Any action against a laboratory or an individual for failing to pass on a
result would be in Negilgence and if a patient seeking damages in such
actions are required to demonstrate three things:
1) a duty of care was owed to the patient (seldom contested). 2) there was a
breach of that duty of care  and 3) any damage was a direct consequence of
that breach of duty. Point 3 is most difficult to prove but is required if
liability is established. If points 1 and 2 can be proven, negligence can be
established. In determining whether there is a breach of a duty of care, the
standard legal test is the "Bolam" test which dates fromn a case in the 50s.
By this, a doctor is not negligent if he is acting in accordance with the
practice of a reasonable body of competent professionals. (While the cxase
concerned medical negligence, similar statements were made with regard to
the practice of other professionals). In other words, if you had acted as
other reasonable professionals in your specialty would have acted then you
cannot be held to be negligent. Further case law has established that
- if there are two schools of thought, then the court is not at liberty to
chose one approach over the other.
- the approach adopted must stand up to "logical analysis"

In the case outlined, if the consultant (or other lab person) got the GP
answer phone and simply put the report aside until the following morning
then strictly speaking he would not be deemed negligent if other similar
professionals would act in exactly the same way, though he may have to
defend his actions and the "logical analysis" rule might apply.

If, as Trevor suggests, every reasonable effort seems to have been made and
only then was the matter deferred 'til the following morning, then the
action taken is more likely to be in keeping with the reasonable actions of
the profession and you could not be held negligent even if someone else in
the circumstances would have sent an ambulance to collect the patient.

I suppose the cynic might say if you'd put the sample in the fridge
overnight, the situation wouldn't have arrisen!!

Joe Begley
Poole Hospital

-----Original Message-----
From: TICKNER TREVOR (RM1) Norfolk and Norwich NHS Trust
<[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Monday, January 15, 2001 2:38 PM
Subject: Re: LABS NOTIFYING URGENT RESULTS TO GP'S OUT OF HOURS


>We have a similar problem and I have spent up to 4 hours trying to find a
>responsible recipient for the results. The local view is that it is the
>responsibility of the lab to inform the GP or his/her deputising service
and
>it is the responsibility of the GP/service to ensure that such information
>can be received/acted upon in a timely manner. As a matter of good medicine
>I suspect I am duty bound to do all that is possible to protect the
>patient's best interests. If the best one can do is 'phone the next morning
>so be it. I should be interested in the opinions of those with a
>medico-legal background.
>
>Trevor Tickner
>
>> -----Original Message-----
>> From: Peter Stromberg [SMTP:[log in to unmask]]
>> Sent: 15 January 2001 14:07
>> To:   [log in to unmask]
>> Subject:      LABS NOTIFYING URGENT RESULTS TO GP'S OUT OF HOURS
>>
>> In our hospital most of the ward work comes in in the morning and the
>> samples from general practice from noon onwards.In very busy days or days
>> with lots of technical problems the GP work carries on into the evening
as
>> we have a policy of not leaving any routine work to the next day.All of
>> the GP's subcontract to an emergency medical service which has no means
of
>> contacting GP's outwith office hours .About every week or so we come
>> across an unexpected high glucose  etc which we are unable to pass over
to
>> any doctor responsible for this patient.One doctor ,working for the
>> emergency medical service said that GP's would know when results are
going
>> to be significantly abnormal and would phone the lab for the results.With
>> the slow introduction of extended working days,shift systems etc.this
sort
>> of problem is bound to increase.Am I over-reacting to a non-problem or is
>> this a medicolegal accident waiting to happen?
>>      A general practitioner takes off a glucose at 1200 and sends the
>> sample which arrives in the lab at 1600.It is a bad day and the sample
>> result is not available till 1830.The biochemist attempts to phone result
>> but gets no-where.The result is phoned to the GP surgery the next morning
>> and the doctor goes to the house to find the patient dead.The Fiscal
>> (Scottish coroner equivalent ) may say that the lab had the sample ( with
>> a glucose of 40 mmol/l) for for 16 hours and did nothing about it.
>>        Should I be setting up some kind of administrative mechanism to
>> deal with problems like this or am I just over-reacting?What would you
do?
>>
>>
>---------------------------------------------------------------------------
>The information contained in this e-mail is confidential and is intended
>only for the named recipient(s). If you are not the intended recipient you
>must not copy, distribute, or take any action or reliance on it. If you
have
>received this e-mail in error, please notify the sender. Any unauthorised
>disclosure of the information contained in this e-mail is strictly
>prohibited.