One game into the new Premier League football season and the reigning champions, Chelsea FC (or rather their flamboyant manager, Jose Mourinho) brought to the fore a prominent issue in the field of clinical negligence.
The fundamental principle behind any clinical negligence claim is that medical professionals have a duty to take reasonable care when treating their patients. This duty is reached if doctors achieve the standard of a reasonable and responsible body of medical opinion. If they act below this standard, they are negligent. If their negligence causes loss and damage to their patient, a claim exists.
The General Medical Council issues clear guidelines on good medical practice which need to be met in order for a doctor to maintain a licence to practise and satisfy the criteria for professional revalidation every five years. Maintenance of the duty of care from the doctor to the patient is fundamental to these guidelines.
Chelsea had been leading their opening game of the 2015/16 season at home to Swansea, when their goalkeeper was sent off, leaving them with ten players on the field. Sometime later, a tackle resulted in injury to one of their key outfield players. The referee signalled the Chelsea team doctor, who promptly attended the pitch to treat the injured player. Under Premier League rules, if a player receives medical treatment, they must leave the field before returning. This left Chelsea with only nine players temporarily, at an important moment in the game. They went on to sacrifice their lead and only drew the match.
After the game, Chelsea’s manager, Jose Mourinho, criticised the team doctor, calling her ‘naïve’ for attending the player at a crucial time. She has now been removed from her touchline duties and from even attending games.
The conduct of the Chelsea manager raises the issue of a medical professional’s duty of care to his or her patient, and whether these are balanced against the needs of a hugely successful sports club and brand, with its own sporting agenda – in Chelsea’s case, winning the Premier League!
Unsurprisingly, the incident has prompted discussion. The Premier League Doctors’ Group (PLDG) released a statement that expressed ‘concern' that Mourinho’s actions put out a message that results are more important than the wellbeing of players (patients). The statement said: “Doctors working for Premier League teams and attending matches in a professional capacity are bound by the same professional and ethical boundaries as any other doctor practising in the United Kingdom.”
A significant concern now is that other doctors in similar positions who value their role of employment will be dissuaded from acting appropriately and adhering to their professional duties to their patient. It is easy to imagine that team doctors may adhere to the implied expectations of their employer – that key players should be allowed to play even if injured - and this places their patients at considerable risk of long term, potentially career threatening injury, potentially due to negligence.
It is encouraging that the PLDG has spoken out promptly, raising concern at Mourinho’s conduct.
Although in this particular case the injury to the player was slight and transient, similar decisions could have far reaching consequences. The widely publicised case of Fabrice Muamba, the Bolton Wanderers player who suffered a cardiac arrest during a game in 2012, demonstrates this point. The prompt attention of the medical staff on that occasion proved life-saving. Had there been a delay or failure to treat appropriately, arising from internal team pressures, the outcome could tragically have been very different.