Several here failed because the complication was a known risk that had been explained, or because a responsible body of surgeons would have done the same.
Claim failed
[2026] EWCC 50·2026·Liability decided at trial
A widow brought a dependency and bereavement claim against the hospital after her husband died from an infection picked up during heart surgery. Because he had already settled his own claim in full against the equipment manufacturer while alive, the court held no Fatal Accidents Act claim survived for his dependants.
A dependant's claim under the Fatal Accidents Act only exists if the deceased could still have sued at the moment of death. Settling a claim in the patient's lifetime can extinguish the family's later dependency claim, so settlement terms need careful thought where death is foreseeable.
Claimant succeeded£550,000
[2026] EWHC 1284 (KB)·2026·Liability decided at trial
A patient developed life-threatening pancreatitis after a gallstone-removal ERCP. The judge found the consultant never prescribed or instructed the standard preventive diclofenac suppository, so it was not given, and entered judgment for £550,000 against him.
Failing to give a recognised prophylactic drug before a procedure can be negligent even in private care. The prescribing doctor, not the hospital, carried the liability here.
Claim failed
[2026] EWHC 704 (KB)·2026·Liability decided at trial
During long spinal surgery for scoliosis and chest wall deformity the claimant deteriorated, arrested while being turned over, and was left with severe sight loss. He alleged the anaesthetist negligently failed to treat a raised potassium reading, but the judge found that reading was spurious and the arrest was caused by a pulmonary embolism, so the claim failed.
Even after a devastating complication a claim fails if the court finds the true cause was a non-negligent event, so proving the mechanism of injury is often the decisive issue.
Claimant succeeded£811,247
[2026] EWHC 657 (KB)·2026·Damages assessed at trial
The trust admitted it negligently failed to diagnose Daisy Lynch's developmental hip dysplasia at birth, so it was not picked up until she was three, by which time simple non-surgical treatment was no longer possible. She went through repeated hip operations and a total hip replacement at 22, and the court assessed her damages after an eight-day trial.
Even where liability is admitted, damages can be heavily contested, and the court can add a provisional damages order letting the claimant return for more if a specified complication later occurs. The award covered pain and suffering, lost earnings, future care and future surgery.
Claim failed
[2025] EWHC 2576 (KB)·2025·Liability decided at trial
After a sleeve gastrectomy the claimant had trouble swallowing; the surgeon performed a gastroscopy and balloon dilatation, after which the sleeve leaked. The judge found no breach of duty in the post-operative care or the dilatation and dismissed the claim despite the very serious consequences.
A bad outcome after a recognised complication is not enough; the claimant must show the treatment decision fell outside what a responsible body of surgeons would do. Sympathy for the patient does not change the legal test.
Claimant succeeded
[2025] EWHC 2121 (KB)·2025·Liability decided at trial
A 25-year-old with congenital heart disease suffered a severe brain injury when her aorta was cut during a high-risk repeat sternotomy and it took around 24 minutes to get her onto full bypass. The judge found the surgeon should have exposed the femoral vessels in advance (saving around 13 minutes) and that consent was deficient; she would still have gone ahead with the operation, but with that precaution taken.
Surgeons planning a known high-risk operation must take reasonable precautions beforehand and tell the patient about them; a court can find negligence in planning and consent even where the intra-operative error itself was not negligent.
Claim failed
[2025] EWHC 2025 (KB)·2025·Liability decided at trial
The claimant developed anal stenosis after a private haemorrhoidectomy and argued her haemorrhoids had been over-graded, non-surgical options were not discussed and the stenosis risk was not explained. The judge found the grading was correct, alternatives were discussed and the risk was disclosed on the consent form and in the information leaflet, so the claim was dismissed.
Documented consent, including a signed form and a written leaflet naming the specific complication, can be decisive in defeating a Montgomery consent claim.
Claim failed
[2025] EWHC 1907 (KB)·2025·Liability decided at trial
A 27-year-old flight attendant saw her GP with severe back and leg pain, having mentioned perianal numbness in a message two days earlier; she had emergency surgery for cauda equina syndrome four days after the consultation. The judge accepted that the GP asked the right red-flag questions and that the patient answered no, so there was no breach of duty.
In cauda equina cases the court looks closely at what safety-netting questions the GP actually asked and what the patient answered on the day. Contemporaneous notes and messages matter greatly for both sides.
