§ GUIDE · HEAD INJURY

Sent home, or left waiting,
with a bleed on the brain

A head injury with vomiting or confusion, or a sudden severe headache, is supposed to trigger a scan. The five judgments here are cases where that did not happen or happened late. Two succeeded, including one in the Supreme Court. The others show why atypical symptoms make these claims hard.

Judgments read

5

Claimant succeeded

2 of 5

Key issue

When scan was due

Highest court

Supreme Court

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§ BEFORE YOU GO FURTHER

For a head injury or brain bleed claim, these things usually need to be true

  • You attended A&E or a doctor with a head injury, reduced consciousness, vomiting, confusion or a sudden severe headache.
  • A CT scan or referral was not done, or was done hours later than it should have been.
  • The delay allowed a bleed to grow or go untreated, and the resulting damage is worse than it would have been with a prompt scan.
  • It happened within the last three years, or you only recently found out.

Where the symptoms were unusual and no red flags were recorded, courts have accepted that a scan was not required. That is the difference between the wins and the losses below.

§ 01

The delayed CT scan

John v Central Manchester is the reference case for a delayed scan. A doctor who fell downstairs and was found vomiting and confused was admitted to A&E just before 7 am; his CT head scan was not done until after 1 pm. The court held the scan should have been performed by about 10 am and that the delay was negligent.

The judgment turned on when a scan became mandatory given the recorded symptoms. That is the question every one of these claims comes back to.

§ 02

Leaving A&E before being seen

Darnley v Croydon reached the Supreme Court. A man with a head injury was told by an A&E receptionist he faced a long wait; he left, deteriorated at home and suffered permanent brain damage. The court held the hospital owed him a duty not to give misleading information about waiting times. It is the leading case on what a hospital owes a patient who walks out.

§ 03

Why headache claims often fail

Jaciubek v Gulati involved severe headaches seen by a GP and then A&E; a subarachnoid haemorrhage followed days later. The judge accepted the earlier small bleeds had not presented with typical warning signs and found no breach by anyone. Mulholland v Medway, a brain tumour diagnosed seven months after an A&E visit, failed for the same reason: the A&E doctor's assessment was within acceptable practice at the time.

The lesson is not that headache claims cannot succeed. It is that the notes from the visit have to show red flags that a reasonable doctor would have acted on.

§ 04

What decides these cases

The exact time of arrival, the recorded observations, when a scan was requested and when it was done. Ambulance and triage records matter. If you left before being seen, what you were told matters. A solicitor will obtain the full A&E record before advising.

§ THE JUDGMENTS BEHIND THIS GUIDE

The five judgments behind this guide.

Each is a published decision of the courts of England and Wales, linked to its source.

Claimant succeeded

John v Central Manchester and Manchester Children's University Hospitals NHS Foundation Trust

[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

Darnley v Croydon Health Services NHS Trust

[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.

Claim failed

Jaciubek v Gulati & Anor

[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

Mulholland v Medway NHS Foundation Trust

[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.

Mixed outcome

Arksey v Cambridge University Hospitals NHS Foundation Trust

[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.

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

How quickly should a head injury be scanned?

It depends on the recorded symptoms. In John the court held a scan should have been done within about three hours of arrival for a confused, vomiting patient. National guidance sets triggers, and a solicitor will match the notes against them.

I left A&E because of the wait and collapsed later.

That is Darnley. The Supreme Court held a hospital can be liable for misleading information about waiting times that causes a patient to leave. The details of what you were told are crucial.

I had headaches for weeks and then a bleed. Is that negligence?

Only if the earlier presentations showed warning signs a reasonable doctor should have investigated. Jaciubek failed because they did not. The GP and A&E notes decide it.

Does the size of the bleed matter?

Yes. The claim has to show the delay made the injury worse. If the bleed would have caused the same damage with a prompt scan, the claim fails on causation even where the delay was negligent.

How long do I have?

Three years from the injury, or from when you first realised care may have fallen short. Longer for children and for people without capacity.

§ MORE GUIDES

Plain answers to the other questions people ask.

Why claims fail →

Eleven real judgments where the claim failed, and what each one teaches about proving breach of duty, causation and loss in a medical negligence claim.

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.

Stroke claims →

Seven published judgments where a stroke, mini-stroke or its cause was missed or not treated. Five failed. What separated the two that succeeded.

Payout examples →

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

Fatal negligence payouts →

What compensation after a death caused by medical negligence can include: the bereavement award, dependency, funeral costs and the estate's claim.

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.