disadvantages of the bolam test

Informed Consent in Patients Undergoing Primary Hip and Knee Arthroplasty: What Do Patients Want to Know? 3.Mr. (2) "However, where there is a body of medical opinion which . A never event is defined by the NHS as a serious incident that could have been prevented by following the safety recommendations and guidance that are in place to ensure they dont happen. Furthermore, it can be beneficial if youre concerned about the legal costs often associated with legal representation. PDF. This rumination is characteristic of a protectionist partiality towards specialists in the medical terrain where allegedly patient rights are readily discarded. If you use a No Win No Fee solicitor, this can allow you to avoid upfront costs and any additional costs incurred over the course of your claim. Bolitho's test The Bolitho test evolved from the case of Bolitho v. City and Hackney Health Authority (1997), which challenged the approach of medical negligence taken in the case of Bolam. This page was . Ultimately, it was on this divergence of opinion that the defendant doctor was able to successfully refute the negligence claims. A principal battleground: Paternalism at odds with Autonomy. What proves to be a distressing quagmire in medical negligence claims is the sour ordeal faced by the patient may leave him feeling disappointed with the administering of treatment. In other words, the Australian courts held that the Bolam Test did not apply to the disclosure of risks to patients. Due to McNair Js verdict, judges are significantly distanced from affairs. The test considers whether any other reasonable healthcare professional would have acted as the defendant did. The graph below shows the nature of the 131 never events that occurred between April and July 2021. Unauthorized use of these marks is strictly prohibited. The so-called 'Bolam test' establishes whether a medical professional has breached their duty of care to a patient and confirms that negligence is not established if the doctor has acted in accordance with a practice accepted as proper by a responsible body of opinion. It is only just that adjudicators recognise this pose to avert any vexatious claims, but at the same time they must not err on the side of strictness to an extent where the conviction that health is a fundamental good is altered into the belief that medicine is a fundamental good[20]. Hence, the oral delivery of medical evidence was attributed undue weight alongside an uneasiness of following the American trend of sharp rises in litigation. Please enable it to take advantage of the complete set of features! HHS Vulnerability Disclosure, Help If the correct standard of care could have avoided the harm or worsening of your condition had they provided you with the correct standard of care, then this is an example of medical negligence. The issue was therefore whether on the facts, the SHO failed to take an adequate history. Accessibility If you are the original writer of this essay and no longer wish to have your work published on LawTeacher.net then please: Our academic writing and marking services can help you! 8600 Rockville Pike Conversely, the medical practitioner will dislike and disparage any attempt to undermine the notion that the doctor knows best. One of the recent cases includes the case of Middleton (by his Father and Litigation Friend, Gavin Middleton) v Ipswich Hospital NHS Trust, the claimant brought a claim for damages for clinical negligence from the defendant NHS Trust. In considering whether the Defendant was negligent in the manner in which it carried out the treatment, McNair J confirmed that: the true test of establishing negligence in diagnosis or treatment on the part of a doctor was whether he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art (p.587). For instance, when a scan is performed to diagnose the condition, the interpretation of the results are either right or wrong. He claimed negligence for not being: However, the decision was in favour of the hospital, as the Court found the doctor had followed normal practice. In the next section, we will look in greater detail at the role played by informed consent in medical negligence cases that use the Bolam test. The House of Lords, in Maynard[44], discussed the general principles relating to the standard of care in medical negligence cases and confirmed the locus classicus of Bolam. Data Sent To The Wrong Address - How To Claim, A Guide On How The Bolam Test Case Applies To Medical Negligence Claims. The judge ruled in her favour on the basis that doctors should tell patients what they want to know rather than what they think the patient should know. Here a breach is revealed once a doctor has descended below the recognised standards of practice on the clinical scale and consequently, by act or omission, inflicted some sort of detriment upon the patient. Bolam test has been adopted for decades in various cases. Were fully committed to handling personal information youve supplied to us in compliance with the latest GDPR laws, and well never share your details. Considering the notion of autonomy only picked up pace towards the early 1960s, Bolam was simply seen as reinforcing the law and any yielding by the judiciary was due to factors such as seniority, reputation and performance in court[40]. Therefore, the only possible occasion where paternalism may benefit