Mixed outcome
[2024] EWHC 3318 (KB)·2024·Liability decided at trial
After spinal surgery the hospital failed to give Ms Tuffin the prescribed anti-clotting injection, and she developed a deep vein thrombosis and post-thrombotic syndrome; three years later her leg was amputated above the knee. The judge held the trust liable for the DVT and its after-effects but found the amputation was caused by complex regional pain syndrome from the surgery itself, not the clot.
A missed dose of thromboprophylaxis that causes a DVT is negligent, but compensation covers only the harm the clot actually caused. Where a separate condition drives the worst outcome, the claimant must show the negligence at least materially contributed to it.
Claim failed
[2024] EWHC 2338 (KB)·2024·Liability decided at trial
Admitted with perforated diverticulitis, the claimant had a laparoscopic washout and deteriorated about 36 hours later, needing an emergency Hartmann's procedure with a stoma and intensive care. She alleged she had asked for a colorectal referral, was improperly moved to private care and was not properly consented, but the judge found none of this proved and dismissed the claims against both the surgeon and the trust.
Consent disputes turn on evidence of what was actually discussed; where the records and the surgeon's account show the alternative procedure was explained, a claim based on inadequate consent is likely to fail.
Claim failed
[2024] EWHC 2011 (KB)·2024·Liability decided at trial
Ms Spellman alleged a hospital radiologist missed cauda equina compression on an MRI scan taken the day after her fall, delaying diagnosis until private surgery six days later. Damages had been agreed at £300,000 if she won, but the judge found the scan showed only mild stenosis with no compression to be found, so the claim failed.
Parties sometimes agree the damages figure in advance and fight only liability, so a claimant who loses on breach of duty recovers nothing. Expert evidence on what the scan actually showed was decisive.
Claimant succeeded£195,888
[2024] EWHC 1688 (KB)·2024·Liability and damages decided at trial
The patient had a hysterectomy, pelvic floor repair and incontinence tape fitted by one consultant, then mesh removal and a colposuspension by a second consultant. The court cleared the first surgeon but found the second performed the colposuspension without clinical justification, leaving the patient with severe bladder symptoms.
Performing an operation that is not clinically justified is a breach of duty even if it is technically done well. Damages are limited to the harm caused by the negligent procedure, not the patient's pre-existing symptoms.
Claimant succeeded£1.2M
[2024] EWHC 1360 (KB)·2024·Liability decided at trial
Mr Healey died nine days after bowel cancer surgery at a private hospital when a leak at the surgical join was not recognised in time. The hospital settled the widow's claim for £1.2 million and the court ordered the surgeon to bear 75% of it, finding his failure to diagnose the leak the principal cause of death.
Post-operative deterioration after bowel surgery must prompt urgent consideration of a leak. Both the private hospital and the individual surgeon can be liable, with the court apportioning responsibility between them.
Claim failed
[2023] EWHC 3163 (KB)·2023·Liability decided at trial
Ms Beatty, in hospital with severe cellulitis, developed ischaemic toes; a vascular surgeon diagnosed vasculitis rather than an embolism and did not order a CT angiogram, and she later needed a below-knee amputation. The judge found the surgeon's diagnosis was supported by a responsible body of medical opinion and dismissed the claim.
A diagnosis that turns out to be wrong is not automatically negligent; if a responsible body of specialists would have reached the same view on the information available, the claim fails under the Bolam test.
Claimant succeeded£1.3M
[2023] EWHC 3115 (KB)·2023·Liability decided at trial
Before bowel cancer surgery, anaesthetists made three failed epidural attempts while the patient was awake and then seven more after putting her under anaesthetic, one of which pierced her spinal cord. Ritchie J held the anaesthetist should have obtained her informed consent before the unconscious attempts and offered alternatives, and that this failure caused the injury.
Consent is not a one-off: when a procedure changes course (here, moving to unconscious epidural attempts), the patient must be told of the options and risks again. The full agreed £1.3m followed from that single consent failure.
Claimant succeeded£340,000
[2023] EWHC 2986 (KB)·2023·Liability decided at trial
The Trust admitted it missed an aortic dissection that emergency surgery would probably have cured, and settled the fatal claim for £340,000. When the widow and children later sued for psychiatric injury from witnessing the death, the Trust tried to strike that out but withdrew after discovering the earlier settlement had never been court-approved.
