Thousands of clinical/medical negligence cases are brought against the NHS and other healthcare providers in the UK each year, in many different areas of medical negligence, from birth injuries to surgical error. However, exceptional cases can lead to changes in the law or the requirements expected of medical professionals. Here are three recent cases in the UK that have led to such changes.
UK Medical Negligence Cases
Montgomery v Lanarkshire Health Board 2015
This Scottish delict English tort law medical negligence case resulted in a landmark ruling around informed consent. The case changed the Bolam test by introducing the general duty to attempt the disclosure of risks.
The case was brought with the context of whether a doctor was negligent for not informing Mrs. Montgomery (a woman of small stature and a diabetic) of the 9-10% risk of shoulder dystocia, a condition where the infant’s shoulders are not able to pass through the pelvis. The doctor viewed the risk as very slight and did not believe a caesarean section was in the claimant’s interest.
After birth, the baby suffered from severe disabilities due to shoulder dystocia. Mrs. Montgomery sought damages from the health board for negligence on the part of the doctor who failed to advise her on the risk associated to shoulder dystocia. A Court of Session ruling rejected Mrs. Montgomery’s claim on the grounds that the doctor was not negligent, and that the claimant would not have elected to have a caesarean section even had she been told of the risks. Mrs. Montgomery appealed to the Supreme Court.
The landmark ruling of the Supreme Court affirmed the requirement of ‘informed choice’ or ‘informed consent’ by patients under medical care rests fully on the duty of disclosure by medical practitioners.
ABC v St George’s Healthcare NHS Trust And Others 2017
In 2007, the claimant’s father was placed under a hospital order on the grounds of diminished responsibility after shooting and killing her mother. Whilst in hospital he was diagnosed with the inheritable neurological condition, Huntington’s Disease. There is a 50% chance that children will inherit this disease from a parent who develops it. However, the claimant’s father urged medical staff not to inform his daughter of his disease as she was pregnant, and he was concerned she would terminate the pregnancy if told.
In 2010, the claimant gave birth to a daughter and shortly afterward was accidentally informed about her father’s diagnosis by a clinician. In 2013, the claimant was then diagnosed with Huntington’s Disease herself. She brought what is sometimes referred to as a “wrongful birth” claim against numerous NHS trusts concerned in dealing with her father’s care, claiming that had she been given information about the diagnosis she would have sought to terminate her pregnancy.
The claimant was initially unsuccessful in her claim but a Court of Appeal ruling concluded that: “in special circumstances, it may be justified to break confidence where the aversion of harm by the disclosure substantially outweighs the patient’s claim to confidentiality”. As such, ABC should have been provided with information that would have averted harm to her family.
Darnley v Croydon Health Services NHS Trust 2018
In a landmark 2018 ruling, an A&E receptionist was found negligent due to providing misleading information on waiting times. Mr. Darnley arrived at Croydon’s A&E department with a head injury after he had been assaulted. The receptionist booked him in but advised him he would have to wait up to five hours to be seen. During the trial, receptionists gave evidence to say that the information he was given was not correct: patients with head injuries should be seen by a triage nurse within thirty minutes.
After remaining in the waiting area of the A&E department for a short time, Mr. Darnley went home as he felt too unwell to stay. His condition rapidly worsened and he was rushed back to hospital in an ambulance for the evacuation of a haematoma. He suffered acute and disabling brain damage.
The proceeding case rested on whether a duty of care could be extended to the receptionist who provided incorrect waiting time information. The Court of Appeal took the stance that there was no such duty present, so the case was appealed further to the Supreme Court.
The Supreme Court ruled that when Mr. Darnley attended the A&E department seeking urgent medical attention, a duty of care had been established and that an “averagely competent and well-informed A&E receptionist would not provide misleading information”.