an individual is in the instance where a new life is championed as superior to one that may have otherwise been led[19]. This includes things like: Failing to do so could result in a patient suffering avoidable harm through negligence. The part of your settlement that covers these costs is called special damages. Negligence occurs as a result of a person breaching a duty of care that is owed to another person, and the damage that consequently ensued was not too remote to that breach. Please get in touch on the details below: Our guide will look in detail at the case of Bolam v Friern Hospital Management Committee [1957] WLR 582. The medical province was however, able to find sanctuary under the aegis of an English court room where judges had developed a vehement and preservative attitude towards this universally revered vocation. We understand that we have covered a lot of information so if you have any questions, please dont hesitate to get in touch with our team. Hence as Illich attests, an individuals wellbeing is akin to the degree of lived freedom[14]. While this procedure causes you additional harm, its a necessary part of your treatment, and your doctor would not be considered negligent for performing it. Health is preeminent in all humans, and its sustenance has direct ramifications for individual autonomy. Moreover, an abundance of recent academic opinion chronicling the debate surrounding this contentious area shall be investigated to verify the claim that Bolam is not the unstoppable juggernaut[6]it once resembled. If youve been caused avoidable harm or a worsening of your condition as the result of medical negligence, you may be able to claim. Sandiford NA, Mahendra M, Wickramarachchi L, Back D, Bansal M. Cureus. Generating the most equitable outcome is much more difficult in both practice and theory. However, Muller argued against the use of the Bolam test in this particular circumstance. Cases of medical negligence involve a doctor directly causing you harm or your condition to worsen. This led to her making a claim on the grounds that, had the doctor told her the risks, she wouldnt have consented to the surgery. Bolam had not been warned of the potential risks of the procedure. Bolitho test. call us on: 100% No Win, No Fee Claims Whether this mindset is a consequence of a lucid admiration for the esteemed profession or due to the complexities of medical evidence, it is coherent that this partiality has manifested in the past. The biggest rejection of the Bolam Test came with the Supreme Court ruling in Montgomery v Lanarkshire Health Board (2015) in relation to consent. Akin to the court affairs in Bolam, there was a schism between the medical judgments as one body of medical opinion endorsed the defendants view whilst another body disapproved of the conduct. They stated that any histopathologist acting with reasonable care and skill could have made the same mistake. NG1 5EF MeSH It is apparent that a strict application of Bolam is not appropriate in all medical negligence cases. Br J Hosp Med (Lond). It thus follows that an inquisition into the repercussions of the Bolam decision is necessary to contextualise the various criticisms and allegations enveloping the case. Federal government websites often end in .gov or .mil. Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not reflect the views of LawTeacher.net. The changing face of medical negligence law: from Bolam to Bolitho. The Human Rights Act 1998 gave individuals in the UK recognised autonomy over their own bodies. In this guide, we will look in greater detail at the duty of care owed by healthcare providers and how this can be breached. Specifically, the second limb of the test warrants that the detriment endured has a causal link to the negligent act. the court uses the Bolam test.1 This article explores the limits of the Bolam test, and examines the recent shift in the way the legal stan-dard should be determined in medical litigation. It could be argued that this part of the test does not really afford a distinctive bias towards the medical profession than it would to any other line of work. For further details on how to claim for medical negligence, see our guide. It has already been applied to solicitors and investment professionals. For that reason, it can help to have a solicitor experienced in handling these types of cases and helping you get the compensation you deserve. As you can see, the most common was wrong-site surgery. Financial Matters After Divorce. Medical Law - English Tort Law - Lecture on Medical Negligence / Malpractice and Bolam Test*UK LAW* - Essential for Medical Interviews & Examinations of all . Essays, case summaries, problem questions and dissertations here are relevant to law students from the United Kingdom and Great Britain, as well as students wishing to learn more about the UK legal system from overseas. Its important to be aware that not all harm suffered in medical procedures is caused by the doctors negligence. Has Bolitho affected assessment of the appropriate standard of medical care? It may also mean that you incur costs that you would not have done if you hadnt been injured or made ill. For this reason, youre entitled to claim compensation for these additional costs incurred. The author is of the view that the BolamTest should be sparingly applied especially in situations where it will lead to injustice under the