Diabetes claims against doctors on the increase says MDU

The number of patients suing doctors increased by 28% from 162 claims between 2003-7 to 207 cases between 2008-12, although the vast majority of cases did not lead to compensation being paid. In total 92 negligence claims have been settled for just over £8.2 million plus legal costs of around £1.2 million over the decade.

The MDU, the leading indemnifier of UK doctors, helped its members with over 1,215 incidents involving diabetes over the ten year period to 2012. As well as negligence claims, there were 489 complaints, 123 coroner’s inquiries and 44 GMC investigations.

Dr Caroline Fryar, Head of advisory services at the MDU, said:

“With the announcement by Diabetes UK that the number of UK adults living with diabetes has reached 3.3 million, a 60% increase over the past decade, 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.

“Diabetes is a growing problem in the UK so 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.”

MDU case examples:

• A diabetic patient who suffered a gangrenous bowel leading to peritonitis and sepsis received £800,000 in compensation - the largest single payout by the MDU among the cases studied.

• Another patient received £70,000 in compensation for the amputation of several toes because their foot symptoms had not been properly treated.

• A GP asked for advice after a diabetic patient did not attend a number of monitoring reviews but still asked for repeat prescriptions.

• A young woman 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 MDU has issued advice for doctors to help them minimise the risk of delays in diagnosing and managing diabetes. This 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.

• Ensure 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.

• Ensure patients with diabetes receive regular monitoring and screening.

• Contact diabetic patients who repeatedly fail to attend review appointments and provide sufficient information to ensure 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.