General Advice

Mandatory Reporting In The Medicolegal Setting

The national law governing health practitioners in Australia contains a subsection dealing specifically with mandatory reporting. This is where practitioners who are aware of some significant underperformance on the part of a colleague are obliged to report that underperformance for investigation and appropriate management if necessary. This is most commonly seen in a clinical setting, in a hospital or an environment where clinicians are able to observe each other.

Consider this Scenario

Occasionally, this can also arise in the medicolegal setting. I recall a telephone call from a colleague received recently. He had seen a young woman who had sustained a seemingly relatively innocuous injury to a knee joint and who had been managed variously by three orthopaedic surgeons over a four year period. The woman was in her late twenties and over that four year period, with those three orthopaedic surgeons, had undergone no fewer than twelve operations. It appeared that some of the operations were particularly unwise and possibly poorly performed. For example, the ninth operation was the performance of a total knee replacement. This would be a very uncommon operation for a woman in her late twenties who was otherwise relatively fit and well. The tenth and eleventh operations were aimed at eradicating overwhelming sepsis within the joint. The operations were poorly timed, poorly performed and destined to fail. Unfortunately, the final operation was in the form of an above knee amputation.

The question posed by my colleague in the telephone conversation was how he should go about addressing the matter outside the medicolegal arena.

It was clear to me. He had no option but to advise AHPRA (Australian Health Practitioner Regulation Agency) of the sequence of events and leave it with them. Whilst I do not have total confidence in the system, there is no better avenue available. At least he could expect a thorough investigation and hope for appropriate action thereafter. Simply letting the matter rest would be unacceptable.