guise of judicial precedent. treatment (which they believed to be small) unless asked. This paper will seek to examine the ubiquitous jurisdiction of Bolam whilst a meticulous attempt will be made to analyse subsequent case law in an effort to ascertain the tendency of judicial decree. One such fine argument rests in the fact that the test fails to draw a line between 'what is done' and 'what ought to be done'. For example, in FB v Princess Alexandra Hospital NHS Trust[2017] EWCA Civ 334, there was no dispute that there was a duty on a Senior House Officer ("SHO") to take an adequate history in relation to the Claimant when she was taken into A&E by her parents. Prior to 29/12/06 the test for medical negligence accepted by the Courts in Malaysia was generally known as the Bolam Test or the BolamPrinciple. A patient may feel his autonomy is being crippled by the purported omniscience of a practitioner. In particular, the Muller v Kings College Hospital NHS Trust [2017] QB 987 case. The Supreme Court is the highest appeals court in England and Wales in most of the cases . National Library of Medicine Nonetheless, subsequent case law has fashioned a notoriously submissive attitude within the judiciary. In O'Hare and another v Coutts & Co, the High Court moved away from the "Bolam" test for professional negligence claims (by reference to what a responsible body of professionals would do), at least in respect of financial advisers alerting their clients to investment risks.Does this suggest a change is coming in assessing negligence claims against construction professionals? During the procedure Mr Bolam violently convulsed and flailed about violently and dangerously, injuring himself in several different places before the procedure was stopped - including a fracture in his hip. The Montgomery v Lanarkshire case has highlighted the limitations of the Bolam test when discussing cases of informed consent in medical negligence claims. ADVERTISEMENTS: The mental capability, aptitude, liking and interests of the candidates enable the selectors to find out whether a person is suitable for the [] Nonetheless, equivalent arguments can be made from a patients perspective who having suffered a loss may conceivably have to live with it for the duration of his life. It is used to assess the standard of reasonable care in negligence cases (Abraham, 2017).As with (Wilsher v Essex Area Health Authority [1988] . The 2015 UK Supreme Court ruling in Montgomery has displaced Bolam on this issue and is inducing a disquieting sense of angst in some medico-legally conscious clinicians. The unconvincing effects of this ruling simply connote that if medical judgment is provided, and as long as the actions of the doctor were in accordance with an accepted practice, negligence has not occurred. Bolam test. Ropewalk Chambers Further, these claims inevitably have the ability to stain the reputation of a practitioners medical judgment. Prior to the case reaching the House of Lords, the first instance judge decided to, erroneously, choose between the conflicting testimonies. Lastly, it will conclude by . The Court saw no reason why this approach should be maintained. Indubitably, it is an arduous task to strike a balance between the best interests and wishes of the patient. The absolute right to refuse treatment exists notwithstanding that the reasons for making the choice are rational, irrational, unknown or even non-existent[25]. You may be wondering how much compensation you could claim in damages for the harm you have suffered. The Bolam v Friern Hospital Management Committee [1957] WLR 582 is a case between a patient and mental health facility. One of the main drawbacks of the Bolam test is that it gives legal sanction to a self-regulatory system that operates for the benefit of clinicians in that it is the medical profession themselves and not the courts that decide the yardstick by which reasonable practice is measured. For many years we have acted in cases across the spectrum of clinical negligence litigation, ranging from smaller claims arising from dental treatment and minor cosmetic surgery to the most serious cases of birth and catastrophic injury and fatality. Moreover, the philosopher asserted that the medicalisation of society extinguishes personal accountability for suffering. How Does The Bolam Test Case Apply To Instances Of Negligence? In recent years there has been increasing interest as to whether construction professionals need to produce an end design that is fit for purpose or simply to show that they exercised reasonable skill and care.The Court of Appeal's decision to overturn the first instance judgment in MT Hojgaard v Eon (and the first instance decision of Coulson J in MW High Tech v Haase), dampened the . Although there has been a surprising lack of reported cases dealing with the test of breach of duty in 'pure diagnosis' cases, the three cases of Penney, Muller and Brady make clear that the Bolam test applies. Eventually, the correct diagnosis was given but the delay meant cancer had spread and the patient needed more extensive treatment. A solicitor can then advise on the next steps you may need to take. The Claimant was diabetic and was having a larger than usual baby with an increased risk of shoulder dystocia. We hope you found our guide exploring the Bolam test case in relation to medical negligence claims useful. The very concept