Law \ Legal

What Are The Four ‘Ds’ Of Medical Negligence?


In the period 2020/21, there were a total of 12,629 clinical claims made against the NHS. This figure was 133% higher than 2006/07 when just 5,426 claims were made and processed. Of course, we may have seen an increase in negligence claims following the coronavirus pandemic, when NHS resources were further stretched and a larger number of clinical errors were made.

Medical negligence claims are underpinned by ‘the four Ds’. What do these letters stand for and why are they so important?

1. Duty

We’ll start with duty, which describes the so-called “duty of care” that medical professionals have towards their patients.

In legal parlance, duty of care is an obligation that’s imposed on healthcare and similarly qualified professionals. In this instance, it outlines an agreed and reasonable standard of care while diagnosing and treating patients, including a broad range of acts that could foreseeably harm others.

The duty of care must be upheld consistently and at all times, while clinical and medical negligence cases are usually based on events where this has been breached. This is also one of the central pieces of evidence required to demonstrate your case and achieve any kind of compensation payout.

2. Dereliction

Dereliction is the term used to describe instances where medical professionals deviate from the standard of care required. This can manifest itself in a number of ways and at different stages of your journey as a patient. For example:

  • Missed Or Misdiagnosis: In this case, healthcare professionals (often doctors or nurses) either fail to spot the clinical signs of a condition or diagnose the wrong condition. This can cause conditions to worsen and cause irreparable harm over time.
  • Birth Injury: Birth injuries can be incurred by both infants and mothers, usually due to the failure to spot issues during late pregnancy or delivery. Head trauma is common here, so you may need to liaise with brain injury solicitors in this instance
  • Surgical Or Post-Op Negligence: Surgical errors are key drivers of medical negligence claims, while post-operative mistakes or carelessness can also cause significant damage. Common examples may include errors regarding anaesthetic dosing or working on the wrong body part.
  • Medication Error: This can occur at any juncture during the patient’s journey, while it usually sees doctors either administer an erroneous drug or utilise an incorrect dosage.

3 & 4. Damages And Direct Causation

We’ve combined the last two ‘Ds’ in this section, as they’re inextricably linked and central to every medical negligence case. Damages refer to the injuries, conditions and harm incurred by claimants. This can include both physical and mental ailments, while they may influence the extent of your compensation claim by causing a long-term loss of earnings.

The final ‘D’ refers to direct causation, as you’ll need to demonstrate the relationship between dereliction and damages for your claim to be successful.

Your medical negligence solicitor will usually help in this respect, as they’ll collate medical records and feedback to prove causation and demonstrate that healthcare professionals were at least partially at fault.


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