Fatal claims involving children need court approval of any settlement or it may not bind them. A missed aortic dissection in a chest-pain patient was accepted as negligent and fatal.
Claim failed
[2023] EWHC 2803 (KB)·2023·Liability decided at trial
Mr Ward's stomach was perforated during keyhole removal of a gastric band; the hole was not seen during the operation and was repaired the following morning after he deteriorated. The judge found the perforation was not visible at the time and so there was no negligent failure to identify and repair it.
A perforation missed during surgery is only negligent if there was visible evidence the surgeon should have seen. Post-operative pain that leads to timely re-operation may not give rise to a claim.
Claimant succeeded
[2023] EWHC 2719 (KB)·2023·Liability decided at trial
Two radiologists reporting a newborn's abdominal X-rays in October 2010 did not identify or report abnormal alignment of the hips that was visible on the films. The hip dysplasia was not diagnosed until 14 months later and the court found both radiologists in breach of duty.
Radiologists must report any obvious abnormality visible on an X-ray, even if it is outside the reason the scan was ordered. A missed incidental finding can found a negligence claim.
Claim failed
[2023] EWHC 1304 (KB)·2023·Liability decided at trial
During surgery for a giant calcified thoracic disc the surgeon changed from the planned approach to opening the dura, and the patient was left partially paralysed. The judge found the change of approach and the surgical technique were supported by a responsible body of neurosurgical opinion and dismissed the claim.
Changing surgical plan mid-operation is not negligent where the alternative is a recognised, logical approach. Catastrophic outcomes from high-risk spinal surgery do not by themselves establish a breach of duty.
Claimant succeeded
[2023] EWHC 1290 (KB)·2023·Liability decided at trial
A woman with long-standing back pain saw a pain consultant in 2009 and 2010 who did not order an updated MRI or examine her neurologically; a thoracic disc prolapse went undiagnosed until she became paraplegic in 2017. The court held the consultant negligent and that timely surgery would have given a full neurological recovery, but found the A&E nurse practitioner in 2017 was not at fault.
Failing to re-image or examine a patient whose back pain has changed can amount to negligence years before the catastrophic outcome. Each clinician's conduct is judged separately.
Claimant succeeded£298,617
[2023] EWHC 42 (KB)·2023·Liability and damages decided at trial
An engineer had a then-novel transanal rectal cancer operation without being told of the risks to sexual, urinary and bowel function, and was consented on the day of surgery. The judge found the trust failed to follow NICE guidance, accepted he would have chosen a conventional laparoscopic operation, and awarded £298,616.73.
Consent taken on the day of surgery without explaining material risks or alternatives can found a claim even if the surgery itself was competently done. New or learning-curve procedures need particularly careful counselling.
Claim failed
[2022] EWHC 2981 (KB)·2022·Liability decided at trial
Mr Middleton's acutely ischaemic leg was diagnosed at lunchtime but bypass surgery did not happen until after midnight, about 14 hours later. The judge found it was reasonable to obtain CT imaging first and that surgery by mid-afternoon was not mandatory, and that earlier surgery would not have prevented the nerve injury in any event.
Obtaining imaging before emergency vascular surgery can be reasonable practice, and a claim fails unless earlier treatment would probably have avoided the injury.
Claimant succeeded£4.68M
[2022] EWHC 2417 (KB)·2022·Damages assessed at trial
A 20-year-old motorcyclist with leg fractures developed compartment syndrome which the trust admitted it treated too late, so his right leg had to be amputated below the knee. Liability was admitted and the court assessed damages at £4,676,442 covering lifelong prosthetics, care, adapted housing and lost earnings.
Where a hospital admits that quicker treatment of compartment syndrome would have saved a limb, the case becomes about valuing lifelong needs, and prosthetics, accommodation and care can each run to six or seven figures for a young claimant.
Claim failed
[2022] EWHC 100 (QB)·2022·Liability decided at trial
After routine day-case removal of a scrotal cyst, the claimant returned in the early hours in severe pain; intravenous antibiotics were not started when they should have been and an ultrasound request was delayed, and he was later diagnosed with Fournier gangrene, needing repeated surgery and losing both testicles. The judge found breach of duty but held the claimant could not prove the delays changed the outcome.
