Clinical errors and medical negligence

Femi Oyebode is Professor and Head of the Department of Psychiatry at the University of Birmingham (Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2QZ, UK. Email: Femi.Oyebode{at}sbmht.wmids.nhs.uk). He was Chief Examiner of the Royal College of Psychiatrists from 2002 to 2005, and is a member of the Council of the Medical Defence Union. He has an interest in clinical risk and medical negligence.

This article discusses the definition, nature and origins of clinical errors and potential means of prevention. The relationship between clinical errors and medical negligence is examined, as are the characteristics of litigants and events that prompt litigation. Legal aspects of medical negligence are outlined and clinical situations most commonly associated with negligence claims are described. Probably no more than 1 in 7 adverse events in medicine results in a negligence claim and the factors that predict whether patients will resort to litigation include a prior poor relationship with the clinician and the feeling that they are not being kept informed. The actual rate of negligence claims in psychiatry is unknown, but it is rising. Clinicians must therefore be aware of the risks and of which areas of practice are most risky.