The MDU in action

Dermatology and cosmetic clinic cover scenario

27.09.24

The following is drawn from the real life experience of MDU risk advisory partners supporting healthcare organisations at times of crisis. It illustrates the depth of support and guidance available to MDUConnect members.

The scenario

A 33-year old woman attended a cosmetic clinic for advice on treatment of deep 'smile lines' in the nasolabial folds and loss of fullness and definition in her upper lip. Following a discussion, it was agreed that she would return the following week for collagen dermal filler treatment.

The treatment was provided without apparent complication, and the patient was given an information sheet to take away.

Five days later, the patient called the clinic distraught, as the areas where filler had been injected were lumpy and unsightly. She was reviewed that same day, and it was clear that there were several non-erythematous nodules in the areas that had been injected with filler.

The patient was reassured that the nodules would not be permanent and would resolve naturally, without further treatment.

Two weeks later, the clinic received a letter of complaint from the patient. She said that the clinician had played down the risk of any complication, saying it was a safe procedure. The patient stated that, if she had known she might look worse after the treatment, she would never have had it in the first place.

She demanded a refund of her fees and threatened to post negative reviews on social media.

Risks and impacts

In a scenario like this, of course a medical malpractice claim can arise, but there are many other avenues of potential investigation, some of which impact the corporate entity itself.

They include:

Complaint: a common impact that must be dealt with quickly and sensitively
CQC obligations: there is a need to follow the statutory duty of candour processes
Digital media: the risks of reputational damage following a patient’s review cannot be underestimated, particularly if the review is shared on social media.

Support from an MDU risk advisory partner

In a scenario like this, an MDU risk advisory partner (RAP) would be able to step in, supporting the business and ensuring that the incident and any fallout are dealt with in an efficient and professional manner. This support could include:

Duty of candour guidance: advice to the clinic on discharging its duties in accordance with the statutory duty of candour. Timescales for duty of candour notification to the patient are set out in statute and are short (notification is to be made as soon as is practicable).
Risk management advice: the process of explaining procedures to patients, must include benefits and risks, in order to obtain informed consent. Seeing the patient before treatment offers a good opportunity to provide both bespoke advice and general literature on dermal fillers.
Complaint resolution: advice on a suitable draft response to the complaint, including advice on how to approach making an ex-gratia payment of the cost of the treatment fee. Although the patient had threatened to post negative reviews about the company on social media, dealing with the complaint promptly, empathically and professionally is likely to lessen the risk.
Employee disciplinary support: if considered necessary, advice (via partner organisation) on disciplinary/employment matters relating to the clinician. The (Peninsula) team provides 24-hour employment law and health and safety advice through dedicated consultants with in-depth experience in employment legislation, contractual requirements, and case law precedents; telephone coaching when managing difficult or complex employee relations and access to a team of specialist solicitors who can advise on contractual matters.
Reputational risk: advice from the MDU’s media team on how to manage scrutiny on social media, taking into account the need to maintain strict patient confidentiality.