Proving that care fell below standard is only half the case: the claimant must also show the negligence made a difference. Where surgery would have happened at the same time anyway, delayed antibiotics or scans may not be shown to have caused the injury.
Claim failed
[2021] EWHC 643 (QB)·2021·Liability decided at trial
The executors of Mrs Neill argued her surgeon should have enlarged the aortic root to fit a larger valve rather than implant a 19mm mechanical valve, and failed to warn her about that option. Eady J found the valve choice was not negligent and, although the possibility of root enlargement should have been mentioned, it would have made no difference to her decision.
A consent failure only leads to compensation if the patient would have made a different choice with proper information. Surgical decisions supported by a responsible body of opinion are not negligent just because another surgeon would have done differently.
Claim failed
[2021] EWHC 323 (QB)·2021·Liability decided at trial
A teacher with a back injury attended A&E and was referred for a routine MRI; the scan two weeks later showed a disc prolapse and she had emergency surgery but was left with permanent damage. The court found the registrar was not negligent in not suspecting cauda equina at that visit, and that her condition had not materially worsened during the delay.
Not every back-pain patient with some red-flag features must be scanned urgently; the court looks at the full picture presented at the time. Claimants must also prove the delay itself made the outcome worse.
Claim failed
[2020] EWHC 3445 (QB)·2020·Liability decided at trial
A two-and-a-half-year-old girl seen at a Badger out-of-hours centre was diagnosed with a sore throat and sent home; two days later scans showed hydrocephalus and brain abnormalities needing emergency neurosurgery, leaving her profoundly disabled. This judgment decided only whether the NHS commissioning body was legally responsible for the nurse practitioner's alleged negligence, and held it was not.
When an NHS body contracts an outside provider to run out-of-hours services, the NHS body does not automatically carry a non-delegable duty for that provider's clinicians. Claims must be brought against the clinician and the out-of-hours provider themselves.
Claim failed
[2020] EWHC 3333 (QB)·2020·Liability decided at trial
After removal of a spinal cord tumour, nursing charts appeared to show neurological deterioration two days post-op, but the surgeon was not alerted; four days later the patient suffered sudden permanent paralysis. The court accepted the clinicians' assessments that there was no real deterioration until the final day, so earlier escalation would not have changed the outcome.
Nursing observation charts alone may not prove deterioration if contemporaneous clinical examinations showed improvement. Even a failure to escalate must be shown to have changed the outcome.
Claimant succeeded£2.85M
[2020] EWHC 3269 (QB)·2020·Appeal decision
After a 10-hour facial reconstruction the claimant developed compartment syndrome in both legs in intensive care and was left with permanent damage; the trust settled 70 days before trial for a £2.85 million lump sum plus annual payments of £48,000 rising to £85,000. This later judgment dealt only with the lawyers' success fee and dismissed the claimant's appeal on that point.
Compartment syndrome arising from post-operative monitoring failures can attract multi-million-pound settlements with periodical payments for lifelong care, although this figure comes from a costs judgment rather than a damages judgment.
Mixed outcome
[2020] EWHC 1504 (QB)·2020·Liability decided at trial
A baby born breech by caesarean should have had a hip ultrasound within six weeks, but the appointment was not arranged until nine weeks and, after rescheduling, the scan at 17 weeks showed hip dysplasia in both hips, needing surgery. The Trust admitted breach but, shortly before trial, sought to blame the mother's missed appointment; the judge refused the late amendment.
Babies born breech need a timely hip scan, and a trust's failure to arrange one within its own protocol was admitted as negligent. Defendants cannot raise new causation arguments on the eve of trial without good reason.
Claim failed
[2020] EWHC 310 (QB)·2020·Liability decided at trial
Ms Pepper argued she had only agreed to a Whipple's operation if an intra-operative biopsy proved cancer, and the biopsy was negative. The judge found she had consented to surgery if the biopsy was positive or the pancreas looked suspicious, that intra-operative biopsies are known to be unreliable, and dismissed the claim.
Consent disputes turn on what was actually agreed before surgery, and courts give weight to contemporaneous notes and what a reasonable patient would have decided. A negative result on an unreliable test does not by itself make surgery negligent.
