Contact one of our advisors now Call 0800 088 6004

What are the 4Ds of Medical Negligence?

Reasons to choose Wilson Browne

When you receive any kind of medical treatment you have to put your trust in the specialists who are looking after you.

From the nursing staff to consultants and other medical professionals, your health, welfare, and well-being is in their hands. In the overwhelming majority of cases, medical treatment goes as expected. Nothing is free of risk, however, mistakes sometimes do happen.

In some cases, the consequences can be severe and enduring. When something does go wrong during medical treatment you may be able to submit a medical negligence claim for compensation.

Making a medical negligence application

Medical negligence claims can be one of the most complicated personal injury claims to prove. No two cases are the same and they can range from minor to life-changing and permanent injuries. In some cases, negligence may be life-shortening or even fatal.

The procedure also differs between claims made involving the NHS and those made involving private sector health providers.

The 4Ds of medical negligence

Medical negligence claims require 4 types of evidence that your solicitor must prove for your claim to succeed. These are:


It must be demonstrated that a professional relationship existed between the patient and the medical professional, or the patient and the healthcare provider. This needs to be established because it confirms that a duty of care existed.

This duty means they have a responsibility to look after you for the entire duration of your treatment. If they’ve failed in this duty of care resulting in harm, either action or inaction, then they may be liable.

Duty can be proven through a variety of means including medical records that confirm a provider or professional was treating you. As a result, it’s one of the easiest aspects of a medical negligence claim to prove.


The second D that needs to be established in a medical negligence claim is dereliction. This occurs when a medical professional either deliberately or accidentally fails to follow professional care standards resulting in harm to the patient. For this reason, dereliction is sometimes known as deviation from acceptable standards of care.

Dereliction might occur when a professional may carry out unauthorised procedures, neglect a patient, or prescribe the wrong medicine. Dereliction of duty is important and establishing that it happened goes some way towards proving the strength of your overall claim.

Direct cause

Direct cause occurs when a specific action or failure to act by medical professional causes direct injury or harm to a patient in their care. Direct cause can happen for a variety of reasons. It might include operating on the wrong patient, or the wrong part of the body because a professional misread the notes.

Direct cause may also include misdiagnosis, wrong prescription of medicine, or leaving a medical item inside a patient after surgery. Direct cause is a varied category with a wide range of possibilities.


The fourth D is the damage that the medical negligence has had on the life of the victim. This includes the physical, psychological and financial impact. The financial figures will be calculated by the solicitor who represents you through your medical negligence claim, based on the injury compensation guidelines. These are set by the Judicial College which is part of the Ministry of Justice.

These guidelines help to reduce the possibility of disagreement over the financial consequences of certain aspects of medical negligence impact. This aspect of the claim will be supported by key evidence from medical records, expert witness testimony, prescription records, and the cost of any corrective treatment.

A complex process

Proving medical negligence took place can be a complex process. There are a lot of factors to attend to which is why it’s crucial to get professional legal support as quickly as possible in the process. At Wilson Browne, we have extensive experience in successfully representing people through medical negligence claims.

Our medical negligence service can assess the strength of your claim and advise whether or not a claim could be successful.

If you suspect you’ve been the victim of medical negligence then our professional medical negligence solicitors can help. Call 0800 088 6004 or contact us online to find out more.

Gemma Pabari


Gemma Pabari


Gemma is a Solicitor within the Medical Negligence Team. Gemma has experience in advising on a range of Medical Negligence claims, to include delays in diagnosing and treating Cauda Equina Syndrome, representing clients on matters arising from complications with pregnancy.