It is not only medical practitioners who owe a duty of care to their patients, in conducting themselves with reasonable skill and care. Adminstrative staff at hospitals and doctors’ rooms, e.g. a receptionist at an accident and emergency unit, owe a duty not to provide misinformation to patients. By Donald Dinnie, CEO of Natmed Medical Defence.

The provision of inaccurate information by non-medically qualified staff, resulting in a delay in the provision of urgently required medical attention and, possibly, in serious physical injury being suffered, will attract a liability for that person and their employer when acting in the course and scope of their employment.

Recently, the English Supreme Court of Appeal (in the case of Darnley v Croydon Health Services NHS Trust) had to consider – among other things – whether the hospital operating the emergency unit owed a duty of care when providing, via its receptionists, information as to the period of time within which medical attention was likely to be available. Strangely, two lower courts had held there to be no such duty.

The patient in question had attended the emergency department after being assaulted and struck over the back of his head. He told the unit’s receptionist he was feeling unwell and his head was hurting. The receptionist told him he would need to sit down, and wait four to five hours before somebody looked at him.

The patient sat down, as instructed, but left after 19 minutes without informing anyone of that fact. The patient went to his mother’s house, where his condition subsequently deteriorated and he was consequently admitted to another emergency unit late that evening. His diagnosis included a large extra-dural haematoma overlying the left temporal lobe and inferior parietal lobe, with a marked midline shift.

He underwent an emergency evacuation of the haematoma, but was left with permanent brain damage in the form of a disabling left hemiplegia.

In his claim, the patient alleged – among other things –  that a breach of duty had been committed by the non-clinical reception staff concerning the length of time he would have to wait.

The Supreme Court held it has long been established that a duty of care is owed to patients by those who run and provide casualty departments, to those presenting themselves and complaining of illness/injury, and before they are received and treated in the hospital’s wards. There is a clear duty not to cause physical injury (which was the nature of this injury).

The duty is owed by the hospital, and it is not appropriate to distinguish in that regard between medical and non-medical staff. The hospital had charged its reception staff with the responsibility of first point of contact, in order that patients would be provided with accurate information from the outset as to the availability of medical assistance.

The court referred to an earlier judgment involving the London Ambulance Service, which also founded its liability judgment on the basis that a call handler had given misleading assurances of an ambulance arriving shortly.

It is, of course, not the function of such staff to give medical, or wider general advice and information to patients. But there is a duty inherent in their role not to provide misinformation to patients. The duty of reception staff at hospitals extends, similarly, to not providing any misinformation to patients.

In considering whether there was a negligent breach of that duty, the court said it did not expect a receptionist to provide accurate information to each patient as to precisely when they would be seen, or to give medical advice or information. And the fault did not lie in the hospital allocating the first point of contact to a receptionist. But, they said, it is also not unreasonable to require those in the reception role take reasonable care not to provide misleading information on the likely availability of medical assistance.

The ultimate outcome is not surprising. The position in South African law would be the same. Staff at hospitals, emergency units and doctors’ rooms should all take heed and conduct themselves accordingly.