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Robertson v Nottingham Health Authority
(1997) 8 Med LR 01
Professional liability — Obstetrics — Multicystic-leuco-encephalo-malacia — Interpretation of ultrasound scans — Expectant mother admitted to hospital following reduction in foetal movements — Sporadic bradycardia and foetal distress during Braxton-Hicks contractions — Failure to monitor ultrasound scans by Pinnard's stethoscope — Pattern of concurrent decelerations — Delivery by caesarean section following seventh scan — Baby delivered brain damaged — Whether finding of culpable delay up to a maximum of two hours” duration was correct — Whether delay caused or contributed to plaintiff's condition — Whether finding of negligence on part of doctor was sustainable
Kelly v Bastible
[1997] LS Law Med 15
Limitation — Prejudice — Discretion — Insurance — Action by plaintiff suffering from cerebral palsy allegedly caused by medical negligence — Deceased doctor accused of negligence — Writ issued against doctor's estate 24 ½ years after birth — Finding by trial judge that plaintiff had actual or constructive knowledge before age of majority — Exercise of court's discretion under section 33 — Correct approach when considering prejudice under Limitation Act 1980 section 33 defendant was insured was to treat insurer and defendant as composite unit even where plaintiff had no claim over against his solicitors — Abuse of process — Delay — Cerebral palsy allegedly caused by negligence at birth — Writ issued 24 ½ years after cause of action arose — Whether abuse of process
Rowan v Steinberg
(1997) 8 Med LR 30
Professional liability — General practitioner — Drug dependency — Equanil — Whether patient had established that she was dependent on drug Equanil — Whether, in not withdrawing drug in patient's particular circumstances, general practitioners were negligent — Whether court should reject as unreasonable expert evidence given for defenders — Whether doctors” clinical practice in not withdrawing drug from patient put patient “unnecessarily at risk” — Damages — Damages — Drug dependency — Solatium — Patrimonial loss
Drury v Grimsby Health Authority
(1997) 8 Med LR 38
Limitation — Knowledge — Discretion of court — Operation in 1976 for rodent ulcer on nose — Histology report that carcinoma not totally excised — Failure to recall patient — Operation in 1978 to remove nose — Whether plaintiff had actual knowledge that injury suffered was significant immediately after 1978 operation and constructive knowledge that injury was capable of being attributable to omission complained of by 1982 — Whether equitable for court to exercise its discretion under Limitation Act 1980 sect 33
Corley v NW Hertfordshire Health Authority
(1997) 8 Med LR 45
Professional liability — Obstetrics — Midwifery practice — Cord accident — Hypoxia caused by umbilical cord tight around baby's neck — Whether there should have been continuous CTG monitoring — Whether intermittent electronic monitoring acceptable — Whether labour in high risk category — Whether defence case as to likely scenario should be accepted — Whether defendant health authority was negligent
AB and Others v John Wyeth & Brother Ltd
[1997] LS Law Med 57
Practice — Group litigation — Benzodiazepine litigation — Withdrawal of legal aid by Legal Aid Board — Whether judge acted correctly in striking out remaining actions by non-legally aided plaintiffs on grounds that they were an abuse of process, frivolous, vexatious or otherwise bound to fail — Whether there had been inordinate and inexcusable delay such as to make fair trial impossible
Appleton & Ors v Garrett
(1997) 8 Med LR 75
Professional liability — Dentistry — Unnecessary treatment — Consent — Trespass — Damages — Dentist withholding information deliberately and in bad faith — Whether patients who had undergone unnecessary treatment had not consented to treatment — Whether tort of trespass to person had been made out — Whether patients were entitled to aggravated damages — Damages — Trespass to person — Aggravated damages — Unnecessary dental treatment carried out for financial gain — Patients suffering anxiety and anger — Dentist withholding information deliberately and in bad faith — Patients not consenting to treatment of those teeth that required no treatment — Damages — Future costs — Dental treatment
Betts v Berkshire Health Authority
(1997) 8 Med LR 87
Professional liability — Reproductive surgery — Repair of inguinal hernia — Loss of testicle — Excision of lipoma attached to spermatic cord — Compromise of blood circulation leading to atrophy and loss of left testicle — Quantification of risk — Whether atrophy caused by lack of care or unexplained mechanism
AB and Ors v Tameside & Glossop HA
(1997) 8 Med LR 91
