The complainant has the floor

Of the half a million incidents and accidents declared each year in the Québec health system, an infinitesimal minority end in legal proceedings. When this is the case, caregivers are usually overwhelmed, so you might as well prepare for it. To avoid being caught out, Profession Santé spoke with two lawyers who defend victims of medical errors. “It may seem counter-intuitive, but it is better to be transparent,” said Jean-Sébastien D’Amours. The lawyer specializing in medical errors at the firm Tremblay Bois, in Quebec, noted that health professionals tend to have a reflex to not talk about their errors or to record them imperfectly. Read: Legal column: Imaginary patients In the event of a problem, the first thing to do, said lawyer Jean-Pierre Ménard, “is to talk to the patient about it. He or she must know.” He stressed that this communication is provided in the context of the obligation to report incidents and accidents occurring during the provision of care. “What patients want above all are answers,” said D’Amours, who advises caregivers to explain their error, without admitting their responsibility, but by showing empathy. “And when the victims go to court,” said the lawyer, “it should not be seen as an assault. They don’t want to punish the professional, but to obtain redress.” When the fault or error becomes a legal matter, the best defense remains the care in recording the notes in the medical file. “The notes in the file will make it possible to see what means the doctor used and whether these means were in accordance with the standards of current medicine,” said Ménard. In this perspective, the notes must be precise, detailed, dated and “have a good calligraphy”, half jokes D’Amours, about written notes. He points out more seriously that he often sees medical files “with large sections missing.” The recording of notes in the patient’s file on the care provided is a particularly important ethical obligation for nurses, note Ménard. “They have to prove that they got it right. In the case of a complicated delivery, how and how often did they perform fetal monitoring? What investigations have they carried out to assess a patient’s condition? When did they contact the attending physician and what were the discussions? Everything must be recorded.” Stay up to date From misdiagnosis to surgical error, the two lawyers handle a wide variety of cases. But their daily bread is medication errors which represent a quarter of incidents and accidents reported each year in Quebec. Here again, “the doctor must follow the rules of the art in informing the patient of the risks and possible undesirable effects. The pharmacist is also required to inform the patient, and he is not exempt from doing so because the doctor has done so,” said Ménard. The lawyer adds an advice for “surgeons who work at large volume”: “We must show humility, question ourselves and follow the progress of medicine. Techniques change, knowledge evolves, and the rules of the art follow accordingly.” Originally ran on our sister brand in Quebec, Profession Santé. Translated from French.

The complainant has the floor

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