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, as highlighted in a recent study published in 2019 1. Key examples of gross negligence in medicine include:
- Performing surgery on the wrong patient or body part
- Leaving surgical instruments inside a patient
- Administering lethal doses of medication due to egregious error
- Failing to diagnose or treat an obvious, life-threatening condition
- Practicing medicine while severely impaired by drugs or alcohol To be considered gross negligence, the action (or inaction) must go beyond ordinary negligence or mistakes, as noted in a study from 2009 1. It involves 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. Healthcare providers can protect themselves from gross negligence claims by:
- Following established protocols and best practices
- Maintaining clear and thorough medical records
- Communicating effectively with patients and other healthcare team members
- Staying up-to-date with current medical knowledge and skills
- Recognizing and addressing their own limitations or impairments Understanding gross negligence is crucial for healthcare professionals to maintain high standards of patient care and protect themselves from severe legal consequences, as emphasized in a guideline from 2019 1 and another from 2015 1. It underscores the importance of vigilance, competence, and ethical practice in medicine.
From the Research
Definition of Gross Negligence
Gross negligence in medical practice refers to a significant deviation from the standard of care, resulting in harm to the 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.
Key Elements of Gross Negligence
The four Ds of medical malpractice, including duty, dereliction (negligence or deviation from the standard of care), damages, and direct cause, must be proved to have been present for malpractice to be found 3. Gross negligence can be considered a novus actus interveniens, breaking the chain of causation between a tortious act and the ultimate harm suffered by a plaintiff 2.
Distinguishing Gross Negligence from Ordinary Negligence
The concept of justification and excuse can be used to distinguish gross negligence from ordinary negligence 4. Medical conduct is justified when the benefits outweigh the risks, and the law sanctions the conduct and encourages future conduct under similar circumstances 4. Excuse, on the other hand, relieves a doctor of legal liability under specific circumstances, even though their conduct was not justified 4.
Prevention of Clinical Errors and Gross Negligence
Methods for preventing clinical errors, such as electronic prescribing systems, diagnostic and clinical decision-making aids, and error-resistant systems, can help reduce the incidence of gross negligence [(5,6)]. A good and ethical medical practice, with the proper use of technology, based on knowledge of scientific evidence and ethical principles of medicine, is critical in avoiding medical liability 6.
Characteristics of Gross Negligence
Gross negligence can result in significant harm to patients, and the frequency of adverse events in medicine is a major concern 5. The relationship between clinical errors and medical negligence is complex, and the characteristics of litigants and events that are the source of litigation can vary 5.