Health authority — Negligence — Warning of HIV infection — Accurate, but distressing, news communicated by letter — Whether news communicated in a negligent manner — Whether judge correctly found health authorities in breach of duty — Legal duty on health authorities — Appropriate legal test — Effect of Department of Health Guidelines
Skitt v Khan
[1997] LS Law Med 105
Limitation — Knowledge — Discretion — Deceased injuring his leg in 1977 — Psoriasis diagnosed in 1982 — Varicose ulcer diagnosed in 1984 — On August 10 1986 deceased told that he had cancer in his leg — Deceased deciding not to take action because of lack of finance — On July 4, 1992, deceased died of cancer — Action commenced January 7, 1994 — Whether judge correctly found that deceased did not have actual or constructive knowledge — Whether judge's exercise of discretion in favour of plaintiff would have been flawed
Raji-Abu-Shkara v Hillingdon Health Authority
(1997) 8 Med LR 114
Professional liability — ENT — High Dependency Unit — Patient with infected tracheal tube — Awaiting operation for resection — Respiratory arrest — Alleged negligent failure by nurse and/or senior house officer then on duty to observe and/or report upon signs of developing hypoxia — Whether omission by nurse and/or SHO to carry out arterial blood gas analysis (“ABGA”) was negligent
North Essex District Health Authority v Spargo
[1997] LS Law Med 125
Limitation — Knowledge — “Attributable” — Misdiagnosis — Expert confirmation — Plaintiff released from compulsory admission to mental hospital in November 1981 — Cause of action accruing by time of release — Writ issued 12 years later — Whether plaintiff knew that injury was attributable to act or omission alleged to constitute negligence, nuisance or breach of duty
Brown v Guys & Lewisham NHS Trust
(1997) 8 Med LR 132
Operation — Negligence — Closure of wound following multiple myomectomy — Plaintiff suffering pain and inflammation — Keloid noted — Exploratory operation finding nylon suture deep in wound — Applicability of res ipsa loquitur
Cunningham v North Manchester Health Authority
(1997) 8 Med LR 135
Appeal — New trial — Fresh evidence — Medical negligence case — Defendant health authority's failure to disclose original X — rays and arteriograms — Minaturised copies supplied to plaintiff's experts — Original X — rays and angiograms supplied to defence experts — Facts coming to light on second day of trial — Counsel for plaintiff declined adjournment — Opportunity for plaintiff's expert, before he gave evidence, to examine originals and compare them with miniaturised copies — New report of expert after trial regarding evidential value of miniaturised copies as worthless — Whether further evidence would have important influence on result of case
Coad v Cornwall & Isles of Scilly Health Authority
(1997) 8 Med LR 154
Limitation — Discretion — Reasons for delay — Cogency of evidence — Nurse injured while lifting quadriplegic patient — Action commenced 8½ years after accident — Plaintiff believing she had right of action only if she was incapacitated and unable to work — Plaintiffs explanation for delay accepted by trial judge — Judge's decision that, although evidence at the trial would be less cogent and defendants would have difficulty in evaluating claim, case was remarkably well documented — Judge exercising his discretion under Limitation Act 1980 sect 33 in favour of plaintiff — Whether test when applying sect 33 (a) was objective or subjective — Whether defendants had established that judge was so plainly wrong that his decision exceeded ambit within which reasonable disagreement was possible
Fallows v Randle
(1997) 8 Med LR 160
Professional liability — Gynaecology — Failed sterilisation — Laparoscopic sterilisation by use of “Fallope” ring occluding fallopian tube at isthmus — Ring found not to be in correct position when second operation was carried out — Whether judge entitled to make finding based upon evidence of plaintiff's medical expert as to most likely explanation of what had happened — Applicability of Bolam principle
Re T (A Minor)
(1997) 8 Med LR 166
Medical treatment — Minor — Consent — Baby suffering from biliary atresia — Evidence that baby would die without liver transplantation — Relatively novel treatment available and recommended as in his best interests by three doctors — Parents, experienced health carers, refusing consent for operation — Close attachment between mother and baby — Parents and child out of jurisdiction — Whether it was in best interests of child for court to direct mother to take on commitment where she did not agree with course proposed
Slevin v Southampton and SW Hampshire Health Authority
[1997] LS Law Med 175
Limitation — Knowledge — Actual and constructive knowledge — Action separated from events giving rise to it by 26 years — Date when plaintiff had actual and constructive knowledge under Limitation Act 1980 — Whether fact relevant to plaintiff's right of action deliberately concealed from her or her parents — Whether equitable to allow action to proceed under sect 33