Claim failed
[2020] EWHC 158 (QB)·2020·Liability decided at trial
After an appendectomy a woman developed an abdominal mass that scans labelled a harmless omental infarction; it was actually a rare bacterial infection that later formed an abscess needing surgery. The judge accepted an early biopsy would have avoided this but held the doctors were not negligent in not doing one.
Hindsight showing that a test would have helped is not the same as proving it was negligent not to do it. Unusual infections that mimic benign findings on scans are a recognised trap for both clinicians and claimants.
Claim failed
[2019] EWHC 2488 (QB)·2019·Liability decided at trial
The claimant was discharged two days after a sleeve gastrectomy despite nausea, vomiting and pain, and weeks later developed severe sepsis from a leak. The judge found the discharge and follow-up were not negligent and that earlier action would not have changed the outcome.
Early discharge after bariatric surgery is not negligent if symptoms at the time were within the expected range. Claims fail if the leak would have developed and been treated the same way regardless.
Claim failed
[2019] EWHC 832 (QB)·2019·Liability decided at trial
A 38-year-old woman with a hard breast lump had a mammogram and ultrasound that looked benign and was discharged without a biopsy; cancer was found in 2013. Yip J accepted that a responsible body of breast surgeons would not have biopsied on those findings.
Triple assessment does not always require a biopsy where imaging is reassuring. A later cancer diagnosis does not by itself prove the earlier clinic decision was negligent.
Mixed outcome
[2019] EWHC 1276 (QB)·2019·Liability decided at trial
Mrs Arksey attended Addenbrooke's with a warning bleed from a brain aneurysm but was discharged without a CT scan and suffered a catastrophic re-bleed the next day. The court held she had not proved that admitting her would have avoided the re-bleed, though she succeeded on an admitted delay in fitting a shunt for hydrocephalus.
Proving breach of duty in A&E is only half the battle; the claimant must also show that the correct treatment would have prevented the injury in time, which failed here for the main allegation.
Claimant succeeded£150,000
[2018] EWHC 3461 (QB)·2018·Liability decided at trial
A woman with learning difficulties lost her arm and leg to blood clots in 2012 after several doctors and a hospital failed to spot a blocked artery. Martin Spencer J found only Dr Jackson negligent and causative, and only for the arm, awarding the agreed £150,000.
Where several clinicians see a deteriorating patient, the court examines each contact separately. Compensation was limited to the injury that the negligent consultation could actually have prevented.
Mixed outcome
[2018] EWHC 2715 (QB)·2018·Appeal decision
A man with a disc problem developed cauda equina symptoms and the out-of-hours GP told him to go to A&E rather than arranging direct orthopaedic assessment; surgery came many hours later and he was left with permanent bowel and bladder problems. A Master had struck out the claim against the GP by summary judgment, but the High Court allowed the claimant's appeal so the claim against the GP could go to a full trial.
Clinical negligence claims should rarely be disposed of by summary judgment before the expert evidence has been exchanged. The ruling did not decide whether the out-of-hours GP was negligent, only that the question had to be tried.
Claimant succeeded
[2018] EWHC 1917 (QB)·2018·Liability and damages decided at trial
A 40-year-old had gastric bypass surgery and developed a leak that was not diagnosed until a day after clear warning signs. Yip J found the trust liable for several failings and assessed general damages at £100,000 plus care and therapy costs.
After weight-loss surgery, signs of a leak need to be acted on promptly; delayed diagnosis can turn a treatable complication into life-changing injury. General damages reflect the whole picture of pain, disability and psychological harm.
Claim failed
[2018] EWHC 1345 (QB)·2018·Liability decided at trial
A man with back pain and new groin numbness phoned his GP, who told him to go to A&E rather than ringing the hospital orthopaedic team directly. Master Cook found the GP had credible expert support for that approach and struck out the claim against him.
Sending a suspected cauda equina patient to A&E by ambulance can be a defensible GP response. A GP claim will fail at an early stage if a responsible body of GPs would have done the same.
Claimant succeeded
[2018] EWHC 1225 (QB)·2018·Liability decided at trial
Two days after spinal fusion surgery Mrs Lesforis suddenly lost movement in her feet; re-operation found a compressive blood clot. Martin Spencer J held it was negligent to give the blood-thinner Clexane routinely within about three hours of spinal surgery, which caused the haematoma, although the timing of the re-operation was not negligent.
