GUIDE UNDERSTANDING CLAIMS
Types of Medical Negligence: What Counts as a Claim?
Most people arrive at this question because something happened to them or someone close to them, and they want to know whether it was one of those things or whether it was avoidable. This guide sets out the main types of medical negligence recognised in England and Wales and, just as importantly, where the line falls between substandard care and an outcome that was nobody's fault.
What makes something medical negligence?
Medical negligence, also called clinical negligence, is not simply a bad outcome. It is a specific legal finding, and every claim has to pass through two separate gates. Failing either one ends the claim, however serious the harm.
The care fell below an acceptable standard
Treatment must have fallen below the standard of a reasonably competent practitioner in that field.
GATE ONE
The main types of medical negligence
Negligence is usually easiest to understand by where in a patient's care the failure occurred, rather than by which department was involved. The categories below overlap, and many claims involve more than one.
1. Failures in diagnosis
The largest single source of claims. The harm comes not from the original illness but from the delay in treating it.
Misdiagnosis - a condition wrongly identified, leading to the wrong treatment while the real problem progresses
Delayed diagnosis - a correct diagnosis reached too late for treatment to be as effective as it would have been
Radiology and imaging errors - an abnormality visible on a scan, X-ray or mammogram that was missed or misreported
Failure to act on test results - results returned but not reviewed, not communicated, or not followed up
Failure to refer - a patient not referred to a specialist or onto an urgent pathway when their symptoms warranted it
2. Surgical and procedural errors
rong-site or wrong-procedure surgery - operating on the wrong body part, the wrong side, or the wrong patient
Retained foreign objects - swabs, instruments or fragments left inside the body
Wrong implant or prosthesis fitted
Avoidable damage during surgery - nerve, bowel, bladder or vascular injury that a competent surgeon would have avoided
Anaesthetic errors - incorrect dosage, inadequate monitoring, or awareness under anaesthesia
Inadequate post-operative care - failure to recognise bleeding, infection or a leak in the recovery period
3. Medication and prescribing errors
Prescribing errors - the wrong drug, the wrong dose, or a drug contraindicated by the patient's records
Dispensing errors - a pharmacy supplying the wrong medication or strength
Administration errors - the wrong route, the wrong rate, or a missed dose in hospital
Failure to monitor - drugs requiring regular blood tests, such as anticoagulants or lithium, not monitored as they should be
Allergy failures - a documented allergy overlooked
4. Failure to monitor or to escalate
A patient deteriorates in hospital and the change is either not noticed or not acted upon. Common features include observations not taken at the required frequency, early warning scores calculated but not escalated, concerns raised by family and not acted on, and delays in a senior review.
Sepsis claims frequently sit in this category, where the signs of deterioration were recorded but treatment was not started within the window that would have made a difference.
6. Failure to obtain informed consent
A clinician must take reasonable care to ensure a patient is aware of any material risks in a proposed treatment, and of any reasonable alternatives, including doing nothing.
A risk is material if a reasonable person in that patient's position would attach significance to it, or if the clinician should reasonably be aware that this particular patient would. Where a material risk was not discussed, and the patient would have chosen differently had it been, a claim can follow even where the procedure itself was performed competently.
7. Infection, pressure damage and care-setting failures
Healthcare-acquired infections where infection control fell below required standards
Pressure ulcers that developed because risk assessment, repositioning or equipment provision was inadequate
Falls in hospital or a care setting where the risk was identified but not managed
Nutrition and hydration failures in patients unable to manage their own intake
8. Mental health care
Including failures in risk assessment, inadequate observation of patients known to be at risk, negligent discharge, medication errors in psychiatric prescribing, and failures to act on a deteriorating presentation. These claims raise distinct legal issues and are assessed with care.
That failure caused the harm
It must be shown that the substandard care caused or materially contributed to the injury that, but for the failure, the outcome would probably have been different.
GATE TWO
5. Maternity and birth injury
Claims arising during pregnancy, labour or immediately after birth, affecting the baby, the mother, or both. These include failures to monitor fetal heart rate, delayed emergency caesarean, injuries associated with instrumental delivery, undiagnosed shoulder dystocia, and failures to recognise or treat maternal complications such as pre-eclampsia, haemorrhage or sepsis.
Some of these injuries, including brain injury caused by oxygen deprivation at birth, have lifelong consequences, and claims of this kind are handled quite differently from others, with longer timescales and different limitation rules for children.
9. Dental and cosmetic treatment
Both sit within medical negligence but follow their own patterns. Dental negligence commonly involves undiagnosed periodontal disease, avoidable nerve damage, failed root canal treatment or negligent implant work. Cosmetic negligence raises particular questions about consent, given the elective nature of the treatment and the standard of information a patient should receive beforehand.
Not sure whether what happened to you counts?
That is the most common question we are asked, and there is no cost to asking it. We will tell you what we think, including if we think there is no claim.
Call 0330 818 7754 or email medicaldirectclaims@njslaw.co.uk