Gaughan v Bedfordshire Health Authority
(1997) 8 Med LR 182
Professional liability — Midwifery — Dystocia — Traction used to deliver large baby with shoulder dystocia — Erb's palsy — Whether midwife should have anticipated shoulder dystocia — Whether member of medical team should have been alerted and/or present in labour room when stage 2 of labour began — Whether midwife's strategy for dealing with shoulder dystocia was acceptable judged by 1991 standards — Whether midwife exercised reasonable care and skill in implementing chosen strategy — Whether midwife's lack of care or skill caused brachial plexus injury — Whether, if midwife had used some other method of delivery, it was likely that injury would not have occurred
Miles v West Kent Health Authority
(1997) 8 Med LR 191
Professional liability — — Surgeon – Laparoscopic cholecystectomy — “keyhole” surgery for removal of gall bladder — Bile duct clamped and cut in two places — Situation not remedied for some 11 days — Whether surgeon negligent — Repair operation — Patient suffering from irritable bowel syndrome and depression — Patient unable to work — Whether caused by surgeon's negligence
Hill v West Lancashire Health Authority
(1997) 8 Med LR 196
Professional liability — Gynaecology — Cerebral palsy — Cesarian section — Passage of meconium indicating fetal distress — Persistent fetal circulation — Whether failure to perform cesarian earlier was negligent — Whether plaintiff had established that he suffered cerebral damage caused by hypoxia in hour before his birth and that cerebral damage was cause or material cause of his cerebral palsy — Effect of Apgar scores and development of hypoxic ischemic encephalopathy in neonatal period
Re MB
(1997) 8 Med LR 217
Medical treatment — Consent — Capacity — Mentally competent adult patient refusing to have cesarian because of “needle phobia” — Whether patient could refuse medical treatment where consequence might be death or serious handicap of child she bore or her own death — Whether lawful for doctors to intervene if it were believed that patient lacked capacity to decide — Principles applicable — Procedure to be followed
Le Page Kingston & Richmond Health Authority
(1997) 8 Med LR 229
Professional liability — Obstetrics — Cesarian section — Post partum haemorrhage requiring hysterectomy — Delay in transfusing blood following operation — Accumulation of blood and clot in uterus — Hysterectomy due to post-partum haemorrhage — Whether plaintiff's condition could have been controlled sooner, thereby obviating necessity of hysterectomy directly causative of plaintiff's gradual deterioration into condition in which haemorrhage became ultimately uncontrollable and hysterectomy was necessary and inevitable outcome — Damages — Psychiatric injury — Unnecessary hysterectomy — Resulting physical and psychiatric damage — Whether appropriate to attribute part of general damages to physical sequelae, and balance to psychological sequelae of hysterectomy — Costs — Successful plaintiff unable to receive costs on an indemnity basis — Whether direction under RSC Order 62 rule 10 should be made — Exercise of court's discretion
Parry v Clwyd Health Authority
[1997] LS Law Med 243
Limitation — Knowledge — Objective test — Breech delivery — Baby severly disabled by cerebral palsy — Plaintiff and mother accepting damage as normal hazard of child birth — Plaintiff alerted to possibility of claim by television programme — Whether objective or subjective test applicable — Criteria relevant for application of reasonableness test under Limitation Act 1980 sect 14(3) — Whether knowledge in Limitation Act 1980 referred exclusively to knowledge of plaintiff
Taylor v West Kent Health Authority
(1997) 8 Med LR 251
Professional liability — Surgery — Breast cancer — Diagnosis and treatment — Triple assessment (clinical examination, cytology and ultra sound scan) initiated at first referral in 1989 — Cytology report suggesting biopsy to confirm diagnosis of fibroadenoma and/or fibroadenosis — No biopsy performed — Patient reassured at two six-month reviews — Diagnosis of carcinoma in 1990 — Patient referred for radiotherapy but not at that time for chemotherapy
Armstrong v British Coal Corporation
(1997) 8 Med LR 259
Industrial injury — Vibratory White Finger (VWF) — Coal industry — Preliminary issues decided by judge that (1) from January 1, 1973, employers ought to have recognised that work with tools complained of in actions gave rise to foreseeable risk of VWF; (2) employers ought to have recognised that effective precautions to guard against foreseeable risk of VWF could and ought to have been taken in respect of warnings, system and routine examination from January 1, 1975; in respect of rotation of job from January 1, 1976; and in respect of adaptation of tools or eradicating job, after January 1, 1976
