Claimant succeeded
[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.
Mixed outcome
[2024] EWHC 1304 (KB)·2024·Liability decided at trial
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.
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.
Claimant succeeded
[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
[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.
Claimant succeeded£40,000
[2020] EWHC 2914 (QB)·2020·Liability and damages decided at trial
Ms Leach, alone at home with a brain haemorrhage, waited nearly two hours for an ambulance, of which the trust admitted 31 minutes was negligent delay; she went on to develop PTSD. The judge held that the negligent delay made a material contribution to her PTSD, that PTSD cannot be apportioned, and awarded the agreed £40,000.
Where a negligent ambulance delay materially contributes to a psychiatric injury like PTSD, the trust is liable for the whole injury and cannot reduce damages by arguing only part of the wait was its fault.
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£75,000
[2018] EWHC 3281 (QB)·2018·Liability decided at trial
Mr Bolton, 77, was brought to A&E by ambulance in respiratory failure and distress; after nebulised treatment he improved and the A&E doctor sent him home with antibiotics, without properly considering the paramedic and triage records. He collapsed at home hours later with an obstructed airway and died; the judge found he should have been admitted and awarded the agreed £75,000.
An A&E doctor must take account of the full picture, including paramedic and triage records, before discharging a patient who arrived in respiratory failure. Improvement after treatment does not make discharge safe if the underlying cause has not been identified.
Claimant succeeded
[2018] UKSC 50·2018·Appeal decision
A man with a head injury was told by an A&E receptionist he would wait four to five hours, left after 19 minutes, and collapsed at home with a brain bleed. The Supreme Court held the hospital owed him a duty not to give misleading information about waiting times and that his leaving did not break the chain of causation.
An NHS trust's duty of care in A&E starts at the reception desk, and wrong information given by non-clinical staff can found a negligence claim.
Claimant succeeded
[2017] EWHC 3027 (QB)·2017·Liability decided at trial
A man with type 1 diabetes was brought to A&E after a hypoglycaemic attack, left the department within about 15 minutes, climbed five flights of stairs through unsecured doors to a flat roof, and fell into a courtyard. The judge found the Trust liable because it had not risk-assessed or restricted access to the roof, where furniture made the safety barrier easy to climb.
A hospital's duty to a confused or vulnerable patient covers the safety of the building and how patients are supervised, not just medical treatment. A patient who cannot appreciate the danger because of his condition is not treated as partly to blame.
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 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
[2015] EWHC 2363 (QB)·2015·Liability decided at trial
A woman attending Medway Maritime Hospital A&E in March 2010 with an evolving stroke was not given aspirin promptly after she deteriorated, which the court found was negligent. The claim still failed because the evidence showed her outcome would have been the same even with aspirin.
Proving that A&E staff were negligent is not enough; the claimant must also show the negligence changed the outcome. Where the stroke was untreatable in time, the claim fails on causation.
Claim failed
[2015] EWHC 268 (QB)·2015·Liability decided at trial
A man seen at Medway Maritime Hospital A&E in January 2010 with neurological symptoms was discharged without a CT scan or TIA clinic referral, and a brain tumour was diagnosed seven months later. The court held the triage nurse and A&E doctor acted within acceptable practice, so the claim failed.
An A&E doctor who makes a reasonable assessment and relies appropriately on specialist input is not negligent just because the diagnosis later proves wrong.
Claimant succeeded£522,379
[2014] EWHC 286 (QB)·2014·Liability and damages decided at trial
Ms Leigh dislocated her kneecap boarding a bus and was trapped in severe pain for about 50 minutes before an ambulance arrived; the trust admitted 17 minutes of that delay was negligent. The judge found the negligent delay made a material contribution to her PTSD, that her dissociative seizures were part of the PTSD, and assessed damages at £522,379 plus interest.
Even a short negligent ambulance delay can found a substantial claim where it materially contributes to a serious psychiatric injury. Damages can include lost earnings and pension where the injury ends the claimant's career.
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.