§ GUIDE · HEART

Chest pain sent away.
A heart attack followed.

Chest pain is the presentation every A&E, GP and paramedic is trained to take seriously, and the published judgments show what happens when a normal ECG, a busy department or a quick reassurance stands in for a proper history. Six of the eight judgments here succeeded. The two losses show the causation trap: a missed diagnosis is only compensated if timely treatment would have changed the outcome.

Judgments read

8

Claimant succeeded

6 of 8

Largest sum stated

£340,000

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§ BEFORE YOU GO FURTHER

For a missed heart attack claim to get anywhere, these things usually need to be true

  • You or your relative reported chest pain, breathlessness, palpitations or collapse, and had risk factors or a history a reasonable clinician should have weighed.
  • You were sent away, streamed elsewhere, or reassured without a proper history, tests or referral.
  • Timely investigation or treatment would probably have prevented the heart attack, the dissection or the death.
  • It happened within the last three years, or you only recently found out.

Two of the losses here accepted the care was negligent but found the outcome would have been the same. The records of the first contact and the timeline to the event are what a solicitor needs.

§ 01

Sent away from A&E

Crammond v Medway: a man with four days of central chest pain radiating to both arms was streamed by an A&E doctor to a same-day treatment centre on the strength of a near-normal ECG, without a history being taken; a GP there diagnosed gastritis. Four years later he had cardiac failure and a stroke. The court held a competent A&E doctor would have taken a short history and ordered tests that would have found his heart disease. Bayless v Norfolk and Norwich: an aortic dissection missed in a 42-year-old with chest pain, accepted as negligent and fatal, settled for £340,000. ABC v Barts: a torn aorta undiagnosed for 20 days, breach admitted, settled for £50,000 after the claimant accepted an offer late and paid a heavy price in costs.

§ 02

Missed by paramedics and GPs

Taaffe v East of England Ambulance: paramedics attended a woman with severe chest pain, found it had subsided, took two ECGs, one flagged abnormal by the machine, and left her to see her GP; she died of a heart attack five days later. The court found they failed to take a proper history or weigh her risk factors, and awarded £119,048. Marshall v Schembri: chest pain and breathlessness in a woman with a previous clot, diagnosed by her GP as a strained muscle; she died the next morning of a pulmonary embolism, and the court found she would very probably have survived with hospital referral.

§ 03

Palpitations and rhythm problems

Dakin v South Tees: recurring palpitations seen by a hospital physician who did not arrange 24-hour heart monitoring; atrial fibrillation went undetected and a stroke followed six months later. The court found monitoring would have caught it in time for blood thinners, and gave judgment for the claimant.

§ 04

Where these claims fail

Mellor v Sheffield: years of chest pain with strong risk factors, an exercise test wrongly called negative and a discharge from cardiology; she died of a cardiac arrest a year later. The judge found the discharge negligent but not that she would have reached investigation and treatment in time, so the claim failed. Paul v Royal Wolverhampton went to the Supreme Court on a different question: whether daughters who witnessed their father's fatal heart attack, after his heart disease had been missed, could claim for their own trauma. They could not.

§ THE JUDGMENTS BEHIND THIS GUIDE

The eight judgments behind this guide.

Every one a published decision of the courts of England and Wales, linked to its source.

Claimant succeeded

Crammond v Medway NHS Foundation Trust

[2015] EWHC 3540 (QB)·2015·Liability decided at trial

Mr Crammond went to A&E with four days of central chest pain radiating to both arms, but an A&E doctor streamed him to the same-day treatment centre on the strength of an essentially normal ECG without taking a history, and a GP there diagnosed gastritis. The judge held that a competent A&E doctor would have taken a short history and ordered tests that would have revealed his heart disease, avoiding the severe heart problems he suffered four years later.

An A&E doctor cannot rely on a normal ECG to send a chest-pain patient away without taking a proper history. Redirecting a patient to a lower-acuity service without assessing their risk factors can itself be negligent.

Claimant succeeded£340,000

Bayless & Ors v Norfolk and Norwich University Hospitals NHS Foundation Trust

[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.

