Case study and reflections library - Veterinary Practitioners Registration Board of Victoria
Back Main menu Next

Case study on providing veterinary care in an emergency

Published in the November 2015 issue of Vetboard Victoria's newsletter

The following case study provides an opportunity for general reflection. The case study is based on a complaint about an individual set of circumstances at a particular time. As veterinary knowledge and professional and community standards and expectations change over time, readers should not assume that the Vet Board would make the same decision when presented with a similar complaint.

A dog became seriously ill and was rushed to the nearest veterinary clinic. While in transit, the owners phoned the clinic to advise of their imminent arrival and were instructed that they should go directly to an emergency clinic as their clinic was busy and there would be a wait before the dog could be seen. By this stage, the owners had arrived at the clinic and entered with the dog - which was in a collapsed state.

The owners were met by the clinic’s receptionist, who again advised that it would be best to go elsewhere - as the clinic was due to close soon and there were other patients still waiting. The owners left the clinic and travelled a further twenty minutes to an emergency clinic. Upon arrival at the emergency clinic, the dog was found to be comatose, cyanotic, and with agonal gasping. Resuscitation was successfully undertaken; however, the dog’s condition did not improve and euthanasia was performed the following day.

The owners alleged that the first veterinary clinic was negligent in that they refused to provide veterinary care in an emergency situation. The complaint was raised against the practice principal of the clinic.

After a preliminary investigation, the Board did not find the requisite degree of evidence to support the allegation of unprofessional conduct, based upon the following reasons.

The preliminary investigation panel acknowledged that the dog was not offered veterinary care at the first veterinary clinic despite being presented in a collapsed state. In response to the Board, the practice principal advised that they were not working on the day in question but had since investigated the matter and established the following:
  1. There were three staff members working that day: a veterinary practitioner, a veterinary nurse, and a receptionist.
  2. The only person to liaise directly with the dog’s owners was the receptionist.
  3. The receptionist answered a phone call from the owners at approximately 3.30pm. The owners asked the receptionist if the clinic was open and advised that their dog needed to see a veterinary practitioner as it was unwell.
  4. The owners advised that they were in the car on their way to the clinic.
  5. The receptionist spoke with the veterinary practitioner on duty (who was in consultation at the time) and asked if the dog could be seen.
  6. The veterinary practitioner advised that they should go straight to an emergency clinic as there were other ill animals to be seen and as a result there would be a wait until the dog could be examined.
  7. At this stage, the owners entered the clinic with the dog.
  8. The receptionist established with the owners that she had just been speaking with them on the phone.
  9. Once the receptionist established that it was the same animal, she again discussed the situation with the veterinary practitioner.
  10. The veterinary practitioner was unaware that the owners and dog were in the clinic and reiterated the advice that the owners should go to an emergency clinic that provided after-hours care.
  11. The receptionist relayed the veterinary practitioner’s recommendation, and the owners left the clinic with their dog.

The panel considered that there was miscommunication between the receptionist, and the veterinary practitioner. There is no evidence that when speaking with the dog’s owners on the phone the receptionist enquired as to the dog’s condition and as such this important information was not available to the veterinary practitioner. The veterinary practitioner was also not advised that the owners and dog had arrived at the clinic. The panel was concerned that the arrival at the clinic of a patient in a collapsed state was not recognised by the receptionist nor communicated to the veterinary practitioner on duty.

Veterinary practitioners have an obligation under the Prevention of Cruelty to Animals Act 1986 (POCTA) to provide veterinary care to an animal in an emergency situation. Failure to provide veterinary care with the result that unreasonable pain or suffering is caused, or is likely to be caused, to an animal may be defined as an act of cruelty under POCTA. Further, refusal to treat an animal in such circumstances may be in contravention of the requirements of POCTA.

The panel acknowledged the seriousness of this incident. As well as having a legal obligation and a duty of care to provide veterinary care to animals in emergency situations, it is a reasonable expectation of the public that a veterinary practitioner will render care and assistance in situations where animals may be suffering and/or in pain.

In response to the Board the practice principal acknowledged that there had been a breakdown in communication between staff members, and that the receptionist was not adequately trained in dealing with emergency cases.

In response to the incident, the practice principal implemented the following changes in practice protocol:
  1. All emergency phone calls must be triaged by a veterinary practitioner or a veterinary nurse.
  2. If the animal is at the clinic it must be seen by a veterinary practitioner or a veterinary nurse.
  3. A recommendation that a client goes to an emergency centre can only be made by a veterinary practitioner, following an assessment of the patient.
  4. All staff are empowered to interrupt a consultation in the event of an emergency.

In reviewing this matter, the preliminary investigation panel considered both the incident and the practice principal's response to it. While the panel could not know if the failure to provide veterinary treatment at the clinic in any way influenced the eventual outcome, it acknowledged the gravity of the error made, and the potentially serious consequences which may have resulted from it. The panel further acknowledged the distress caused to the dog’s owners.

It is a practice principal’s responsibility to ensure that practice protocols and staff training are adequate and appropriate. In response to the Board, the practice principal acknowledged that both practice protocols and staff training were lacking in this instance, and the panel concurred. As a result of this incident, the practice principal took immediate steps to address the practice protocols, and offered the dog’s owners an unconditional apology. The panel was of the opinion that the emergency and triage protocols initiated by the practice principal were reasonable and the response to the matter was considered and genuine.

In weighing up the practice principal's conduct in this matter, the preliminary investigation panel, while acknowledging the gravity of the receptionist’s misjudgement, considered that the practice principal appropriately addressed the situation with the timely implementation of emergency triage protocols and an acceptance of responsibility with sensitivity and sympathy. The panel considered that the actions of the practice principal in responding to the situation were reasonable and did not constitute unprofessional conduct.

Relevant guidelines