• Avant Medico-legal Advisory Service

    Expert medico-legal advice you can always count on

  • Avant’s Medico-legal Advisory Service (MLAS) provides expert advice to help minimise the chance of a complaint or claim occurring. The service is staffed by 70 claims managers, solicitors and doctors in our Adelaide, Brisbane, Melbourne, Perth and Sydney offices.
    Our medico-legal experts are available 24 hours a day, 365 days of the year - after hours and on weekends in emergencies.
    You can be reassured that, we have the experience and resources to cover your medico-legal queries.

  • Do you need advice?

    • 1
      Many queries are easily resolved. See if the scenarios below address your issue
    • 2
      If you can't find the answer you need, contact our medico-legal team
    • 3
      Our medico-legal experts are available whenever you need them, 24/7 in emergencies
  • Frequently asked questions

    • I've had a request to provide a patient's records.

      I’ve had a request to provide a patient’s records (patient direct, solicitor/insurer, subpoena/coroner).

      • Legislation varies across the states. Generally patients have a right under Commonwealth or State/Territory legislation to request access to their health records, or can authorise others to receive them on their behalf (for example, lawyers, and insurance companies).
      • Requests for access to medical records should be done in writing and signed and dated by the patient.
      • There are limited circumstances when health records can be withheld from patients eg: disclosure would cause a serious threat to the health or safety of a patient or third party.
      • If you are unsure about whether and what to disclose you should contact the medico-legal advisory team.
      • You are usually entitled to receive reasonable expenses to produce documents, to cover the administrative costs of copying the documents.
      • If you receive a request in the form of a subpoena to produce documents to a court or tribunal do not ignore it – it is a legal document.
      • A patient’s consent is not required to respond to a subpoena. The patient (or their solicitor) will normally receive a copy of the subpoena if they are involved in legal proceedings. If the health records are particularly sensitive consider letting the patient know that you have received a subpoena to produce them.
      • The documents must be produced to the court or tribunal by the date specified on the subpoena.
      • Only send copies of documents not the original health records. Check with our medico-legal advisory team if you are uncertain about what to send.
      • Generally if the police request records – for a criminal investigation or on behalf of a coroner, they should provide an authority from the patient, a court order or a warrant.
      • In some cases information can be given to the police without an order / warrant or the consent of the patient or relatives. 
      • All health information, including correspondence from other health professionals, such as specialists’ letters, form part of the health record.
      • If you are unsure about what you should do, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.
      Further information:
    • There has been an adverse event – should I notify Avant?

      There has been an adverse event. Should I notify Avant?

      • You should notify us if a patient suffers a complication from treatment, or if it appears that an incident (an act, error or omission in relation to providing healthcare) may lead to a claim or complaint against you.
      • By itself, a notification has no adverse impact on your claims history.
      • If you wish to discuss the matter, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.
        Further information:
    • I need to prepare a death certificate.

      I need to provide a death certificate

      • A death certificate is a legal document. You need to be certain that you are the appropriate person to sign the certificate. The death certificate should only be signed if the cause of death is known.
      • A doctor who was responsible for a patient’s care immediately prior to death or one who saw the deceased after death must sign such a certificate unless the death is reportable to the Coroner.
      • If the death is reportable to the Coroner do not sign the death certificate. Refer the matter to the Coroner.
      • The legislation in each state and territory defines a "reportable death" somewhat differently, but generally  they include:
        • Any violent or unnatural death
        • Sudden death of unknown cause
        • Death under suspicious or unusual circumstances
        • When the deceased had not been recently seen by a doctor
        • During or following an anaesthetic and /or a medical procedure
        • Following an accident that contributed to the death
        • If the deceased person was a child or person in care or custody.
         
      • It is not legally necessary to view the body before signing the death certificate, but it is advisable to do so.
      • If you wish to discuss the matter, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.

      Further Information:

       

      Useful links – for what is a reportable death in each state and territory:

      Victoria
      State Coroner’s Office

      New South Wales
      State Coroner’s Court

      Australian Capital Territory
      Coroner’s Court

      Queensland
      Office of the State Coroner

      South Australia
      Coroner’s Court

      Tasmania
      Coronial Division of the Magistrates Court

      Western Australia
      Coroner’s Court

      Northern Territory
      Coroner’s Office

    • I’ve had a formal disciplinary complaint (e.g. AHPRA, health complaints body, hospital).