Routine practices that fall outside the normal range at the time can be negligent even if the surgeon always did it that way. Post-operative anticoagulation after spinal surgery carries a recognised bleeding risk that must be weighed for each patient.
Claim failed
[2018] EWHC 343 (QB)·2018·Liability decided at trial
Five days after surgery to reverse his ileostomy the 60-year-old claimant developed sepsis and his whole colon had to be removed because its blood supply had failed. He alleged the surgeon had damaged the marginal artery, but Yip J was not satisfied that the injury was caused by negligence rather than a naturally occurring clot.
A serious complication after bowel surgery is not itself proof of negligence; the claimant must show on the balance of probabilities that a surgical error, rather than an unavoidable event, caused the harm.
Claimant succeeded
[2017] EWHC 3147 (QB)·2017·Liability and damages decided at trial
After surgery at Charing Cross Hospital in 2001 the patient was never told his tumour was malignant or that he needed regular CT surveillance, and the cancer recurred undetected until 2010. The court found a continuing duty to inform him of his diagnosis and follow-up needs which the Trust failed to discharge.
Hospitals must tell patients the result of their treatment and the follow-up they need; failing to communicate a cancer diagnosis and the need for monitoring is negligent.
Claimant succeeded
[2017] EWHC 2608 (QB)·2017·Appeal decision
A woman who had vaginal tape surgery in 2007 sued in 2015, saying she was never properly told about the product or the alternatives. The surgeon had died by then, but the court allowed the late claim to proceed and the High Court refused to interfere.
A late claim can still go ahead even where the doctor has died, if independent records and expert evidence mean a fair trial is possible. The court weighs the harm to each side rather than applying the deadline mechanically.
Claim failed
[2017] EWHC 1900 (QB)·2017·Liability decided at trial
After a heart attack and angioplasty, Mrs Lane developed a blocked artery in her right arm; it was diagnosed at 02:30 but she was not transferred to the vascular unit until the morning and thrombectomy was done that evening. The judge found the delays and surgery were not negligent and that, in any event, the arm was successfully reperfused so the later amputation was not caused by any delay.
Delay alone is not enough: a claimant must show both that the delay fell below a reasonable standard and that earlier treatment would have changed the outcome. Deferring surgery for an unstable cardiac patient can be a reasonable clinical judgment.
Claimant succeeded
[2017] EWHC 497 (QB)·2017·Liability decided at trial
Mrs Thefaut was told her disc operation had about a 90% chance of curing her leg pain and would probably settle her back pain, with tiny risks. Green J found the real prospects and risks were materially different, that she was not properly informed, and that the claim succeeded on consent although the surgery itself was not negligently performed.
Overstating the benefits or understating the risks of surgery can breach the Montgomery duty even when the operation is done competently. Patients must be given a fair picture including the option of not operating.
Claimant succeeded£92,500
[2016] EWHC 2878 (QB)·2016·Liability decided at trial
A consultant agreed a plan of physiotherapy with surgical review in three months, but the hospital instead listed the patient straight for surgery and warned him he would lose priority if he did not attend. He suffered a rare nerve injury in the operation, and the judge held that but for the hospital's failure to follow the agreed plan he would not have had surgery then.
Hospitals must implement the treatment plan actually agreed with the patient. A non-negligent surgical complication can still be compensated if the operation itself should not have happened at that time.
Claim failed
[2016] EWHC 1729 (QB)·2016·Liability decided at trial
After a radical hysterectomy for cervical cancer the patient developed an abscess and a narrowed ureter, and later lost a kidney; she alleged the bowel was perforated at surgery and that urologists should have been involved in a second operation. The judge preferred the hospital's explanation for the infection and found no negligence in either operation.
Ureteric and kidney damage after pelvic surgery is not automatically negligent; the court will examine the most likely mechanism. Expert evidence on the cause of infection is often decisive.
Claim failed
[2016] EWHC 1101 (QB)·2016·Liability decided at trial
A mother alleged that a registrar negligently failed to spot on an ultrasound that a substantial piece of placenta had been left behind after birth, leading to infection and an emergency operation two weeks later. The parties agreed the claim depended on proving a substantial (about 7 cm) piece was retained, and the judge was not persuaded of that on the evidence.
Retained placenta claims often turn on what the scan would actually have shown; if the retained tissue was small, a missed scan finding may not be negligent. Agreed thresholds for success can decide a case.
