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Breaking the chain of Causation: no ‘special rule’ for Negligent Medical Treatment

<!-- wp:paragraph --> <p>In <strong>Jenkinson v Hertfordshire County Council [2023] EWHC 872 (KB), </strong>the High Court have provided guidance as to when negligent medical treatment will break the chain of causation. To sum up the case in a nutshell, the High Court clarified that negligent medical treatment is to be treated exactly the same as any other potential intervening act; there is no special rule (as was previously thought) that the treatment had to be ‘grossly negligent’ before it would break the chain of causation.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p><strong>The Facts</strong></p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>Mr Jenkinson badly fractured his ankle when his foot entered an uncovered manhole or drain gully. Breach of duty was admitted by the Council but the extent of the injury and causation were disputed.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>Mr Jenkinson had surgery on his ankle. The Council’s medical expert opined that the surgery had been performed negligently and that, as a result, Mr Jenkinson’s prognosis was much worse than it should have been. According to the Council’s expert, Mr Jenkinson should have made a relatively full recovery from the ankle injury, but instead had to undergo six further surgeries.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The Council applied to add the relevant NHS Trust and amend its defence to include the assertion that the negligent treatment had broken the chain of causation between the accident and the Claimant’s poor outcome.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The application to amend was refused by District Judge Vernon, who directed himself that, ‘<em>in cases where alleged negligent medical treatment is given to address injuries sustained as a result of an earlier tort, <u>only medical treatment so grossly negligent as to be a completely inappropriate response to the injury inflicted by the defendant</u> should operate to break the chain of causation.’ </em>&nbsp;</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>District Judge Vernon derived that proposition from <strong>Webb v Barclays Bank and Portsmouth Hospitals NHS Trust [2001] EWCA Civ 1141. </strong>In effect, District Judge Vernon was of the view that <strong>Webb </strong>was authority for the proposition that it was only in situations where the medical treatment was so grossly negligent as to be a completely inappropriate response that the chain of causation between the Defendant and the Claimant could be broken.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The High Court examined the decision in <strong>Webb </strong>and the earlier case law to determine whether District Judge Vernon directed himself correctly. <strong>Webb </strong>was a case about what contribution to damages (if any) should be paid by an NHS trust who had negligently advised Mrs Webb to have an above-knee amputation after falling at work.&nbsp; </p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The Court of Appeal identified that there was no general rule on the question of whether the liability of an employer to its employee for negligence is terminated by the intervening negligence of a doctor who treated the original injury. The Court of Appeal went on to approve a reference in Clerk &amp; Lindsell on Torts which stated, ‘<em>Moreover, it is submitted that only medical treatment so grossly negligent as to be a completely inappropriate response to the injury inflicted by the defendant should operate to break the chain of causation.’</em></p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The Court of Appeal in <strong>Webb </strong>went on to make the finding that the doctor’s negligence did not eclipse the employer’s original wrongdoing. In reaching that decision, the Court of Appeal considered that the original wrong-doing remained a causative force; that the medical intervention was plainly foreseeable; and that the doctor’s conduct was negligent but not grossly negligent. Notably, it can be seen that the Court of Appeal considered more factors than simply whether or not the doctor’s conduct was negligent or grossly negligent.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The High Court decided that there was no such rule of law as set out by District Judge Vernon. It noted that there was no logical justification for creating a specific rule of law in the context of negligent medical intervention. It anticipated that such a rule would be a recipe for litigation over the side-issue of determining when treatment is so poorly executed that it becomes an inappropriate response to the original injury.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p><strong>Comment</strong></p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The High Court decision must be correct. The issue of whether or not an intervening act has broken the chain of causation is one which requires consideration of a multitude of factors. The court has to make an assessment as to whether or not the ultimate damage is damage for which the original tortfeasor should be responsible. It is not a question for which bright-line rules of law are suitable, nor is there any apparent reason why intervening acts performed in the context of medical treatment should form a special category of their own. &nbsp;</p> <!-- /wp:paragraph -->