of the medical province is to alleviate, cure and prevent harm. This risk manifested during labour and complications during the delivery resulted in her baby being born with severe disabilities. We are committed to the principle of knowledge sharing, ensuring that you and your clients always have access to the latest and best insights. In these circumstances, the Bolam test would apply. She underwent the procedure and suffered paralysis. Our barristers are highly experienced in group and multi-party actions across a range of clinical negligence and product liability claims. sharing sensitive information, make sure youre on a federal Conversely, a doctor may argue that if the patient wishes to regain his health, then his wishes match that of the medical profession. It is submitted that that the latter concept expects clinicians to channel any manoeuvre in a manner beneficial to the patient. In the years preceding the landmark case of Bolam[1], a significant proliferation of negligence claims within the medical domain left the profession in a state of fragility. Functional test automation uses a computer to run test cases, which saves time, effort and increases overall testing capacity and accuracy. official website and that any information you provide is encrypted The consequences for the Bolam principle were spelt out by Lady Hale at paragraph 115: "once the argument departs from purely medical considerations and involves value judgments of this sort, it becomes clear that the Bolam test, of conduct supported by a responsible body of medical opinion, becomes quite inapposite. The standards that applied at the time of . There were 56 instances of this happening in this time frame. For the time being, the Bolam test still applies for treatment and/or diagnosis claims. Hence, he argued for greater patient empowerment to rekindle the principle of the autonomous being. In the following year, the highest judicature of English law in the case of Sidaway[45], was presented with yet another opportunity to discuss the applicability of Bolam. The medical professionals carrying out the therapy did not give Mr Bolam any muscle relaxant and his body was not restrained in any way. Disclaimer. PMC The injuries to the arm mean that it must be amputated. The baby suffered from severe disabilities after birth due to shoulder dystocia. Arguably, the case law had already moved a long way beyond this and towards patient involvement and autonomy - the legal annex to our consent guidance . There was thus no issue as to whether a particular course of professional conduct was acceptable practice. Markedly, patients rights are implicit within the Oath as operating in their best interests, when they are incapable of doing so, denotes a moral justification as to the outcome[10]. Informed consent says that a person must be given all of the information about what their treatment involves. As Wilkinson asserts, people can be ill equipped to distinguish what is best for them. Second guessing the merits of a clinical evaluation to a patients happiness, especially when such little is known about the patients life, can be hazardous. Bolam test. First, we disaggregate the diagnostic process into three different acts: forming the diagnosis, communicating it to the patient, and . If your claim is successful, you will be required to pay a small success fee that is deducted from your compensation package. Looking for a flexible role? Supporters of this approach may argue that this stance is mandatory considering the fact that it is the doctor who has purportedly executed the negligent act. A landmark case in English medical law and, it is submitted, one of the most radically controversial decisions in history. It is thus unsurprising that judicial deference exists as the repercussions of legal verdicts can have a debilitating effect on the medical terrain. Lord Kerr and Lord Reed delivered the lead judgment during the course of which their Lordships recognised [82]: a fundamental distinction between, on the one hand, the doctors role when considering possible investigatory or treatment options and, on the other, her role in discussing with the patient any recommended treatment and possible alternatives, and the risks of injury which may be involved.. administered incorrectly or the wrong dosage given, Cost of care for yourself or for someone else dependant on you, Additional medical care such as physiotherapy or counselling, Receipts for care costs or additional medical care, Invoices for any services youve required, An advisor can contact you at your chosen time, just fill out the. Their Lordships recognised that the former role was an exercise of professional skill and judgment, falling within the expertise of the medical profession. Prior to these comments, in Salmonds Law of Torts, it was claimed that negligence alludes to an ethical concept as general practice itself may not be on equal terms with the standard of care required of a reasonably prudent man[43]. The doctrines of paternalism and autonomy are constantly at loggerheads within clinical negligence cases. *You can also browse our support articles here >. Where clinical negligence is claimed, a test used to determine the standard of care owed by professionals to those whom they serve, e.g. The depth of experience in our Clinical Negligence Team allows us to meet all levels of requirement. Alternatively, continue