From the Guidelines
Gross negligence in medicine refers to an extreme departure from the standard of care that a reasonable healthcare professional would provide, demonstrating a reckless disregard for patient safety. This concept is supported by the most recent and highest quality study, which emphasizes the importance of adhering to established standards of care to prevent medical errors and ensure patient safety 1.
Examples of gross negligence in medicine include:
- Performing surgery on the wrong patient or body part
- Leaving surgical instruments inside a patient
- Administering a lethal dose of medication due to carelessness
- Failing to diagnose a life-threatening condition despite obvious symptoms
- Deliberately ignoring critical lab results or test findings
To avoid gross negligence, healthcare providers should:
- Double-check patient identities and procedures
- Follow established safety protocols and checklists
- Maintain clear communication with patients and colleagues
- Stay up-to-date with current medical knowledge and best practices
- Thoroughly document all patient interactions and decisions
Gross negligence is more severe than ordinary negligence and can result in serious legal and professional consequences, including license revocation and criminal charges, as highlighted in a study on malpractice litigation in the diagnosis and treatment of acute stroke 1. It implies a conscious and voluntary disregard of the need to use reasonable care, which is likely to cause foreseeable grave injury or harm to persons, property, or both. The Institute of Medicine's report "To err is human: building a safer health system" also emphasizes the importance of preventing medical errors and ensuring patient safety, noting that between 44,000 and 98,000 patients die each year in the USA as a result of a clinical error 1.
Healthcare providers should be aware that failure to adhere to guidelines or standards of care does not necessarily constitute negligence, but rather a deviation from the expected standard of care, as noted in the British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018 1 and the European Dermatology Forum consensus on the management of bullous pemphigoid 1. However, adhering to established standards of care and prioritizing patient safety is crucial to preventing gross negligence and ensuring the best possible outcomes for patients.
From the Research
Definition of Gross Negligence
Gross negligence in medical practice refers to a significant deviation from the standard of care, which can lead to harm or injury to a patient 2. It is argued that more clearly defined parameters are needed to distinguish ordinary, actionable negligence from gross negligence in a clinical context 2.
Characteristics of Gross Negligence
Gross negligence can be characterized by:
- An extreme departure from the standard of care 3
- A deliberate deviation from accepted rules or norms 3
- A failure to acquire sufficiently informed consent 3
- Inadequate monitoring or treatment 3
- A significant violation of medical protocols or guidelines 3
Distinction from Ordinary Negligence
Gross negligence is distinct from ordinary negligence, which is typically defined as a failure to conform to the standard of care 4. Gross negligence, on the other hand, involves a more significant breach of duty, which can result in serious harm or injury to a patient 2.
Factors that Contribute to Gross Negligence
Several factors can contribute to gross negligence, including:
- Poor communication or informed consent 3
- Inadequate training or expertise 5
- Insufficient monitoring or follow-up 3
- Failure to follow established protocols or guidelines 3
- Deliberate deviations from accepted medical practices 3
Determining Gross Negligence
To determine whether gross negligence has occurred, the following elements must be present:
- Duty: a healthcare provider's obligation to provide a certain level of care 6
- Dereliction: a deviation from the standard of care or a failure to meet the duty of care 6
- Damages: harm or injury suffered by the patient as a result of the dereliction 6
- Direct cause: a direct link between the dereliction and the damages 6