27 April 2023 | Parklane Plowden to attend RE-DRAWING IDENTITY Conference

<!-- wp:paragraph --> <p>Parklane Plowden Chambers are delighted to be attending the<a href="https://www.social-return.co.uk/conference-2023.html"> <strong>Re-Drawing Identity: Help Me Feel Different, Don’t Change Who I am</strong></a> conference. </p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>In this conference, Social Return will explore what happens when the continuity of the ‘who I am’ story is abruptly interrupted, fractured by a catastrophic event that forever changes the story, whether through pain, trauma, loss of function, severe psychological distress, or in the case of acquired brain injury, damage to the very mechanisms which generate the sense of self in the first place.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>The fundamental tension embedded in the challenge to identity that a catastrophic event can bring, and the desire to move forward without losing the sense of self, will be explored through presenters who will highlight collaborative practices, new approaches, experiential learning and opportunities for change.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p><strong>Venue: </strong>Leeds Conservatoire, LS2 7PD </p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p><strong>Time: </strong>9:20 - 16:15</p> <!-- /wp:paragraph --><!-- wp:image {"id":7890,"width":274,"height":274,"sizeSlug":"full","linkDestination":"none"} --> <figure class="wp-block-image size-full is-resized"><img src="https://www.parklaneplowden.co.uk/app/uploads/2023/04/27-April-1.jpg" alt="" class="wp-image-7890" width="274" height="274"/></figure> <!-- /wp:image -->

Parklane Plowden’s Hannah Whitehouse and May Martin are featured in the March edition of the Family Law Journal

<!-- wp:paragraph --> <p>Parklane Plowden’s <a href="https://www.parklaneplowden.co.uk/our-barristers/hannah-whitehouse/">Hannah Whitehouse</a> and <a href="https://www.parklaneplowden.co.uk/our-barristers/may-martin/">May Martin </a>collaborate to review "Failure to remove’ cases: when does the duty of care arise – and what is the impact on the family justice system?”</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>- The article looks at the effect of claims made by children against local authorities for failing to commence care proceedings and leaving them in neglectful/abusive home environments.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>- Explores the principles of negligence that have been used to formulate claims against local authorities and analyses those principles in the social work context specifically.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>- Identifies the uneasy transfer into the public law arena of concepts such as assumptions of responsibility.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>- Looks at the issue from a family law perspective, asking what effect these claims are likely to have on local authorities, particularly as against public policy decisions that are made within the family justice system, particularly around the increased focus on the use of the pre-proceedings process.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>More detail on the article can be found <a href="https://www.familylaw.co.uk/news_and_comment/failure-to-remove-cases-when-does-theduty-of-care-arise-what-is-the-impact-on-the-family-justice-system?utm_source=SalesForce-1f6024d7-e389-4cdd-87da-8d86c26c238c&amp;utm_medium=email&amp;utm_content=https%3a%2f%2fwww.familylaw.co.uk%2fnews_and_comment%2ffailure-to-remove-cases-when-does-theduty-of-care-arise-what-is-the-impact-on-the-family-justice-system&amp;utm_campaign=Family+Law+ENL+3+April+2023">here</a>.</p> <!-- /wp:paragraph -->

PLP Pupils &#8211; Robert Allen, Rajni Virk and Oliver Bailey start second six

<!-- wp:paragraph --> <p>Pupils <a href="https://www.parklaneplowden.co.uk/our-barristers/robert-allen-pupil/">Robert Allen </a>and <a href="https://www.parklaneplowden.co.uk/our-barristers/rajni-virk/">Rajni Virk</a> start their second six on the <strong>03 April 2023</strong>. Pupil <a href="https://www.parklaneplowden.co.uk/our-barristers/oliver-bailey/">Oliver Bailey</a> will start his second six on the <strong>11 April 2023</strong>. All three will be available to receive instructions from April.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>Robert commenced his specialist civil and commercial pupillage under the supervision of <a href="https://www.parklaneplowden.co.uk/our-barristers/claire-millns/">Claire Millns</a>, <a href="https://www.parklaneplowden.co.uk/our-barristers/michael-james/">Michael James</a>, and <a href="https://www.parklaneplowden.co.uk/our-barristers/jim-hester/">Jim Hester</a>.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>Oliver commenced his specialist civil law pupillage under the supervision of &nbsp;<a href="https://www.parklaneplowden.co.uk/our-barristers/hylton-armstrong/">Hylton Armstrong</a>&nbsp;and&nbsp;<a href="https://www.parklaneplowden.co.uk/our-barristers/bronia-hartley/">Bronia Hartley</a>.</p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p><strong>Robert will be accepting instructions on all civil and commercial matters.</strong></p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p><strong>Oliver will be accepting instructions on all civil matters.</strong></p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>Rajni commenced her family pupillage under the supervision of <a href="https://www.parklaneplowden.co.uk/our-barristers/louise-mccallum/">Louise McCallum</a> and <a href="https://www.parklaneplowden.co.uk/our-barristers/julia-nelson/">Julia Nelson</a>. <strong>Rajni will be accepting instructions on all family matters.</strong></p> <!-- /wp:paragraph --><!-- wp:paragraph --> <p>To instruct counsel, please contact the clerks on <strong>0113 228 5000</strong> (switch board) or <a href="mailto:clerks@parklaneplowden.co.uk">clerks@parklaneplowden.co.uk</a>.</p> <!-- /wp:paragraph -->