As news of the patient safety incident at the Belfast Royal Victoria Hospital emerges, involving the care of 2,500 patients by consultant neurologist Dr Michael Watt, the Belfast Health and Social Care Trust moved to contain the fall-out.
Even at this early stage, however, it is clear there will be significant legal consequences. Numerous issues have been identified by the trust and the Royal College of Physicians in respect of alleged misdiagnosis and mistreatment of both adult and child patients, prompting the Belfast Trust to recall all current patients.
Recall is a necessary first step for the patients potentially affected by the alleged shortcomings in care, ensuring that their health is not further prejudiced by any delay in the provision of appropriate therapy. Hopefully patients will be reassured and promptly treated, but the Belfast Trust has already accepted the possibility that some may have come to harm by reason of substandard care.
Mistakes in the provision of medical treatment are commonly investigated using serious adverse incident procedures.
However, the unprecedented number of patients potentially affected appears to have necessitated a wider ranging investigation.
Media reports indicate that Dr Watt, who continues to be employed by the trust, has not seen any patient since June 2017.
In this situation it would be expected that the trust would undertake immediate assessment of the consultant's conduct and capability and it is likely that such a process has already started.
Should Dr Watt's capability or conduct be found, after proper investigation, to have fallen short of the standards expected, then disciplinary or capability procedures may well be brought against Dr Watt to determine whether the consultant should remain in the employment of the trust or, failing that, whether other disciplinary measures be applied.
The Belfast Trust advises that it has taken "all appropriate action including liaising with the GMC (General Medical Council)".
The GMC is the professional regulator of the medical profession and has primary responsibility for investigating if a concern suggests that a doctor's practice should be restricted or stopped.
Typical investigations include "serious or repeated mistakes in patient care" and "failure to respond reasonably to patient needs". It would be expected that the trust would have notified the GMC when concerns came to light, and good governance requires such a report to be raised.
If after investigation the GMC determines that allegations against the doctor suggest a serious failure to meet standards, then proceedings will follow before the Medical Practitioner's Tribunal Service, to address 'fitness to practise'.
Penalties can include revoking the registration of the doctor. It remains to be seen if the Department of Health proposes to conduct any wider inquiry, given the huge number of patients potentially affected by these issues.
As for the individual patients, if they have come to harm by reason of mistreatment or misdiagnosis then they will have the right to look to Belfast Trust for proper legal redress.
Most importantly, it is essential that any deficits in the medical care are clearly identified and rectified without delay.
Thereafter, any patient who has suffered harm by virtue of substandard treatment may be entitled to seek compensation.
Generally it is the hospital trust, as employer of a doctor, who is legally responsible for treatment failures. Loss and damage includes, but is not limited to: death, personal injuries, mental upset and distress, loss of earnings and costs of care.
Damages for personal injury can run into many thousands of pounds.
Patrick Mullarkey is healthcare partner at O'Reilly Stewart Solicitors