Chaperone essential

01 March 2007

Dr R, a young Foundation Year 1 doctor, saw an A&E patient presenting with abdominal pain. Dr R undertook appropriate investigative procedures which included a rectal examination. After recovery 6 months later the patient alleged that Dr R had performed the rectal examination without her consent, and without the use of a chaperone. The patient directed her complaint to the hospital and to the GMC.

An MDDUS medico-legal adviser offered Dr R assistance and support throughout the investigation by the GMC which included meetings, liaison and review of appropriate paperwork and case notes. The GMC decided in this case to take no further action and directed the matter back to the hospital.

The hospital complaints officer called a meeting and asked the doctor for an account of the incident.  The doctor admitted that he had performed the examination without a chaperone and apologised for this, but he insisted that he had obtained the patient's consent to undertake the examination.

Analysis and outcome

Ultimately, the patient accepted an apology by the hospital on behalf of the doctor, and a reassurance that in future the doctor would ensure that the patient understood the purpose and nature of a proposed examination and that he would use a chaperone when an intimate examination was required.

Key points

• Be aware of local Trust policies on the use of chaperones.
• Consent must always be informed: ensure patients fully understand the purpose and nature of procedures.
• Foundation doctors are advised to consult with supervisors before carrying out intimate examinations, except in emergency situations.

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