Settlement approved£50,000
[2016] EWHC 500 (QB)·2016·Settlement approved by the court
The Trust admitted it negligently failed to diagnose the claimant's torn aorta for 20 days, but disputed that this caused his later stroke; the claimant accepted a £50,000 offer just before trial, months after it had expired. This ruling decides who pays the legal costs, applying the normal rules so the claimant pays the defendant's costs for the period after the offer lapsed.
Accepting a settlement offer late can cost a claimant heavily in legal costs even when negligence is admitted. A missed aortic dissection was accepted as negligent, but the disputed stroke was never proved.
Claimant succeeded
[2016] EWHC 407 (QB)·2016·Liability decided at trial
A GP who fell downstairs and was found vomiting and confused was admitted to Manchester Royal Infirmary A&E at about 6.52 am in December 2007, but his CT head scan was not done until 1.12 pm. The court found the scan should have been performed by about 10 am and that the delay was negligent.
A patient with a head injury and reduced consciousness needs a CT scan urgently; an unexplained delay of several hours in A&E can amount to negligence.
Claimant succeeded£39,000
[2016] EWHC 330 (QB)·2016·Liability decided at trial
A woman hurt her wrist playing football and was seen at Ysbyty Gwynedd A&E in April 2009, where the doctor did not properly carry out all three standard clinical tests for a scaphoid fracture. The fracture went undiagnosed and she later needed a bone graft and further surgery; the court found the examination fell below a reasonable standard.
A&E doctors are expected to perform and record all the recognised tests for a scaphoid fracture when a wrist injury is suspected. Skipping part of the examination can amount to negligence even if the X-ray itself is not at fault.
Claim failed
[2016] EWHC 331 (QB)·2016·Liability decided at trial
A teenager with back pain had a lumbar microdiscectomy and afterwards developed cauda equina syndrome. She argued the surgeon should have sought a second opinion and consented her properly; the court rejected the criticisms and found the CES was a non-negligent complication.
Cauda equina syndrome can be a recognised complication of spinal surgery rather than evidence of negligence. Consent claims fail if the court accepts the surgeon gave adequate advice.
Claim failed
[2016] EWHC 269 (QB)·2016·Liability decided at trial
A woman saw her GP and then attended the Royal Free A&E with severe headaches in June and July 2010, was not investigated for a bleed, and suffered a subarachnoid haemorrhage days later while abroad. The judge accepted that earlier small bleeds did not present with typical warning signs and found no breach by the GP, A&E doctor or triage nurse.
Headache claims against A&E succeed only if the presentation should have prompted a scan or lumbar puncture; atypical symptoms without red flags can make it very hard to prove negligence.
Claim failed
[2016] EWHC 251 (QB)·2016·Liability decided at trial
After surgery for a broken femur at St Richard's Hospital, Chichester, the patient was discharged in April 2008 without arrangements to repeat his inflammatory-marker blood tests, and a deep infection was diagnosed later. The court found this discharge and a four-day debridement delay were breaches of duty, but there was no evidence they made his condition materially worse, so the claim was dismissed.
Discharging a patient without arranging follow-up blood tests can be a breach of duty, but compensation depends on showing the delay actually worsened the outcome.
Claimant succeeded
[2016] UKPC 4·2016·Appeal decision
A patient with appendicitis waited hours for a CT scan and surgery; by the time his appendix was removed it had ruptured and sepsis had damaged his heart and lungs. The Privy Council held the hospital was liable because its delay materially contributed to the injury, even though some harm would have occurred anyway.
Where negligent delay makes an existing condition worse in a cumulative way, a claimant need not prove the whole injury would have been avoided, only that the delay made a more-than-negligible contribution. This is often relied on in sepsis and delayed-treatment claims.
Claimant succeeded£459,758
[2015] EWCA Civ 1244·2015·Appeal decision
During surgery to repair a bladder-vagina fistula caused by an earlier hysterectomy, the surgeon damaged the femoral nerve while dissecting the sigmoid colon. The trial judge awarded £459,758 and the Court of Appeal upheld the finding that the injury was caused by negligent direct injury rather than retractor pressure.
Where a nerve is damaged in an area the surgeon was working on, a court may infer negligence from the mechanism of injury and the expert evidence. Appeal courts rarely overturn a trial judge's factual findings on how an injury occurred.
