John v Central Manchester and Manchester Children’s University Hospitals NHS Foundation Trust - Viewing document

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[2016] WLR (D) 115

Queen’s Bench Division

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

[2016] EWHC 407 (QB)

2016 Feb 1–5, 8, 10, 15; March 2

Picken J

Negligence— Causation— Brain injury— Claimant suffering head injury resulting in brain damage— Claimant alleging defendant’s negligent delay in performing CT scan materially contributing to brain injury— Whether sufficient to show defendant’s negligence materially contributing to brain damage— Whether “but for” test appropriate to establish causation

The claimant suffered a head injury and was taken to a hospital managed by the defendant. A CT scan was performed some six hours after his admission and he was transferred to another hospital where he underwent surgery. He was left with cognitive and neuropsychological deficits. He claimed damages in negligence against the defendant contending, inter alia, that the defendant’s negligent delay in undertaking the CT scan had resulted in a period of raised intra-cranial pressure which had caused or materially contributed to his brain damage. The defendant contended that only if the claimant could establish that damaging raised intra-cranial pressure caused by the defendant’s negligence had caused his brain injury that, applying the classic “but for” test of causation, he could recover as against the defendant, and that it was insufficient to establish “material contribution”.

On the claim—

Held, claim allowed and damages awarded in the sum of £454,858·65, inclusive of interest. The defendant had been negligent as alleged, resulting in the claimant suffering a period of raised intra-cranial pressure. As to causation, “material contribution” was an appropriate test in a case like the present concerning material contribution to injury or damage rather than contribution to risk. Unlike a case which had as its focus risk rather than injury or damage, where for causation to be made out there had to be a single agent, the “material contribution” approach applied to both single agency and multiple factor cases. Further, in “material contribution” to damage cases (as opposed to “material contribution” to risk cases) the claimant was able to recover in relation to the entirety of his or her injury without the need for apportionment. In view of the expert evidence, the period of damaging raised intra-cranial pressure had made a material contribution to the claimant’s brain injury and, causation having been established, the claimant was entitled to recover without deduction (paras 52, 59, 79, 96–97, 101, 104, 105, 121).

Bailey v Ministry of Defence [2009] 1 WLR 1052, CA and Williams v Bermuda Hospitals Board [2016] UKPC 4, PC considered.

Darryl Allen QC (instructed by Slater & Gordon (UK) LLP, Manchester) for the claimant.

Andrew Kennedy (instructed by Hempsons, Manchester) for the defendant.

Benjamin Weaver Esq, Barrister