Advice line: medical malpractice

As wheat bags are deemed an appropriate form of treatment, physiotherapists must take precautions to ensure they are practising safely, in line with HCPC standards. 

Recent examples of negligence that are difficult to defend include the case of a woman who presented for treatment following soft tissue injuries to her back. Treatment consisted of massage and application of a heat pack, which was heated for two minutes before application. The patient was advised to tell the physiotherapist if it became too hot. There was no indication of any redness or reaction, but the patient later went to her GP complaining of blistering. In a negligence claim it was admitted that there had been a failure to carry out hot and cold skin testing before applying the pack, and that a towel had not been placed between the heat pack and the patient’s skin. On balance it was admitted that the hot pack had caused the injury and the claim was settled in the sum of £3,500.

Last year a male patient presented for treatment following a musculoskeletal referral for hip pain. He was treated with a microwavable wheat bag. Following treatment, the patient presented to his GP with a third degree burn. A formal claim is pending.

Claims of this nature are entirely avoidable if precautions are taken, including:

• Hot and cold skin testing before application 
• Following the manufacturers’ instructions to ensure the packs are not overheated
• Avoiding direct placement on the skin by  using an appropriate barrier 
• Ensuring the wheat bag/hot pack is not left on the patient for excessive periods, ensuring skin is constantly monitored directly and by asking the patient. 

Members can find out more about legal guidance and support under the Society’s public liability insurance policy on the CSP website.

• Priya Dasoju is a former CSP professional advisor.