Cryotherapy complication

...The FY2 had been trained in using liquid nitrogen cryotherapy… but the following day the patient developed blisters on her hands on top of the warts...

A 52-year-old woman, Miss C, was diagnosed with warts on her hand by her GP. Dr R arranged for her to undergo treatment with liquid nitrogen in the practice.

On her fourth visit to the clinic, Miss C was seen by a foundation year 2 doctor, Dr L. The FY2 had been trained in using liquid nitrogen by Dr R and was deemed competent at the procedure. However, following this latest cryotherapy treatment, Miss C developed blisters on her hands on top of the warts with surrounding redness and was prescribed antibiotics by Dr R.

A few days later they had still not improved and Miss C sought help from her local A&E where the blisters were surgically cleaned and dressed. She was unable to work for several weeks while the wounds healed.

Analysis and outcome

Miss C’s GP practice carried out a significant event analysis following the incident and found that the length of liquid nitrogen treatment in the fourth visit fell outside the recommended guidelines. This prompted them to review their procedures. Miss C lodged a complaint of negligence against both Dr R and Dr L in relation to the cryotherapy. MDDUS lawyers advising Dr R agreed with Dr L’s representatives on a modest joint settlement to the patient in regard to Dr L’s actions under supervision of Dr R.

Key points

  • Doctors in training share responsibility for their own actions or omissions, even if following processes advised by seniors.
  • Ensure safe working practices are in place for treatments using liquid nitrogen.

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