Friday, February 03, 2006

Manslaughter case against UK lab worker collapses

Updated 9 Nov. 2013
As a follow-up to my earlier blog (Manslaughter charged following wrong blood fatality in UK):

The case against the biomedical scientist on trial in the UK for manslaughter has collapsed. The crown decided that, while negligence could have been proved for a civil case, the crime of manslaughter (gross negligence), was not provable in the case:
Negligence Primer

Disclaimer: I am not a lawyer. The following information has been compiled from an Internet search and is presented solely for the interest of readers. Readers are advised to consult the resources in Further Reading, which are provided as aids to identify more information on this complex topic.
By way of review, negligence is often defined as (1) not doing something which a reasonable person would do, or (2) doing something which a reasonable person would not do.

Thus negligence can involve acts of commission and acts of omission. In order to succeed in a negligence civil case, the plaintiff, or person suing, must generally satisfy the court of the following four elements:
  1. Duty of care. A person who practices in a health profession owes the patient a duty. The duty of care involves applying skill, knowledge, diligence and caution when caring for patients.

  2. Breach of standard of care. The standard of care is primarily determined by the general practice of the profession. The practitioner does not need to live up to the highest standards but rather the reasonable, accepted standards set for the profession. Standards of care are determined by consulting experts, and relevant practice guidelines and standards (such as blood safety standards). Patients also have the right to expect a reasonable standard of care from healthcare students who treat them.

  3. Injury or loss. For negligence to occur, the patient must have experienced injury or loss of some kind due to the negligent act.

  4. Causation - the breach must be the proximate cause of the harm (the causal link between the defendant's act and the injury or loss). The most common test is the "but for" test. That is, if the accident would not have occurred but for the defendant's negligence, then the conduct is the cause of the injury. There must be a clear direct connection between the negligent act and the harm caused to the patient.
In the case of the UK biomedical scientist , all 4 elements needed for a civil negligence case would seem to have been met. However, criminal negligence resulting in a charge of manslaughter require additional criteria.

Criminal Negligence
To meet the standard for criminal negligence, the act or omission must show a wanton or reckless disregard for the lives or safety of other persons. For example, a nurse in the USA was found guilty of criminal negligence (reckless manslaughter) for hiding an empty bag of blood after it was transfused to the wrong person. Transfusing the wrong blood by failing to perform required pretransfusion identity checks may show negligence but what made the nurse's act criminal - reckless manslaughter - was the failure to disclose the error upon its discovery.
For discussion of negligence in the context of student health professionals, see TraQ's Case A8:
Further Reading

  1. Berry DB. The physician's guide to medical malpractice. Proc (Bayl Univ Med Cent). 2001 Jan; 14(1): 109–12. (Free full text)

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1 comment:

  1. Anonymous6:49 AM

    As a BMS in the UK I'm horrified by this, but I am also aware how easy this kind of thing is to do. And having said that there is no excuse for these lapses in professional judgement.
    However, I am disappointed that all the focus is on the lab. This patient had a normal Hb (12g/dL) & was transfused anyway. The signs of an acute transfusion reaction were mistaken for bleeding(!) & the second unit was given as an aid! All in all a disaster...