      I’ve had a formal disciplinary complaint (e.g. AHPRA, health complaints body, hospital).

      • You should notify us as soon as possible if you receive notice of any civil or criminal action against you, or a formal complaint from an official body (e.g. AHPRA, health complaints body, hospital).
      • Check the time that the response is due.
      • Please arrange to obtain copies of relevant medical records relating to the matter.
      • Please do not respond to any lawyer until you have obtained advice from Avant.
      • If a response is required, start preparing a draft, but do not let this delay you in contacting us.
      • If you wish to discuss the matter, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.

      Further information:
    • I’ve received notice of a formal claim for compensation.

      I’ve received notice of a formal claim for compensation (e.g. statement of claim).

      • You should notify Avant as soon as possible if you receive notice of any civil or criminal action against you.
      • Please arrange to obtain copies of relevant medical records relating to the matter.
      • Please do not respond to any lawyer until you have obtained advice from Avant.
      • If you wish to discuss the matter, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.

      Further information:
    • Mandatory reporting and other healthcare professionals.

      I’m concerned about another healthcare professional.

      • There are situations in which a doctor is obliged to report another health care professional to AHPRA, the registration body eg. the doctor is impaired, taking or under the influence of drugs or alcohol at work or in a sexual relationship with a patient.
      • Such mandatory notification requires a high level of belief that the health professional represents a risk to patients, and must be done in good faith.
      • We recommend that, before taking action, you contact Avant on 1800 128 268 to speak to one of our experts.

      Further information:
    • I’ve been asked to provide a report for the coroner or police.

      I’ve been asked to provide a report for the Coroner or police.

      • Obtain the request in writing from the Coroner or the police officer acting on behalf of the Coroner.
      • Check the time that the response is due.
      • Send the request to Avant for advice on how to respond.
      • Arrange to obtain copies of relevant medical records relating to the matter.
      • If a response is required, start preparing a draft, but do not let this delay you in contacting us.
      • The report should be accurate, factual and as far as possible based on your medical records. In some cases you may be asked at a later date to give evidence in court based on your report.
      • Please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team before providing any information to the police or the coroner.

      Further information:
    • I’ve been asked to provide a report for an insurance company or solicitor.

      I’ve been asked to provide a report for an insurance company or solicitor.

      • Ensure that you have the patient’s consent to provide the information.
      • The insurance company or solicitor should provide a written, signed and dated authority from the patient or the patient’s authorised representative (eg. parent or guardian).
      • Clarify if you are being asked to provide a “treating doctor’s” report or an “expert” report.
      • You are not legally obliged to provide a report unless ordered to do so by a court or tribunal, but medical practitioners have an ethical obligation to assist patients in providing information which in some cases may require production of a “treating doctor’s” report.
      • If you agree to provide an expert report you must be aware of the ramifications of doing so, including your duties to the court as an expert. Seek advice from Avant if you are unsure whether to take on this role.
      • Gather together all correspondence and a copy of the patient's medical records.
      • The report should be accurate and referable to your medical records.
      • In some cases you may be asked to give evidence in court based on your report or receive a subpoena to give evidence.
      • If you wish to discuss the matter, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.

      Further information:
    • I have a problem with a contractual arrangement.

      I have a problem with my contractual arrangements with my employer.

      Our practice has a problem with an employee / contractor

      • Document your concerns, in particular the date and time of discussions which have caused you concern.
      • Make sure you have available a copy of your contract or, if you have no written contract, copies of letters, emails, etc., relating to your terms of service.
      • Please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team or send us a request for assistance.

      Further information:
    • I need some advice on a difficult patient and whether to end the doctor – patient relationship

      I need some advice on managing a difficult patient

      • A beneficial doctor-patient relationship is based upon trust and effective communication. If you decide that there has been an irrevocable breakdown in the relationship and it would not be in the best interests of the patient to continue treatment you may need to end the relationship.
      • There are various reasons for ending the doctor – patient relationship: loss of trust, conflicts of interest, unacceptable behaviour, non-compliance with treatment, boundary issues, non-payment of bills or the patient has made a formal complaint or issued legal proceedings.
      • A decision to end the doctor-patient relationship should not be made in haste and a discussion with a senior colleague may help you to get matters into focus.
      • It is not appropriate to end the relationship during an acute illness. In an emergency a doctor has a duty to provide assistance.
      • Contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team if advice is required.

