Every one a published decision of the courts of England and Wales, linked to its source. Four losses and three wins.
Claimant succeeded
[2017] EWHC 1795 (QB)·2017·Liability decided at trial
A 53-year-old diabetic attended A&E with fever, rectal pain and urinary difficulty; a possible abscess was noted but he left before blood results and was not properly investigated. He returned two days later in septic shock and lost his lower leg, toes and fingers; the court found that proper care at the first attendance would have avoided the amputations.
Diabetic patients with fever and localised pain need prompt investigation for a source of infection. A&E is responsible for ensuring a possibly septic patient is not allowed to leave without a plan.
Mixed outcome
[2024] EWHC 1304 (KB)·2024·Liability decided at trial
A woman went to A&E with extreme lower-leg pain and was sent home by a nurse practitioner instead of being seen by a senior doctor or referred to surgeons; she developed a necrotising soft tissue infection and lost her leg. The Trust admitted negligence but tried to rely on the nurse's evidence disputing how much pain she reported; the Master ruled that evidence inadmissible because the defence had never properly pleaded that dispute.
An NHS trust cannot admit negligence and then quietly contest the facts at trial without pleading them. Severe, out-of-proportion pain in a limb is a recognised warning sign of necrotising infection that calls for senior review.
Claim failed
[2023] EWHC 1911 (KB)·2023·Liability decided at trial
A woman attended a GP drop-in clinic with groin pain after an injection had missed the vein; the GP diagnosed a haematoma and sent her away with painkillers, and days later she was admitted with necrotising fasciitis and her right leg was amputated at the hip. The judge found the GP's examination and diagnosis were ones a reasonable body of GPs would support, so the claim failed despite the defendant accepting that referral would have saved her leg.
Even where a devastating outcome and causation are accepted, a claim fails unless the clinician's decision fell outside what a responsible body of practitioners would have done. A properly documented history and examination that reasonably excluded infection was a complete defence.
Claim failed
[2022] EWHC 100 (QB)·2022·Liability decided at trial
After routine day-case removal of a scrotal cyst, the claimant returned in the early hours in severe pain; intravenous antibiotics were not started when they should have been and an ultrasound request was delayed, and he was later diagnosed with Fournier gangrene, needing repeated surgery and losing both testicles. The judge found breach of duty but held the claimant could not prove the delays changed the outcome.
Proving that care fell below standard is only half the case: the claimant must also show the negligence made a difference. Where surgery would have happened at the same time anyway, delayed antibiotics or scans may not be shown to have caused the injury.
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.
Claim failed
[2016] EWHC 251 (QB)·2016·Liability decided at trial
After surgery for a broken femur at St Richard's Hospital, Chichester, the patient was discharged in April 2008 without arrangements to repeat his inflammatory-marker blood tests, and a deep infection was diagnosed later. The court found this discharge and a four-day debridement delay were breaches of duty, but there was no evidence they made his condition materially worse, so the claim was dismissed.
Discharging a patient without arranging follow-up blood tests can be a breach of duty, but compensation depends on showing the delay actually worsened the outcome.
Claimant succeeded
[2024] EWHC 3156 (KB)·2024·Liability decided at trial
A young woman with cerebral palsy had a PEG feeding tube inserted and was found unresponsive two days later with peritonitis and sepsis. The judge rejected the doctor's account of how the tube was fixed, found it was placed under too much tension, and entered judgment for the claimant.
Where a clinician's recollection is unreliable and contradicted by the physical evidence, the court can find a procedure was done negligently. Causation may still be limited where a pre-existing condition would have deteriorated anyway.