As part of the process of interviewing for a new solicitor to join the firm, I have reflected on the types of case we have recently been instructed in and those areas of medicine that are emerging as fertile areas for claim. Traditionally, major repeat areas of work continue to be gynaecology, GP care, neurosurgery, radiology and orthopaedics.
If anything, there has been a reduction in birth injury claims. My view is that this has followed increased standardisation of practices/protocols, in WA’s major obstetric units – I hope this is true and that the reduction in clients is a measure of a reduction in adverse outcomes, which we would all be happy to see.
My review revealed the following points worthy of note:
- Not surprisingly, elective or semi-elective surgery continues to be a ‘growth’ area. We are now seeking a regular flow of bariatric surgery cases (lap band surgery, vertical sleeve gastrectomy etc). We are also seeing the continued fall-out from the very variable expertise of cosmetic surgeons, particularly in breast surgery. Apart from poor outcomes from augmentation (breast enlargement) and breast reconstruction, perhaps surprisingly, we are seeing claims from poor outcomes from breast reduction surgery;
- We have recently seen a ‘spike’ in orthopaedic hip replacement surgery cases: particularly infection problems post-THR. At a recent conference I attended, I was struck by the advice given as to the seriousness of such infection problems with joint replacement surgery, both in terms of incidence + the seriousness of consequences if such an infection arises;
- We continue to see regularly, cases relating to anti-coagulation + DVT (deep vein thrombosis) and PE (pulmonary emboli);
- We have seen several interesting cases in which issues arise as to the comparability of care in regional Western Australia, compared with Perth. Issues arise as to whether appropriate credentialling of country specialists is occurring and whether follow-up/investigations are appropriate in country areas;
- We have seen several cases recently surrounding obstetric complications, but concerning mother rather than baby;
- we continue to see cases involving laparoscopic surgery – reinforcing the impression I have long held, that complication rates with such surgery are more variable, depending on the skills and experience of the surgeon, than many patients would imagine;
- We continue to see cases relating to system failures – hospitals and GP practices in particular, failing to have adequate systems to ensure patient follow up + arrangements for investigations etc. Given extended waiting lists for some non-urgent investigations in the public system, a failure to advise the patient of the date for their MRI scan, ultrasound, colonoscopy etc, can result in delays of 12 months or more in some cases.
Would be interested to hear other comparable practices experiences + whether they are seeing similar focus areas developing.