What osteopaths must do when an adverse event occurs during or following HVT, the duty of candour, how adverse events are assessed in GOsC proceedings, and how to protect your registration when things go wrong.
When an adverse event occurs in osteopathic practice — particularly following HVT — the immediate response determines both patient welfare and the osteopath's regulatory position. This guide explains what to do.
An adverse event in osteopathic practice is any unexpected, unintended, or undesirable outcome of treatment. For HVT specifically, the most serious adverse events include: neurovascular injury following cervical HVT, including vertebral artery dissection, stroke, or neurological deficit; significant worsening of the
presenting condition; and any other serious harm that arises during or following osteopathic treatment.
Minor adverse events, temporary soreness or stiffness following treatment, are expected, should be discussed with the patient as part of consent, and are not fitness to practise concerns.
Serious adverse events require immediate action. The guide to GOsC consent and HVT covers the pre-treatment consent requirements that protect both patients and osteopaths.
Where a serious adverse event occurs or is suspected: stop treatment immediately; assess the patient and call emergency services without delay if acute neurological symptoms are present; remain with the patient until they are safely transferred or have made an informed decision about next steps; document the event
contemporaneously, including the treatment given, the timing of symptom onset, the patient's presentation, and
every step taken in response; contact the iO and your defence organisation immediately; and do not alter or add to the clinical records after the event. The guide to GOsC record keeping covers the documentation standards that apply to adverse event recording.
The GOsC Standard of Proficiency requires osteopaths to be open and honest with patients when something goes wrong. The duty of candour requires: telling the patient promptly that an adverse event has occurred; apologising for the harm caused, an apology is not an admission of liability; explaining what happened and
the implications as clearly as possible; describing what will be done in response; and following up appropriately.
Failure to be candid with a patient following an adverse event is itself a GOsC fitness to practise concern, in addition to any concern about the adverse event itself.
The guide to GOsC professional conduct covers the duty of candour within the broader conduct framework.
CPD Certified, Online, Immediate Access
Not every adverse event following HVT triggers GOsC fitness to practise proceedings, serious adverse events are a known risk of cervical HVT, which is why consent specifically addressing these risks is required.
The GOsC assesses whether: the consent process was adequate, including specific discussion of HVT risks; the contraindication assessment before treatment was thorough; the technique was delivered within the osteopath's competence; the adverse event was recognised promptly and managed appropriately; and the duty of candour was fulfilled.
A chiropractor who consented appropriately, assessed contraindications thoroughly, responded promptly to the adverse event, and was candid with the patient is in a significantly stronger position than one who did not.
The guide to GOsC remediation evidence covers how to build the strongest evidence file where proceedings have arisen.
UK-registered GOsC professionals can access ethics training through Healthcare Ethics Courses.
Professionals with connections to Australia can consult ethics training in Australia.
Those with connections to New Zealand can review professional development in New Zealand.
10 CPD-certified courses for £500. Osteopath-specific consent, ethics, and professionalism CPD demonstrates active engagement with the standards the GOsC applies in adverse event cases.
Bulk Buy 10 Courses →Any unexpected, unintended, or undesirable outcome of treatment — for HVT specifically, neurovascular injury, stroke, neurological deficit, or significant worsening of the presenting condition.
Stop treatment, assess the patient, call emergency services if acute neurological symptoms are present, remain with the patient, document contemporaneously, and contact the iO and defence organisation immediately.
The obligation to tell the patient promptly that an adverse event has occurred, apologise, explain what happened and the implications, describe what will be done in response, and follow up appropriately.
No. An apology is not an admission of liability and is required by the duty of candour under the GOsC Standard of Proficiency.
By assessing whether the consent process was adequate, the contraindication assessment was thorough, the technique was within competence, the event was recognised and managed promptly, and the duty of candour was fulfilled.
No. Serious adverse events are a known risk of cervical HVT — which is why consent specifically addressing these risks is required. Proceedings are triggered where the response to the event, or the pre-event care, fell below the required standard.
Absolutely not. Altering records after an adverse event is treated as fundamental dishonesty in GOsC proceedings and consistently leads to the most serious outcomes.
Contemporaneous records of the treatment given, the timing of symptom onset, the patient's presentation, and every step taken in response.
A thorough assessment for all known contraindications to cervical HVT before every treatment — documented in the clinical record.
Yes, absent an interim order. Contact the iO and defence organisation immediately for advice on the position.
CPD in HVT safety, consent, adverse event management, and professional ethics — completed from day one with specific reflective notes.
Inadequate consent; failure to recognise and respond promptly; failure to be candid with the patient; and failure to document the event contemporaneously.
It demonstrates genuine professional engagement with the clinical and ethical issues raised by the event, which is one of the most persuasive forms of remediation evidence.
This guide is for educational purposes only and does not constitute legal advice. Seek independent advice from a specialist regulatory solicitor.