      Further information:
    • I’ve been asked / received a subpoena to be a witness concerning a patient I’ve treated.

      I’ve been asked to be a witness concerning a patient I’ve treated.

      • You do not have to be a witness in a court or tribunal proceeding unless you receive a subpoena or other form of court order to attend a hearing.
      • If you have received a subpoena to give evidence you cannot ignore it as it is a court order and you could be arrested for failing to attend court.
      • Check the date and time you are required to attend the hearing.
      • If you are not going to be available at the nominated time you must inform the person or organisation that has served the subpoena. Try to arrange an alternative time / date.
      • However, it is often difficult for solicitors and prosecutors to provide a specific time for your attendance until shortly before or once the hearing has commenced.
      • If you are interstate, overseas or a long distance from the location of the hearing you can ask to give evidence by telephone or video link.
      • Courts and tribunals are generally good at accommodating the time constraints of doctors, so ensure you have informed the appropriate people about your availability.
      • You should be served “conduct money” with the subpoena. You may also be entitled to fees or payment of expenses for your attendance at a hearing, but these can vary depending on the jurisdiction. Some jurisdictions have set fees.
      • Ask the relevant person about what expenses you are entitled to claim. It can be stressful being a witness and it is important to prepare when giving evidence.
      • If you wish to discuss the matter, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.

      Further information:
    • I have a lot of old medical records I’d like to dispose of (including x-rays).

      I have a lot of old medical records I’d like to dispose of (including x-rays).

      • Medical records should be stored securely. The rules vary across Australia, but generally adult patient records should be kept for seven years from the date of the last provision of health care. For children they should be kept until the child is 25. It is advisable to keep maternity records for 25 years.
      • X-rays are part of the health record and should be returned to the patient or retained as above.
      • Paper based records can be scanned into a computer based system and then destroyed securely.
      • Records should be destroyed securely and a record should be kept of the date of destruction of each record.
      • If you wish to discuss the matter, please contact Avant on 1800 128 268 to speak to one of our experts in the medico-legal advisory team.

      Further information
  • Paying close attention to your physical, mental and financial health is vital for maintaining a balanced life and career success in medicine. Attending to your wellbeing makes you a better doctor and is better for your family, your patients and your community.

    Take charge of your wellbeing  
  • Avant's Personal Support Program (PSP) provides a range of support options to members who are suffering health issues. The counselling service offers objective psychological support and the provision of coping skills for a range of work-related issues such as work stress, issues with patients, personal issues relating to anxiety or depression, and legal issues around medico-legal complaints.

    Access the personal support program  
  • John Kamaras - MLAS

    John Kamaras

    BSc (Hons), LLB

    Coronial

    John Kamaras is Special Counsel - Coronial in Avant Law in New South Wales. He has combined scientific and legal training and has extensive experience in coronial inquests, medical negligence claims, employment disputes, Medicare investigations and criminal proceedings.

    Morag Smith - MLAS

    Morag Smith

    Bjuris, LLB

    Western Australian Law

    Morag Smith is a Senior Solicitor in Avant Law based in Western Australia. She acts for members in civil claims in the District Court and Coroners Court. She also tackles regulatory issues, mainly professional conduct and impairment matters.

    David Pakchung - MLAS

    Dr David Pakchung

    Claims

    Dr David Pakchung is Head of Claims in Queensland. He has combined legal and medical practice for 20 years. He has expertise in Medicare queries and investigations. One major case resulted in government changes to the law.

  • This page contains general information relating to legal and/or clinical issues within Australia (unless otherwise stated). It is not intended to be and should not be considered as a substitute for obtaining personal, legal or other professional advice or proper clinical decision-making with regard to the particular circumstances of the situation. Avant Mutual Group Limited and its subsidiaries will not be liable for any loss or damage, however caused (including through negligence) that may be directly or indirectly suffered by you or anyone else in connection with the use of information provided in this publication.

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