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.
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£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.
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
[2016] EWHC 1604 (QB)·2016·Liability decided at trial
A man with known arterial disease and prior strokes developed severe foot pain and was treated for months by an orthopaedic surgeon, a pain specialist and a rheumatologist, none of whom checked for a vascular cause or felt for foot pulses. By the time critical ischaemia was diagnosed the leg could not be saved; the court found each of the three consultants negligent and held the leg was salvageable earlier.
Clinicians treating limb pain in a high-risk arterial patient must exclude a vascular cause, which starts with checking pulses. Multiple specialists can each be liable for the same missed diagnosis.
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.