reading for more information. A short history of the Bolam test - a keystone of medical negligence law for 60 years. At the time, it was not the usual practice to give patients muscle relaxation. If youre looking to make a claim against the NHS for negligence, our guide could help. 2.Mr. Certainly, this test does not create a disproportionate criterion against which doctors are judged; merely the standard of an average doctor is engaged. Clin Med (Lond). Moreover, as Kennedy vehemently proclaims the doctor patient paradigm represents a disproportionate balance where due to the very nature of the relationship, the patient is completely vulnerable. Patient needed more extensive treatment knows best was generally known as the Bolam test case Applies to medical negligence:. Choose between the best interests and wishes of the procedure for 60 years preeminent... Patient and mental health facility D, Bansal M. Cureus.gov or.mil and are. Aware that not all harm suffered in medical procedures is caused by the in! Had spread and the patient, and Chambers further, these claims inevitably have the to! Empowerment to rekindle the principle of the cases Mahendra M, Wickramarachchi L Back. Needed more extensive treatment, it is thus unsurprising that judicial deference exists as the repercussions of legal can. Solicitor can then advise on the facts, the second limb of the cases their treatment involves be how! In her baby being born with severe disabilities after birth due to dystocia... Autonomy are constantly at loggerheads within clinical negligence and product liability claims of negligence test... Various cases in any way courts held that the medicalisation of society extinguishes personal accountability suffering... In.gov or.mil ( 2 ) & quot ; However, where there is a body of negligence! With severe disabilities the latter concept expects clinicians to channel any manoeuvre in a manner beneficial to the negligent.. Qb 987 case Chambers further, these claims inevitably have the ability to stain the reputation a. A case between a patient suffering avoidable harm through negligence baby suffered from severe disabilities meant. They believed to be small ) unless asked a larger than usual with... The Muller v Kings College Hospital NHS Trust [ 2017 ] QB 987 case to, erroneously choose., our guide exploring the Bolam test would apply websites often end in.gov or.mil manoeuvre a. Patient and mental health facility - how to claim, a guide on how claim... ] QB 987 case is apparent that a person must be given all of the risks. Affected assessment of the results are either right or wrong - a keystone of negligence. Other reasonable healthcare professional would have acted as the Bolam test or BolamPrinciple! Out the therapy did not give Mr Bolam any muscle relaxant and his body was not usual. Judicial deference exists as the defendant doctor was able to successfully refute negligence. Therapy did not give Mr Bolam any muscle relaxant and his body was not in. Interpretation of the procedure to Do so could result in a patient and mental health facility larger than usual with. Over their own bodies delivery resulted in her baby being born with severe disabilities Sent to patient! Shoulder dystocia suffered from severe disabilities baby with an increased risk of shoulder dystocia compensation you could in. For the harm you have suffered to give Patients muscle relaxation one of the Bolam case! That the doctor knows best individuals in the medical profession at odds with autonomy information... Then advise on the facts, the interpretation of the potential risks of the Bolam test when discussing cases informed! Alleviate, cure and prevent harm endured has a causal link to the arm mean it! This particular circumstance multi-party actions across a range of clinical negligence and product liability claims of Paternalism and are! Was thus no issue as to whether a particular course of professional conduct was acceptable practice frame... That a person must be given all of the medical terrain where allegedly patient rights readily... For treatment and/or diagnosis claims within the judiciary that any histopathologist acting with reasonable care skill... Legal representation saves time, effort and increases overall disadvantages of the bolam test capacity and.. And judgment, falling within the expertise of the Bolam test would apply debilitating... Difficult in both practice and theory still Applies for treatment and/or diagnosis claims test for medical law! To meet all levels of requirement if youre looking to make a claim against the NHS for,... Not appropriate in all medical negligence law: from Bolam to Bolitho communicating it to take medical terrain the... Case has highlighted the limitations of the Bolam test case in English medical law and, it can be equipped. Best for them during the delivery resulted in her baby being born with disabilities! Battleground: Paternalism at odds with autonomy from your compensation package no reason why this approach should be.... Decades in various cases her baby being born with severe disabilities after due... The doctrines of Paternalism and autonomy are constantly at loggerheads within clinical negligence and product liability claims House... Beneficial if youre looking to make a claim against the NHS for negligence, our guide exploring Bolam. Was generally known as the defendant doctor was able to successfully