Claim failed
[2015] EWHC 2627 (QB)·2015·Liability decided at trial
A diabetic electrician's eye pressure rose to 40-56 mmHg in the days after retinal surgery and was managed with drugs rather than urgent further surgery. The judge held that continuing medical treatment was a logical clinical judgment supported by a responsible body of eye surgeons and dismissed the claim, including the late-raised consent argument.
Choosing medical management over urgent surgery is not negligent if a responsible body of specialists would have done the same. A Montgomery-style consent argument will fail if the patient would have followed the specialists' recommendation anyway.
Claimant succeeded
[2015] EWHC 293 (QB)·2015·Liability and damages decided at trial
A 68-year-old woman fell downstairs and broke her neck; the fracture was wrongly judged stable and she was got up and moving before surgery on 5 January 2011. Andrews J found her permanent paralysis was caused by the failure to operate and stabilise the spine by 29 December 2010.
Misjudging whether a spinal fracture is stable can turn a recoverable injury into permanent paralysis. The court decided causation by tracing when her neurology got worse relative to when she was mobilised.
Claim failed
[2013] EWHC 4088 (QB)·2013·Liability and damages decided at trial
A widower and four children claimed after Mrs Shah, who had collapsed with leg weakness days after giving birth, died from an undetected arterial tear. The court found the A&E doctor's failure to check leg pulses was not negligent and would not have changed the outcome, so the claim failed.
Fatal claims need proof both that care fell below a reasonable standard and that better care would probably have saved the patient. The judgment nonetheless shows how dependency damages for a spouse and children are built up from the deceased's earnings and services.
Claimant succeeded£92,391
[2013] EWCA Civ 117·2013·Appeal decision
Mrs Thomas's bile duct was injured during keyhole gallbladder removal and the surgeon also failed to arrange fluid and kidney monitoring when she was readmitted unwell. The trial judge found both failures negligent and awarded £92,391; the Court of Appeal dismissed the surgeon's appeal.
Bile duct injury during gallbladder surgery is not automatically negligent, but a court can find negligence where the anatomy was recognised and the injury still occurred, and separately for inadequate monitoring afterwards.
Claim failed
[2012] EWHC 2335 (QB)·2012·Liability decided at trial
Mrs Clements alleged that during bowel cancer surgery the surgeons twisted the bowel's mesentery before rejoining it and failed to check, causing obstruction, a second operation and catastrophic complications. The judge found the join was properly formed and the later obstruction was caused by adhesions, so there was no negligence.
Serious complications after surgery do not by themselves prove the operation was done negligently. The court will weigh the operating surgeons' evidence against what was found at the second operation.
Claimant succeeded
[2011] EWHC 219 (QB)·2011·Liability decided at trial
A GP re-examined a nine-week-old baby's hips after a colleague had noted they were stiff, recorded them as seeming fine and did not refer her to an orthopaedic specialist; the dislocated right hip was only discovered when she was seven and needed major surgery. The judge found the GP should have detected the limited hip movement and referred immediately, and that early referral would have led to simpler treatment.
When an infant hip check raises concern, a GP must refer for specialist assessment rather than arranging a distant re-check. Missing a dislocated hip in infancy turns a condition treatable with a splint into one needing major surgery.
Claimant succeeded£2,000
[2010] EWHC 1888 (QB)·2010·Liability and damages decided at trial
A doctor at a same-day treatment centre in April 2005 examined a man with a cold, painful foot but her findings were recorded only on an X-ray request form and never passed to the GP, who then failed over several weeks to diagnose limb-threatening ischaemia. The court found negligence but held the leg could not have been saved, awarding only £2,000 for extra pain.
Examination findings must be communicated to the next clinician, not left on a request form. Even proven negligence yields little compensation if the outcome could not have been changed.
Mixed outcome
[2006] EWCA Civ 1131·2006·Appeal decision
A woman who hurt her ankle ice skating attended University Hospital Cardiff A&E in May 2001, where an X-ray showed a fibula fracture but associated ligament ruptures went undiagnosed for a week. The trial judge dismissed her claim, but the Court of Appeal found the judgment flawed and sent the case back for a fresh trial.
An X-ray showing one fracture does not end the assessment; associated ligament injuries visible from the alignment need to be considered. A flawed first-instance judgment can be reopened on appeal.