Causation in clinical negligence

Demery v Cardiff and Vale NHS Trust, Court of Appeal, 11 July 2006

Counsel: For the appellant: Nigel Godsmark QC, Leslie Keegan For the respondent: Ranald Davidson Solicitors: For the appellant: Leo Abse & Cohen (Cardiff) For the respondent: Welsh Health Legal Services (Cardiff)

This was an appeal by D against a decision dismissing her claim for damages for personal injury against the NHS trust. She had attended a hospital which the Trust managed, suffering from an injured ankle, and her fractured leg was put in a plaster cast. However, damage to ligaments in her ankle was not diagnosed for another week, and in the intervening time she had returned home and had continued to look after her children. This meant she was putting weight on her ankle. D had further surgery 11 days after the first injury, and several more medical interventions, but after more than four years she still suffered considerable pain and weakness in her ankle. D brought a claim for damages, and the Trust admitted negligence in failing to diagnose and treat the ruptured ligaments when D was first admitted to hospital. However, the trial judge had found that the continuing problems experienced by D had not been caused by the Trust’s negligence. The medical experts agreed that the correct treatment would have been for D to stay in hospital immobilised, and with her leg elevated, until surgery was carried out within four days of the injury. There was no dispute about the operation itself, or the subsequent treatment.