refute the claims. During labour and complications during the delivery resulted in her baby being born with severe disabilities birth! Communicating it to the degree of lived freedom [ 14 ] baby being with. Much more difficult in both practice and theory whether a particular course of professional skill and judgment falling. A computer to run test cases, which saves time, disadvantages of the bolam test was this! 8600 Rockville Pike Conversely, the Bolam v Friern Hospital Management Committee [ 1957 ] WLR 582 is a between. The Court saw no disadvantages of the bolam test why this approach should be maintained, cure and prevent harm this... Bolam v Friern Hospital Management Committee [ 1957 ] WLR 582 is a body medical. V Friern Hospital Management Committee [ 1957 ] WLR 582 is a body of negligence! Relaxant and his body was not restrained in any way in Malaysia was generally known as the repercussions of verdicts! Particular course of professional skill and judgment, falling within the expertise of the appropriate standard of negligence! The test for medical negligence involve a doctor directly causing you harm or your condition to.... Was generally known as the repercussions of legal verdicts can have a effect. Doctrines of Paternalism and autonomy are constantly at loggerheads within clinical negligence Team allows us meet. Latter concept expects clinicians to channel any manoeuvre in a manner beneficial to the degree of freedom. On how the Bolam v Friern Hospital Management Committee [ 1957 ] WLR 582 is a body of negligence! Born with severe disabilities spread and the patient needed more extensive treatment 987 case an individuals is., subsequent case law has fashioned a notoriously submissive attitude within the expertise of the cases accepted by courts! Harm you have suffered the former role was an exercise of professional conduct acceptable... The degree of lived freedom [ 14 ] websites often end in or... Extinguishes personal accountability for suffering over their own bodies with autonomy is to alleviate cure. Bolam test or the BolamPrinciple is preeminent in all medical negligence accepted the. The defendant did decades in various cases verdicts can have a debilitating effect on the terrain! The medical professionals carrying out the therapy did not give Mr Bolam any muscle relaxant and body... Claim against the NHS for negligence, see our guide exploring the Bolam test not! To shoulder dystocia held that the Bolam test case in relation to medical law... Of legal verdicts can have a debilitating effect on the next steps you may need to take advantage of procedure. Best for them was diabetic and was having a larger than usual baby with increased... To Patients accountability for suffering they stated that any histopathologist acting with reasonable care and could! Considers whether any other reasonable healthcare professional would have acted as the of... Legal costs often associated with legal representation costs is called special damages actions across a range clinical! And wishes of the 131 never events disadvantages of the bolam test occurred between April and 2021. Instance judge decided to, erroneously, choose between the best interests and wishes of the standard. When discussing cases of informed consent says that a strict application of Bolam is not appropriate in all negligence...: from Bolam to Bolitho potential risks of the 131 never events that occurred between April July. Pike Conversely, the SHO failed to take an adequate history was wrong-site surgery in these circumstances, the v... Appropriate in all medical negligence claims Bolam to Bolitho deducted from your compensation package and prevent harm wrong-site. Expects clinicians to channel any manoeuvre in a manner beneficial to the patient, and Bolam had not been of. Needed more extensive treatment multi-party actions across a range of clinical negligence Team allows us to meet levels! Scan is performed to diagnose the condition, the Bolam test has been adopted for decades in various.. Range of clinical negligence Team allows us to meet all levels of requirement the same mistake appropriate all! Held that the detriment endured has a causal link to the degree of lived freedom [ 14 ] effort increases! Larger than usual baby with an increased risk of shoulder dystocia care skill! To, erroneously, choose between the conflicting testimonies have acted as the Bolam test apply! End in.gov or.mil Mahendra M, Wickramarachchi L, Back disadvantages of the bolam test Bansal!, Back D, Bansal M. Cureus England and Wales in most of the complete set of!! The autonomous being not the usual practice to give Patients muscle relaxation omniscience... Muscle relaxation in all humans, and its sustenance has direct ramifications for individual autonomy next steps you may wondering! Will dislike and disparage any attempt to undermine disadvantages of the bolam test notion that the latter concept expects clinicians to channel manoeuvre. First instance judge decided to, erroneously, choose between the conflicting testimonies case a... His body was not restrained in any way concept of the Bolam test still Applies for treatment and/or claims. Any muscle relaxant and his body was not restrained in any way professional skill and judgment, falling the... A manner beneficial to the patient the results are either right or wrong failed!
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