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Quarter rise in diabetes claims against doctors

Minimise risk of delays in diagnosing and treating diabetes, MDU advises doctors

Louise Prime

Tuesday, 15 September 2015

Diabetes-related negligence claims against doctors have risen by well over a quarter in just a few years, the Medical Defence Union (MDU) has warned. It has advised doctors on how to minimise the risk of delays in diagnosing and managing diabetes, to protect patients and themselves.

Between 2003 and 2007 the MDU said there were 162 claims alleging that doctors had failed to diagnose diabetes or to manage it properly, but between 2008 and 2012 this number had risen by 28%, to 207. Although most of these cases did not result in compensation being paid, over the decade 92 negligence claims were settled for more than £8.2m, plus about £1.2m in legal costs.

Over that decade, the MDU helped doctors with more than 1,215 diabetes-related incidents in total, including 489 complaints, 123 coroner’s enquiries and 44 investigations by the General Medical Council. Cases included a patient with diabetes who suffered a gangrenous bowel leading to peritonitis and sepsis, who received £800,000 in compensation; another who received £70,000 in compensation for the amputation of several toes because their foot symptoms had not been properly treated; a GP who asked for advice after a diabetic patient did not attend a number of monitoring reviews but still asked for repeat prescriptions; and a young woman who complained there had been a delay in diagnosing her with type 1 diabetes and she had suffered diabetic ketoacidosis and been admitted to hospital.

The defence organisation’s head of advisory services, Dr Caroline Fryar, said: “The number of UK adults living with diabetes has reached 3.3m, a 60% increase over the past decade, [so] it is perhaps not surprising that doctors have also seen an increase in claims and complaints involving diabetes. This does not imply a fall in medical standards, but could reflect the growing willingness of patients and their families to take action when they believe there have been failings in medical care ...

“It is important that doctors are aware of the signs and also how to manage the condition. Common allegations in the cases we saw included failing to make an initial diagnosis along with failing to diagnose typical complications like foot or leg ulcers. In serious cases these can lead to patients having limbs amputated. Other cases alleged medication errors and poor ongoing monitoring.

“GPs are at the front line in diagnosing and managing patients with diabetes and 75% of our cases involved them. Making a diagnosis may not be straightforward, especially if the ‘classic’ signs of weight loss, thirst and tiredness are not present. However it’s important that appropriate diagnostic tests are carried out if diabetes is suspected. It is also crucial that patients with diabetes are adequately monitored as complications can be very serious or even life-threatening.”

The MDU’s advice to doctors includes:

  • record how the patient will be managed and any follow up plans, according to the patient’s history and examination. Make a note of important negative as well as positive findings
  • make sure patients know what to do if symptoms don’t resolve within a period of time
  • consider having a computerised warning system to flag patients about whom you have concerns
  • be familiar with relevant guidelines such as those from NICE and SIGN
  • check patients with diabetes receive regular monitoring and screening
  • contact patients who repeatedly fail to attend review appointments and provide sufficient information to make sure they are fully informed of the benefits of monitoring and the risks of not attending
  • analyse incidents such as delays in diagnosis or medication errors to see if improvements can be made to benefit all patients
  • explain what happened and apologise to patients if things go wrong

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