Pickford v ICI Plc
(1997) 8 Med LR 270
Industrial injury — Typist's cramp (PDA4) — Duty of care — Action against employers alleging that plaintiff secretary had contracted PDA4 (typist's cramp) caused by excessive typing for prolonged periods without proper breaks or rest pauses — Whether judge had misdirected himself in saying that onus was upon plaintiff to establish that cramp of hand(s) had an organic cause — Whether judge's finding that plaintiff's condition was psychogenic could be supported — Whether foreseeable that typists might suffer from PDA4 if they typed for prolonged periods without break — Duty to tell plaintiff that she must take breaks and rest pauses; and why that was necessary
Smith v Ealing Hammersmith & Hounslow Health Authority
(1997) 8 Med LR 290
Practice — Stay — Evidence — Medical examination — Medical negligence action by transsexual alleging negligence in oral and maxillofacial surgery — Order by judge that action should be stayed unless plaintiff underwent psychiatric examination — Appeal by plaintiff
Saxby v Morgan
[1997] LS Law Med 293
Limitation — Knowledge — Validity of extension of writ — Action for medical negligence — Unwanted pregnancy — Alleged negligent failure to advise — “Date of knowledge” of plaintiff — Whether later than date when cause of action accrued
Sharpe v Southend Health Authority
(1997) 8 Med LR 299
Professional liability — Radiography — Plexiform neurofibroma of mediastinum and neck — Balance between risks of disease against hazards of surgical intervention — No surgical intervention — Medical surveillance advised — Lump increased in size and trachea compressed — Standard practice of hospital to compare latest x-ray with previous x-ray — Excision not possible without significant damage to surrounding structures — Failure to give special instructions to radiologists — Evidence — Medical negligence cases — Expert witnesses — Acceptance of approach/practice adopted by defendant — Comments by court
Coban v Allen
(1997) 8 Med LR 316
Limitation — Knowledge — Reasonableness — Plaintiff failing to take steps to acquire knowledge under Limitation Act 1980 because of illegal immigration status — Whether plaintiff acted reasonably
Malhotra v Dhawan
(1997) 8 Med LR 319
Practice — Evidence — Documents destroyed by defendant — Omnia praesumuntur contra spoliatorem — Whether trial judge dealt correctly with consequence of destruction by defendant of client files — Costs — Indemnity basis — Whether trial judge right in (1) recognising letter as effective Calderbank letter for purposes of costs; (2) in ordering that costs should be taxed on indemnity basis
R v North Derbyshire Health Authority, ex parte Fisher
(1997) 8 Med LR 327
Judicial review — National Health Service — Funding of treatment — Treatment of relapsing remitting multiple sclerosis with beta-interferon — NHS Circular EL(95)97 — Whether Circular constituted directions which respondent health authority was under duty to apply, or merely guidance which it was required to take into account in performing its statutory functions — Whether health authority acted unlawfully in adopting policy not to fund — Relief to be granted — Whether health authority would be required to formulate and implement policy which took full and proper account of national policy as stated in NHS Circular EL(95)97
Scott v Wakefield Area Health Authority
(1997) 8 Med LR 341
Professional liability — Ophthalmic surgeon — Laser therapy — Duty to refer — Patient suffering from insulin dependent diabetes from age of two — Signs of sight — threatening change at age nineteen — Patient treated by laser photo — coagulation for retinopathy in both eyes — Deterioration and removal of right eye — Diagnosis of retinal detachment of left eye — Whether surgeon negligent in not referring patient to micro — surgeon at earlier date — Whether deputy judge correctly dismissed patient's claim — Hospital notes criticised by expert — Finding by deputy judge that, had referral taken place and vitrectomy performed earlier, patient would probably have been left with useful vision of 6/12 corrected in left eye
Phillips v Taunton & Somerset Health Trust
(1997) 8 Med LR 348
Practice and procedure — Particulars of claim — Deferment — County Court Rules Order 6 — Plaintiff in medical negligence action given leave to issue proceedings without particulars of claim, medical report or schedule of special damages — Whether order permitting service of particulars of claim to be deferred should not have been made without affidavit setting out reasons why deferment was necessary — Whether extension of time generally should have been granted — Whether County Court Rules gave court power to extend time for service of particulars of claim without affidavit
Queen v Central London County Ct
(1997) 8 Med LR 352