Settlement approved£50,000

ABC v Barts Health NHS Trust

[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£119,048

Taaffe v East of England Ambulance Service NHS Trust

[2012] EWHC 1335 (QB)·2012·Liability and damages decided at trial

Paramedics attended Mrs Taaffe for severe chest pain, found it had subsided, took two ECGs (one flagged by the machine as abnormal) and left her to see her GP the next day; she died of a heart attack five days later. The judge found the paramedics failed to take a proper history or assess her risk factors and should have advised hospital attendance, where her condition would have been found and treated.

Ambulance crews owe a duty to take a proper history and weigh risk factors, not just current symptoms, before deciding not to convey a chest-pain patient. Where hospital assessment would have prevented the death, the ambulance trust is liable.

Claimant succeeded

Marshall v Schembri

[2019] EWHC 283 (QB)·2019·Liability decided at trial

A woman with a previous pulmonary embolism saw her GP with chest pain and breathlessness and was diagnosed with a strained muscle; she died the next morning. The GP admitted he should have referred her to hospital, and Stewart J found she would on the clear balance of probabilities have survived with anticoagulation and monitoring.

Chest pain and breathlessness in someone with a past clot is a red flag needing same-day hospital referral. Where survival chances on admission would have been very high, the court will find the death was caused by the failure to refer.

Claimant succeeded

Dakin v South Tees Hospitals NHS Foundation Trust

[2026] EWCC 26·2026·Liability decided at trial

A theatre nurse with worsening palpitations saw a hospital physician who admittedly failed to arrange 24-hour ECG monitoring. The judge found monitoring would have caught her atrial fibrillation in time for anticoagulants to prevent the stroke she suffered.

Palpitations that keep coming back need proper heart-rhythm monitoring. Where a missed test would have led to blood-thinning treatment, a later stroke can be laid at the hospital's door.

Claim failed

Mellor v Sheffield Teaching Hospitals NHS Trust & Ors

[2004] EWHC 780 (QB)·2004·Liability decided at trial

Mrs Mellor had years of chest pain with strong cardiac risk factors; a hospital cardiologist wrongly described her exercise test as negative and discharged her, and she died of a cardiac arrest a year later. The judge found the discharge negligent but that the claimant could not prove she would have reached angiography and treatment in time, so the claim failed; the claims against the two GPs also failed.

Proving a doctor was negligent is not enough: the claimant must also show that proper care would have changed the outcome. Where the deceased would only have had routine priority for investigation, a claim can fail on causation even with a clear breach.

Claim failed

Paul and another v Royal Wolverhampton NHS Trust; Polmear and another v Royal Cornwall Hospitals NHS Trust; Purchase v Ahmed

[2024] UKSC 1·2024·Appeal decision

Three families sought damages for psychiatric injury after watching a relative die from a condition that doctors had negligently failed to diagnose. The Supreme Court (Lord Burrows dissenting) held that doctors do not owe relatives a duty to protect them from the shock of witnessing a patient's death or medical crisis.

Relatives who develop a psychiatric illness from witnessing a loved one's death caused by medical negligence generally cannot claim as secondary victims. Their remedies are limited to the Fatal Accidents Act dependency and bereavement claims.

Browse the whole case library →

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.

§ QUESTIONS

Common questions

A&E said my ECG was normal and sent me home. Then I had a heart attack.

Crammond is that case, and it succeeded because no proper history was taken. A normal ECG does not rule out heart disease, and the records of what was asked and recorded decide it.

Paramedics said it was a panic attack or a muscle strain.

Taaffe and Marshall both succeeded on exactly that. Chest pain with risk factors, or with a previous clot, calls for hospital assessment. The crew's or GP's notes are the evidence.

My relative died of a heart attack after a doctor missed it. Can the family claim?

Yes, the estate and dependants can. Taaffe and Bayless were both fatal claims that succeeded. Relatives who witnessed the death cannot usually claim for their own trauma after Paul v Royal Wolverhampton.

The hospital admits it should have investigated. Does that win the case?

No. In Mellor the discharge was found negligent and the claim still failed because timely investigation could not be shown to have saved her. Causation is the central question in every one of these cases.

How long do I have?

Three years from the heart attack, or from when you first realised care fell short. For a death, the family has three years from the death.

This guide is general information about the law in England and Wales, not legal advice about your case. ClaimGavel is run by Costart Projects Ltd on behalf of Tomlin & Partners, a specialist medical negligence firm regulated by the SRA. The free assessment on this page is an AI overview to show you roughly where you stand; a solicitor confirms the position in a free, no-obligation conversation.