§ GUIDE · FATAL DISCHARGE

Sent home,
and they died.

Losing someone hours or days after they were seen and sent away is the hardest version of a medical negligence claim, and one of the most common things people ask us about. The law asks two questions: should they have been admitted or referred, and would that have saved them? These seven judgments show how both are answered.

Judgments read

7

Families succeeded

4 of 7

Henderson: agreed sum

£75,000

Bayless: settlement

£340,000

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§ BEFORE YOU GO FURTHER

For a fatal discharge claim to get anywhere, these things usually need to be true

  • The person who died was seen with the illness that killed them, by A&E, a GP, paramedics or a ward, and was sent home, left at home or not taken in.
  • There was a warning the clinician had or should have had: the paramedic and triage records, an abnormal ECG, a known previous clot, breathing difficulty on arrival.
  • Admission or referral that day would probably have led to treatment that saved them. This is where three of the seven claims below failed.
  • The death was within the last three years, or the family only recently learned that care fell short.

An inquest finding, an apology, or an admitted mistake does not by itself win the claim. Callaghan and Mellor both had a breach and still failed, because the court was not persuaded the death would have been avoided.

§ 01

The duty is to look at the whole picture.

Henderson v The Hillingdon Hospital NHS Foundation Trust [2018] EWHC 3281 (QB) is the A&E discharge case to read first. Mr Bolton, 77, was brought in 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 what the paramedic and triage records showed. He collapsed at home hours later with an obstructed airway and died.

The judge found he should have been admitted and could not safely have been discharged, and entered judgment for the agreed £75,000, to be shared between his dependants. The principle is simple and applies far beyond this case: improvement after treatment does not make a discharge safe if the underlying cause has not been identified, and a doctor must take account of everything the department already knows.

§ 02

Sent home by a GP, or left at home by paramedics.

Marshall v Schembri [2019] EWHC 283 (QB)

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

Taaffe v East of England Ambulance Service [2012] EWHC 1335 (QB)

Paramedics attended a woman with severe chest pain, found it had subsided, took two ECGs, one of which the machine flagged as abnormal, and left her to see her GP the next day. She died of a heart attack five days later. The judge found they had failed to take a proper history or weigh her risk factors and should have advised hospital; damages of £119,048 were awarded.

Bayless v Norfolk and Norwich University Hospitals [2023] EWHC 2986 (KB)

The trust admitted it had missed an aortic dissection in a chest-pain patient that emergency surgery would probably have cured, and settled the widow's and children's claims for £340,000. The later judgment arose because that settlement had never been approved by the court, as it must be where children are involved.

§ 03

Where the claims failed: causation.

Callaghan v South Tees Hospitals [2023] EWHC 1199 (KB)

A baby was discharged two days after birth and died of Group B strep meningitis and sepsis. The judge found one limited breach, a missing piece of discharge advice, and that it did not cause the death because the mother would not have returned to hospital in time. Damages of £18,000 had been agreed if the claim succeeded; nothing was payable.

Shah v North West London Hospital [2013] EWHC 4088 (QB)

A 37-year-old mother collapsed with leg weakness days after giving birth and died of 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. The judgment is still read for its worked example of how a widower's and children's dependency would have been calculated.

Mellor v Sheffield Teaching Hospitals [2004] EWHC 780 (QB)

A woman with years of chest pain and strong cardiac risk factors had her exercise test wrongly called negative and was discharged from cardiology. She died of a cardiac arrest a year later. The judge found the discharge negligent but that she could not be shown to have reached investigation and treatment in time, so the claim failed.

§ 04

What a fatal claim is made of.

Two statutes do the work. Under the Fatal Accidents Act 1976 the family claims the statutory bereavement award, a fixed sum that is currently £15,120 for deaths since May 2020, and dependency: the income, pension and practical support the person would have provided. Under the Law Reform (Miscellaneous Provisions) Act 1934 the estate claims for the pain and suffering before death and the funeral costs.

