Mistakes no reason for junior doctors to quit, judge says

Junior doctors who work long hours under pressure should not lose heart or abandon medicine if they make mistakes, a top judge has said.

Doctors were human and even good and conscientious ones might fall short from time to time, said Lord Justice Jackson

He was ruling on an appeal by the mother of a brain-damaged teenager against the High Court's dismissal of her negligence claim against the hospital that treated her.

The mother, identified only as WAC, took her then one-year-old daughter to the accident and emergency (A&E) department of Princess Alexandra Hospital in Harlow, Essex, in September 2003.

She alleged that the senior house officer who saw the child failed to take an adequate history before discharging her.

If she had, the child would have been referred to the paediatric team and given antibiotics that would have prevented the spread of meningitis.

As it was, she was very ill when she was admitted to the hospital that evening and later transferred to Great Ormond Street.

Now 14, she has learning difficulties and is profoundly deaf.

On Friday at the Court of Appeal, three judges said the High Court's decision in March in favour of Princess Alexandra Hospital NHS Trust could not stand.

Lord Justice Jackson said the conduct of the doctor must be judged by the standard of a reasonably competent senior house officer in A&E.

The required standard of skill and care was not diminished because she was 25 and relatively inexperienced.

History-taking was a basic skill that hospital doctors at all levels were expected to possess.

The fact that the child's eyes had been rolling and uncoordinated was the event that precipitated the hospital visit.

He did not accept the judge's conclusion that only a more senior doctor could reasonably have been expected to elicit this important fact, which had been picked up by the ambulance staff.

He acknowledged that junior hospital doctors worked long hours under considerable pressure, were often involved in life-and-death decisions and the pressures could be even greater when they were working all night, as this doctor was.

"If mistakes are made, it is devastating for the patient and it is expensive for the NHS trust," he said.

"Doctors, however, are human. Even good and conscientious doctors may, from time to time, fall short.

"That is not a reason to lose heart or, even worse, to abandon medical practice.

"Those who have learnt from past mistakes often have even more to offer."