Allegations of sexual assault in healthcare settings carry serious implications for healthcare providers, hospitals, and medical professional liability (MPL) carriers, and inevitably cause significant distress to patients.
Medical Protection is an international member-owned and not for profit protection organization. The following case study outlines the support offered by Medical Protection to Dr. X after he called the 24-hour advice line.
Case Study
Dr. X had been called to a meeting with his medical director and head of HR and informed of his immediate exclusion from work. A 24-year-old female patient he had seen the day before had raised a concern, and the matter had been referred to the police.
No further information about the nature of the complaint was forthcoming. Dr. X was understandably very distressed.
How Medical Protection Helped
After calling the advice line, a Medicolegal Consultant (MLC) discussed the events of the day before. Dr. X recalled seeing a patient fitting the description given and noted that she had left the room abruptly at the end of the consultation. He explained that she had presented with a two-day history of severe retrosternal chest pain. She had no significant cardiac history, and was otherwise fit and well, though she had twisted her ankle while playing tennis the previous week and had been taking regular analgesia since. Dr. X felt that the history was consistent with a diagnosis of gastro-oesophageal reflux. Cardiovascular and abdominal examinations were reassuringly normal. He advised the patient to avoid ibuprofen and provided a short course of omeprazole.
Dr. X was advised that he should get in contact with Medical Protection again without delay if contacted by the police, and before making any comment. Permission was sought to instruct a legal adviser on his behalf, and an urgent case file was opened. Sources of personal support, such as the free counseling service offered by Medical Protection, were discussed.
The following day, a legal adviser and the MLC arranged a meeting with Dr. X. A draft statement, based on his interaction with the patient identified as the potential complainant, was prepared. Dr. X mentioned that a medical student had been shadowing him that day, and had seen a number of patients with him, although he was unable to recall which. Unfortunately, he had not documented the presence of the student in the notes.
What Happened Next?
Five days later Dr. X was invited to a police interview under caution. The legal representative and MLC talked Dr. X through the police interview process and discussed the wider potential implications of the complaint.
He attended with the Medical Protection legal adviser, who had liaised with the police to confirm the identity of the patient and the nature of the concern. The police stated the patient had alleged that Dr. X had inappropriately touched her breast while examining her. During the interview, Dr. X explained to the police the clinical examination he had conducted that day and the rationale for doing so. He recalled that the patient had consented to examination but acknowledged that he had not fully explained what this would involve, nor the reasons for it. He explained that it can be necessary to move the breast to facilitate auscultation, and that on occasion the side of a hand or the stethoscope may touch the breast during an examination of the cardiovascular system. He stressed that he had acted in accordance with his usual practice that day.
The medical student was contacted and subsequently interviewed by the police. He had been present during the consultation and confirmed Dr. X’s account.
How It Ended
Ultimately, the police case was closed with no further action. Unfortunately, doctors often face a situation of “multiple jeopardy” with a single incident leading to investigations by multiple bodies. Although Dr. X was allowed to return to work soon after the conclusion of the police case, the police informed the UK’s General Medical Council (GMC), which regulates doctors, who in turn opened their own investigation.
Medical Protection assisted Dr. X with this also, with the MLC providing advice on reflection and remediation, including emphasizing the importance of clear communication and the value of considering a chaperone, even for more routine examinations.
The complainant refused to engage with the GMC process, which was subsequently closed with no further action.
Takeaways
Allegations of sexual assault against doctors are rare but may arise due to poor communication and/or a misunderstanding on the part of a patient. It is important to explain what an examination will involve, and why it is being done. While the presence of a chaperone can be helpful for both the doctor and patient, it does not mean a complaint will not be made. The presence of a chaperone should always be documented in the notes.
Medical Protection provides expert support and advice to doctors facing criminal investigation arising from a clinical interaction with a patient. In addition, access to the Medical Protection advice line is unlimited, and the number of times a member calls has no impact on their subscription rate.