Shah shows the arithmetic even though the claim failed: the judge set out funeral expenses of £7,000, a bereavement award of £12,027 at the then rate, loss of the mother's intangible services of £22,750, and dependency losses of £95,309 past and £159,751 future. Taaffe shows a 40 per cent discount applied to dependency because the marriage might not have lasted. Where children are among the claimants, any settlement must be approved by the court, which is the lesson of Bayless.

Most fatal claims follow an inquest. The inquest decides how someone died, not whether anyone was negligent, but its evidence is often the foundation of the claim. Our guide on inquests explains what it can and cannot do.

§ 05

What helps the family's claim.

  • The ambulance or paramedic record, which in Henderson and Taaffe held the evidence the clinician overlooked.
  • Triage notes and observations on arrival, and the ECG printouts.
  • The discharge letter and any advice about when to return.
  • GP records of the consultation, if the person was sent home by a GP.
  • The medical certificate of cause of death, the post-mortem report and the inquest evidence.
  • A timeline of the hours and days after discharge: who was called, when, and what was said.

§ THE JUDGMENTS BEHIND THIS GUIDE

The seven judgments behind this guide.

Four families succeeded and three did not. The three losses explain, better than anything, what the four wins had to prove.

Claimant succeeded£75,000

Henderson v The Hillingdon Hospital NHS Foundation Trust

[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

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£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£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.

Claim failed

Callaghan v South Tees Hospitals NHS Foundation Trust

[2023] EWHC 1199 (KB)·2023·Liability decided at trial

A baby born at James Cook University Hospital was discharged two days after birth and died of GBS meningitis and sepsis. The judge found only one limited breach (a missing piece of discharge advice) and that it did not cause the death because the mother would not have returned to hospital in time.

Even where a hospital gets something wrong, the claim fails unless the mistake is shown to have changed what happened. Record-keeping failings alone did not establish causation here.

Claim failed

Shah v North West London Hospital NHS Trust

[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.

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.

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

My mother died the day after being sent home from A&E. Can we claim?

Possibly. You need to show she should have been admitted or referred, and that doing so would probably have saved her. Henderson v Hillingdon succeeded on exactly that basis; Shah v North West London failed because the court found the doctor's decision was reasonable and would not have changed the outcome.

What is the difference between the bereavement award and dependency?

The bereavement award is a fixed statutory sum, currently £15,120, paid to a spouse, civil partner, qualifying cohabitant or the parents of an unmarried child under 18. Dependency is the family's actual financial and practical loss: income, pension, childcare and household services. Our guide on how dependency is worked out goes through the calculation.

The inquest found neglect. Does that win the claim?

No, but it helps. An inquest decides how someone died, not whether a clinician was negligent, and it applies a different test. The evidence given at the inquest, the records disclosed and the coroner's conclusions are often the backbone of the claim that follows.

The hospital has apologised and admitted mistakes. Do we still have to prove anything?

You still have to prove the mistake caused the death. In Callaghan v South Tees the judge found a breach and still dismissed the claim because the death would not have been avoided. An admission of breach is valuable, but causation is tested separately.

How long do we have?

Three years from the date of death, or from when the family first knew that care may have fallen short. Where children are among the claimants any settlement must be approved by the court, as Bayless shows, and that is the solicitor's job to arrange.

Should we complain to the hospital first?

You can, and the duty of candour means the trust should already have told you what went wrong. But the NHS complaints process cannot award compensation, and making a complaint does not pause the three-year limit on a claim.

§ MORE GUIDES

Plain answers to the other questions people ask.

Sent home from A&E →

A&E discharge claims: the duty that starts at the reception desk, missed warning signs, and the causation hurdle that decides most cases. Real judgments.

How dependency works →

The four parts of a fatal medical negligence claim, how dependency is calculated from income and services, and the settlement trap that can bar a family's claim.

Inquests explained →

An inquest cannot find anyone negligent. The law forbids it. What it can do is establish facts on oath, and that is often where a claim begins.

Breathing problems missed →

A man in respiratory failure discharged from A&E, a chest X-ray never mentioned, a child with severe asthma sent home: five judgments and what they required.

Payout examples →

UK medical negligence payout examples by claim type, typical compensation ranges, and what decides the amount. Then check your own claim free.

NHS payout data →

Official NHS Resolution figures, band by band, for 2024/25.

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.