§ PUBLISHED JUDGMENT · 2024

MAN v St George's University Hospital NHS Foundation Trust

[2024] EWHC 1304 (KB)·High Court (King's Bench Division)·4 March 2024

A woman went to A&E with extreme lower-leg pain and was sent home by a nurse practitioner instead of being seen by a senior doctor or referred to surgeons; she developed a necrotising soft tissue infection and lost her leg. The Trust admitted negligence but tried to rely on the nurse's evidence disputing how much pain she reported; the Master ruled that evidence inadmissible because the defence had never properly pleaded that dispute.

Outcome

Mixed outcome

Sum stated in judgment

Not stated

Claim type

A&E Negligence

Decided

Liability decided at trial

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§ WHAT HAPPENED

The facts, in brief.

Defendant: St George's University Hospital NHS Foundation Trust · this trust’s claims data

Injury: Necrotising soft tissue infection of the left lower leg leading to amputation (level of amputation in dispute)

Specialty: Emergency medicine · England

§ WHAT THE COURT SAID

In the judgment’s own words.

“Taking matters in turn, it seems to me that the witness statement of Nurse Jabeen does deal with matters that are not properly in issue on the pleadings.”

The money

Negligence admitted by the Trust. This ruling decided which defence witness evidence was admissible; causation and the level of amputation remained for trial. No figure printed.

§ WHY IT MATTERS

What this case shows.

An NHS trust cannot admit negligence and then quietly contest the facts at trial without pleading them. Severe, out-of-proportion pain in a limb is a recognised warning sign of necrotising infection that calls for senior review.

About a&e negligence claims →

§ MORE A&E NEGLIGENCE JUDGMENTS

Claimant succeeded

JBX v Frimley Health NHS Foundation Trust

[2026] EWHC 2294 (KB)·2026·Damages assessed at trial

An eight-year-old brought to Frimley Park Hospital in January 2018 with severe breathing difficulty was discharged the same afternoon instead of being admitted and given steroids; the next day he had a cardiac arrest and catastrophic brain injury. The Trust admitted negligence and causation and this judgment decides disputed heads of damages.

Sending a child home from A&E with signs of life-threatening asthma, rather than admitting and treating, was admitted to be negligent. Once liability is admitted the dispute moves to how care and lost earnings should be valued.

Claimant succeeded

Phoebe Charmaine Pickering v Cambridge University Hospitals NHS Foundation Trust

[2022] EWHC 1171 (QB)·2022·Liability decided at trial

Ms Pickering, who had atrial fibrillation, attended A&E with a cold, white leg; doctors diagnosed a resolved ischaemic event and sent her home on aspirin without heparin or a warning about her stroke risk. She had a major stroke 67 hours later, and the court found that anticoagulation would have prevented it.

A transient blockage in a limb can signal a clot from the heart, and discharging such a patient without anticoagulation or advice was admitted to be negligent. The case turned on causation, with the court accepting expert evidence that heparin would have stopped the clot progressing.

Claim failed

Watson v Lancashire Teaching Hospitals NHS Foundation Trust

[2022] EWHC 148 (QB)·2022·Liability decided at trial

A 29-year-old with sudden facial droop, speech problems and arm weakness was told by a junior A&E doctor she had migraine and was not referred to the TIA clinic, which the Trust admitted was a breach. Ritchie J found her March symptoms were in fact hemiplegic migraine, not mini-strokes, so the missed referral did not cause her later stroke.

Admitted breach of duty is not enough; the claimant must prove the correct pathway would have prevented the injury. Detailed findings about the exact sequence of symptoms decided this case.

All a&e negligence judgments →

Contains information licensed under the Open Justice - Licence v2.0. Judgments from Find Case Law, The National Archives. Summaries are ours; amounts only where printed in the judgment.

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