Once Bitten...Treat With Caution, Medical Defence Union Advises

Main Category: Primary Care / General Practice
Also Included In: Veterinary
Article Date: 28 Feb 2008 - 13:00 PDT

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The Medical Defence Union (MDU), the UK's largest medical defence organisation, is warning GP members to ensure they take particular care when treating patients with dog bite injuries. The MDU has assisted a number of GP members in recent years following allegations of failure to treat or refer such patients appropriately.

MDU medico-legal adviser Dr Michael Devlin said: "According to NHS statistics, the number of people attending Accident and Emergency Departments with dog bite injuries has risen by more than 40 per cent in the last four years and it is inevitable that many more people will visit their GPs after a bite from a dog or another animal. If not properly managed, animal bites can have serious repercussions for the patient, including infections, scarring, nerve damage, psychological effects and even death, which is why we are warning GP members to take particular care in assessing trauma caused by animal bites."

The MDU has issued the following advice to its GP members, aimed at avoiding the pitfalls of treating bite injuries:

- As with all aspects of patient care, it is important to keep detailed contemporaneous records. With bite wounds, it's worth taking particular care to record as much as possible about the bite - including diagrams, if your note-keeping system allows for this - and whether the animal was known to the patient or if the trauma occurred abroad.

- Recognise and work within the limits of your competence. If you have concerns about your ability to treat the injury you should refer the patient without delay to an appropriate specialist or Accident and Emergency Department.

- In previous cases, the MDU has received expert advice that the risk of infection with cat bites is high as they are puncture wounds and not easy to clean. It is sound practice after washing the wound to prescribe an antibiotic (bearing in mind that Pasteurella multocida is a common pathogen). Consequently, it may be necessary to consider specialist advice or referral in such cases. Moreover the patient should be warned that if there is not a quick improvement they should waste no time in seeking further medical help.

- If the dog attack is serious and the police become involved, GPs may be asked to disclose patient information. In such cases, you should follow the GMC's guidance in Confidentiality: protecting and providing information (2004) and obtain the patient's consent to disclosure.

- Contact your medical defence organisation as soon as you are aware of an adverse incident.

MDU Services Limited (MDUSL) is authorised and regulated by the Financial Services Authority in respect of insurance mediation activities only. MDUSL is an agent for The Medical Defence Union Limited (the MDU). The MDU is not an insurance company. The benefits of membership of the MDU are all discretionary and are subject to the Memorandum and Articles of Association.

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