Mental health — Compulsory admission — Interim orders — Whether statutory provisions in field of mental health must be construed in favour of liberty — Application for judicial review of (1) ex parte order of county court purporting to displace applicant's mother as applicant's nearest relative; (2) decisions by hospital authority (a) purporting to admit applicant compulsorily to hospital for treatment; (b) purporting to renew applicant's detention; (c) purporting to admit applicant compulsorily to hospital for treatment on “without prejudice” basis
Dobson v North Tyneside Health Authority
(1997) 8 Med LR 357
Property — Conversion — Human tissue — Brain of deceased removed in course of autopsy ordered by coroner — Brain not preserved by health authority — Title to sue — Whether next of kin had legal right to possession of brain — Whether fixing of brain in paraffin by pathologist transformed it into item right to possession of which or property in which belonged to next of kin — - Next of kin's claim against health authority in conversion, bailment, wrongful interference or negligence — Applicability of maxim omnia praesumuntur contra spoliatorem
Queen v HM Coroner for Birmingham and Solihull
(1997) 8 Med LR 362
Inquest — Coroner — Summing up — Death occurred in course of medical treatment — Child with potentially life-threatening condition Attempts to treat him failing to prevent his death — Treatment bringing about death by causing tear to lung that in turn caused pneumothorax that resulted in death — Jury verdict that child died through natural causes — Effect of summing up withdrawing from jury possibility of any other verdict — Whether jury's verdict should be quashed — Whether court should substitute alternative cause of death
Dowdie v Camberwell Health Authority
(1997) 8 Med LR 368
Professional liability — Obstetrics — Shoulder dystocia in macrosomic baby — Serious injury to baby's right brachial plexus — Whether obstetric team should have proceeded to delivery by way of caesarean section -Secondary arrest of labour and signs of fetal distress — Whether management of labour was characterised by over stimulation with Syntocinon — Effect of CTG abnormalities — Alleged use of excessive traction by senior house officer and or registrar prior to registrar undertaking intravaginal manipulation
Hind v York Health Authority
[1997] LS Law Med 377
Limitation — Knowledge — Attributability — Discretion of court — Patient claiming damages in respect of anal sphincter injury suffered during birth of first child in September 1988 — Writ issued in May 1993 — Patient repeatedly assured by medical advisers that incontinence would resolve itself — Whether patient had actual or constructive knowledge that her injury was attributable to alleged causal omission before medical expert made initial verbal report in May 1993 — Whether equitable to allow claim to proceed where health authority unable to trace doctor
McCafferty v Merton Sutton & Wandsworth Health Authority
(1997) 8 Med LR 387
Professional liability — Colorectal surgery — Diverticula — Surgery carried out by general surgeon — Diverticula not shown by tests — Patient complaining of abdominal pain — Appendectomy and laparotomy carried out — General surgeon's decision not to carry out resection at reversal of colostomy - Further laparotomy carried out and diverticula found — Whether failure to resection sigmoid colon at colostomy reversal was negligent — Damages
R v Milling (Medical Referee), ex p West Yorkshire Police Authority
(1997) 8 Med LR 392
Judicial review — Medical referee — Police injury benefit — Delay in application for judicial review — Medical referee certifying that police officer was totally and permanently disabled — Whether medical referee (a) applied correct test; (b) took extraneous matters into account; (c) reached a reasonable decision
Bancroft v Harrogate Health Authority
(1997) 8 Med LR 398
Professional liability — Gynaecological oncology — Conservative treatment — Patient undergoing radiotherapy for cervical cancer — Regeneration of endometrium after radiotherapy — Intermittent bleeding suffered four years' later — Sub-total hysterectomy — Surgeon unable to give patient explanation for bleeding — Bleeding in fact due to second oestrogen implant — Whether reasonable for surgeon to treat plaintiff on basis that she had abnormal endometrium but not pre-malignant condition — Surgeon considering patient at risk of developing endometrial cancer but not that she already had pre-malignant changes — Whether plaintiff suffered recognised psychiatric illness — Whether surgeon negligent in failing to realise that patient's previous implant had lasted unusually long time and that second implant was still active — Whether surgeon acted properly and with all due care when he decided that appropriate operation for patient was sub-total hysterectomy