about the reason for this request. Please could you advise?

A It is likely that this request is based on the fact that the insurer is regulated by the Financial Conduct Authority and has a responsibility towards its customers to ensure they are receiving appropriate treatment. 

From time to time, private medical insurers undertake quality assurance investigations which doctors generally have an ethical obligation to co-operate with, after taking into account their duty of confidentiality to the patient/deceased. 

You may find that you have a contractual obligation to provide this type of information as part of your recognition agreement with the private insurer and it would, therefore, be worth reviewing the wording of your agreement. 

If you have any specific concerns about the request for information or the reasons behind it, you are advised to contact your medical defence organisation for support.

Dr Kathryn Leask is a medico-legal adviser at the Medical Defence Union (MDU)