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Kevin Barraclough is General Practitioner, Painswick Surgery, Painswick, Gloucestershire
Jenny du Toit is General Practitioner, Painswick Surgery, Painswick, Gloucestershire
Jeremy Budd is General Practitioner, East Quay Medical Centre, Bridgwater, Somerset
Joseph E. Raine is Consultant Paediatrician, Whittington Hospital, London
Kate Williams is Partner, RadcliffesLeBrasseur Solicitors, Leeds
Jonathan Bonser is Consultant in the Healthcare Department of Fishburns LLP, Solicitors, London, and former Head of the Claims and Legal Services, Department of the Leeds office of the Medical Protection Society
Contributors
Preface
Abbreviations
Introduction
Part 1 The legal structure of negligence
A few words about error
Medical negligence
Learning from system failures-the vincristine example
Causes of diagnostic errors in general practice and how they can be avoided
How do general practitioners reach diagnoses?
Where do errors occur in diagnosis?
How can we minimise the risks of these errors?
Further reading
Bayesian reasoning and avoiding diagnostic errors
A potpourri of advice on avoiding errors
The history and examination
The telephone consultation
Communication problems
When lack of knowledge plays a part
The unexpectedly abnormal result
The standard of notes
Drug or prescribing errors
Consent
Conditions that are “frequent flyers” in negligence cases
Safety netting
Further reading and references
Part 2 Clinical cases
Introduction
Case 1 A man with iron deficiency
Case 2 When is a headache abrupt?
Case 3 A woman with chest pain
Case 4 A dizzy man
Case 5 Rectal bleeding in a pregnant woman
Case 6 A pulled calf muscle
Case 7 A woman with hemiplegic migraine
Case 8 Irritable bowel syndrome after sickness in Goa
Case 9 A young man with back pain
Case 10 Irregular intermenstrual bleeding in a woman on the Pill
Case 11 A boy with a limp
Case 12 A runner with a cough
Case 13 A woman with classical migraine
Case 14 A young woman with diarrhoea and vomiting
Case 15 Ill-fitting dentures in an elderly man
Case 16 Back pain in a middle-aged woman
Case 17 Cellulitis in a man’s foot
Case 18 A flare-up of ulcerative colitis
Case 19 A woman with a skin lump on her leg
Case 20 A woman with microscopic haematuria
Case 21 A limping young girl
Case 22 A builder tripping over his feet
Case 23 An anxious young woman with
hyperventilation
Case 24 A slightly raised AST in an Asian woman
Case 25 Cough and fever in a 42-year-old accountant
Case 26 Lost prescription: benzodiazepine addiction
Case 27 A febrile baby
Case 28 A limping elderly woman after a fall
Case 29 Indigestion in a stressed executive
Case 30 A hoped-for pregnancy
Case 31 A breast lump that disappears
Case 32 Fever and cough after an ankle fusion
Case 33 Urinary problem in a welder
Case 34 A hypertensive 38-year-old woman
Case 35 A swollen lip in a 56-year-old man
Case 36 A woman with fatigue and weight gain
Case 37 A woman told off for ignoring her friends
Case 38 A man with a headache: swine flu or meningitis?
Case 39 A woman suffering dizziness
Case 40 A middle-aged man with an ankle injury
Part 3 Investigating and dealing with errors
Introduction
How errors and their recurrence are prevented in Primary Care
The Role of the Primary Care Trusts
Other investigations
Legal advice – where to get it and how to pay
External inquiries
The role of the doctor
Emotional repercussions
Conclusion
Index
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