I have been working at Sir Charles Gairdner Hospital since I returned to Perth in 2004. I was keen to remain involved in health-related administration as I had been the manager of St John Ambulance in Broome for over eight years and really enjoy work with that focus. The number of staff at Charlie’s is greater than the populations of some of the small country towns in which I have lived, so at first I felt I would never find my way around the place, let alone get to know everyone.
The medico-legal team at Charlie’s is small – there are two of us, the Medical Administrator and the Senior Medico-Legal Officer (me). The Medical Administrator holds a degree in medicine and a degree in law. My training has covered civil and common law, consent, freedom of information, safety, quality and performance.
We live in an increasingly litigious society and although sadly sometimes things do go wrong in a large organisation such as a hospital, on occasion people enter into legal proceedings when they suffer a complication from a procedure about which they have been warned. When legal action commences, the Charlie’s medico-legal team becomes a sleuthing machine – no detail too small, no clue left unturned. We call for the patient’s medical record, imaging and pathology reports. From this we identify what happened and who was involved. We then notify the hospital’s insurer. The insurer retains a panel of legal firms with specialised knowledge of medical treatment litigation and appoints a legal firm that is suitable for each specific case. We support the panel lawyers by doing the ground work at the hospital, taking statements from staff, identifying relevant policies and procedures, and gathering all the information available to provide the defendant’s discovery in support of our position.
From time to time medico-legal matters are not settled at conference and proceed to trial. In these instances, the Medical Administrator and I attend court with the panel lawyers. More often, matters are settled over a series of informal conferences. If a patient instigates legal proceedings when they have consented to a procedure, knowing the risks and they lose the case, the hospital’s insurer will vigorously pursue costs. Therefore litigation is not something to be entered into lightly. Conversely, if the hospital is in the wrong and unfortunately this can happen, this is swiftly acknowledged and compensation is negotiated.
Besides the interesting aspect of putting the stories together, there is the human aspect of supporting distressed staff or consoling upset patients and their families. I have discovered that there is a storeroom at Royal Perth where spare parts that have been taken from people are retained. It was there that I found a prosthetic knee joint which was crucial evidence to support the hospital’s position in a recent case. Creepily, the fellow who found the prosthesis spoke in hollowed tones, leaving me picturing a hunchback named Igor bending over trays of spare eyeballs and other body parts, shuffling about in the gloom of the RPH dungeon.
Perhaps you need to be a little strange to love this work, to find humour in unlikely ways – but I really enjoy what I do. It is like painstakingly putting together a giant jigsaw, piece by interesting piece.