Claimant succeeded
[2026] EWHC 1574 (KB)·2026·Liability and damages decided at trial
A 37-year-old alcohol-dependent man admitted for a facial abscess was not given the prophylactic vitamin B1 (Pabrinex) that guidelines required during withdrawal, which the Trust admitted was a breach. The judge found this caused Wernicke's encephalopathy and a lasting functional disorder, and set the main heads of damages including a 24-hour care regime.
Breach was admitted, so the case turned on proving the brain injury was caused by the omission rather than by pre-existing conditions. It illustrates how catastrophic-injury awards are built from a care multiplicand, case management and accommodation rather than a single headline figure.
Claim failed
[2025] EWHC 2597 (KB)·2025·Liability decided at trial
An orthopaedic surgeon had a second stroke and the on-call stroke consultant, assessing by telephone because the video link was broken, decided against clot-busting treatment. The judge found documentation was poor but that thrombolysis would probably not have changed the outcome, and rejected the defendants' allegation that the claimant had faked his test results.
Poor record-keeping and a remote consultation do not win a case on their own; the claimant must show the missed treatment would have made a real difference. A defence of dishonesty needs solid evidence and failed here.
Claimant succeeded
[2023] EWHC 2765 (KB)·2023·Damages assessed at trial
A man who fell from a scooter in May 2019 alleged the ambulance crew and the A&E department failed to recognise and immobilise a spinal injury, manage his blood pressure or protect him from pressure sores. On an interim payment application the Master was satisfied he would succeed on the hand-function and pressure-sore injuries and ordered £109,006.96.
Where the evidence of breach and causation is strong, a court can order a substantial interim payment before trial to fund immediate needs, even though the final award remains to be decided.
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.
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
[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.
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
[2015] EWHC 440 (QB)·2015·Liability decided at trial
A man with a bone disorder was admitted with leg pain, given antibiotics without blood cultures being taken first, and later discharged; weeks later he returned with a spinal infection and became paraplegic. The court found basic failures (no cultures, no monitoring of inflammatory markers) but was not satisfied they caused the paralysis.
Proving a hospital made mistakes is not enough; the claimant must show those mistakes probably caused the injury. Infection cases often turn on whether earlier detection would have changed treatment.
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.