From Bolam-Bolitho to Modified-Montgomery - A Paradigm Shift in the Legal Standard of Determining Medical Negligence in Singapore. Andrew Lewis QC dismissed the assertion that this was a case of ‘pure diagnosis’ on the basis that it was the claimant’s case that a range of diagnoses were available upon interpretation of each of the CT scans and that the alleged failure was to perform a specific test (a biopsy) to confirm the correct diagnosis. Inadequacies of the Bolam Bolitho standard First, a key criticism of the Bolam-Bolitho standard is the decaying notion of medical paternalism it seeks to perpetuate. The claimant’s case was that following the first and second CT scans, the omental mass seen on imaging should have been biopsied which would have confirmed a diagnosis of actinomycosis. It ultimately required surgical drainage and multiple surgical interventions; following which, microbiology evidence confirmed actinomyces. Further evaluation was recommended by the reporting radiologist. But the Bolam test is the test for medical negligence and has been routinely rolled out for all types of case for decades. In this case Lord Browne-Wilkinson reminded the court that they are In the case of Brady, Mr Lewis considered the classic statements of Bolam and Bolitho and their respective application in ‘treatment cases’ - where a doctor recommends or undertakes a particular treatment or further diagnostic procedure. In Bolitho v City and Hackney Health Authority, 1997, Lord Browne-Wilkinson restricted the boundaries of Bolam, stating , when he attempted to objectively quantify the expected and required standard of care. It would also introduce a test of culpable fault much harder for defendants to meet than that represented by the Bolam test (even when modified by Bolitho (24)). In 1957, The Bolam Test had stipulated that no doctor can be found guilty of negligence if they are deemed to have acted “in accordance with a responsible body of medical opinion.” The claimant’s case concerned the delayed diagnosis of actinomycosis; a rare, infectious disease in which bacteria spreads from one part of the body to another through body tissues. Neo HY(1). Bolitho test A legal test that modified the 1957 Bolam test, which the English courts had been using to determine medical negligence by a doctor or nurse. Between May 2013 and February 2014 the claimant developed a left-sided psoas abscess containing gas and fluid. A doctor is not guilty of negligence if he or she has acted in accordance with a practice accepted as proper and responsible by a responsible body of medical practitioners skilled in t… In Bolitho v City and Hackney Health Authority, the House of Lords followed and applied the ‘Bolam principle’. Between May 2013 and February 2014 the claimant developed a left-sided psoas abscess containing gas and fluid. If past medical decisions could be rendered 'logical' by future developments, why would the reverse not also be so? The Bolam Test has formed the backdrop to all clinical negligence cases since 1957, providing a cornerstone for the defence of these claims. The classical legal standard of care taught to all budding clinical negligence practitioners is quoted from the judgment of Bolam v Friern HMC [1957] 1 WLR 582: “[The doctor] is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art… Putting it the other way around, a man is not negligent, if he is acting in accordance with such a practice, merely because there is a body of opinion who would take a contrary view.”. What if they are not following a recognised practice, but time and advancements in treatment prove them right? The Bolam Test is a means of assessing clinical negligence in Court. The application of Bolam and Bolitho has come under criticism before in the matter of Muller v Kings College Hospital NHS Foundation Trust. Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 is an English tort law case that lays down the typical rule for assessing the appropriate standard of reasonable care in negligence cases involving skilled professionals such as doctors. That would be an unlikely sea change in clinical negligence. Had this been diagnosed, the ensuing deterioration and treatment in February 2014 would have been avoided. Doctors owe a duty of care to their patient. These were the question facing the court in Jones v Taunton and Somerset NHS Foundation Trust [2019] Med LR 384. Clyde & Co LLP is a limited liability partnership registered in England and Wales. Bolam therefore appears to have become concretised, and Bolitho has not had any major impact on the scope and force of this decision. Over time, it can result in linked abscesses, pain and inflammation. Bolitho v. City and Hackney Health Authority 4 All ER 771 is an important English tort law case, on the standard of care required by medical specialists. Penningtons Manches Cooper LLP is a limited liability partnership registered in England and Wales with registered number OC311575 and is authorised and regulated by the Solicitors Regulation Authority. During the relevant period, the patient underwent two CT scans on 2 August 2013 and 18 September 2013. Bolam-Bolitho to Modified-Montgomery—Han Ranch Homes For Sale In Middletown, Ny,
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