On 23rd November, 2018 the Court of Appeal handed down judgment overturning the decision of Mrs Justice Yip in MNX v Dr Hafshah Khan [ 2017 ] EWHC 2990 ( QB ) .
The Respondent’s nephew had been born in January, 2006 and was subsequently diagnosed with haemophilia. The Respondent wished to avoid having a child with that condition and so consulted her GP in August, 2006 to ascertain whether she carried the haemophilia gene. Blood tests were arranged. The tests were to confirm whether the Respondent had the condition and not if she was a carrier of the gene. In order to determine her position , the Respondent would have had to be referred to an haematologist for genetic testing. On 25th August, 2006, the Respondent saw the Appellant to discuss blood tests and was told that the results were normal. As a result she was left to believe that any child she had would not have had haemophilia.
The Respondent became pregnant with FGN in 2010 and shortly after birth he was diagnosed with haemophilia. The Respondent was referred for genetic testing which confirmed she was a carrier of the haemophilia gene. Had the Respondent been referred for genetic testing in 2006 she would have known she was a carrier of the gene before she became pregnant and she would have undergone foetal testing for haemophilia which would have revealed that the foetus was affected. In these circumstances, the Respondent would have terminated the pregnancy and FGN would not have been born.
In December, 2015 FGN was diagnosed with autism. The fact that FGN had haemophilia did not cause his autism or make it more likely that he would have autism.
The Appellant admitted that but for her negligence FGN would not have been born as his mother would have properly discovered during her pregnancy that he was afflicted by haemophilia and she would have undergone a termination of the pregnancy. The issue at trial before Mrs Justice Yip was whether, as a matter of law, the Appellant’s liability was limited to the additional losses associated with FGN’s haemophilia or whether she was liable for the additional losses associated with both his haemophilia and autism
By an order dated 8th February, 2017 the Appellant consented to judgment being entered on the basis of the allegations of breach of duty and causation as set out in the Particulars of Claim. Prior to trial the parties reached agreement in relation to quantum on the basis that :
Mrs Justice Yip found that the Respondent was entitled to damages in respect of bringing up FGN due to his haemophilia and that she was also entitled to the additional costs in relation to FGN’s autism, albeit that it was an unrelated condition. On a simple application of the “ but for “ test of causation the costs flowed from the negligence as FGN would not have been born. Damages therefore followed in the sum of £9,000,000 as per the agreement reached as between the parties.
THE COURT OF APPEAL
The Appellant appealed with permission granted by Mrs Justice Yip on the basis that in finding that she was liable for damages associated with both FGN’s haemophilia and autism, Mrs Justice Yip had misapplied the scope of duty test set down by Lord Hoffman in South Australia Asset Management Corpn v York Montague Ltd [ 1997 ] AC 191 ( Hereinafter “ SAAMCO “ ). The reasoning behind the test is that in order to protect a defendant from liability for every foreseeable factual consequence of their negligence the courts have placed an additional test on the consequences of a breach that are considered to be within the appropriate scope of the defendant’s liability, namely the requirement that the particular loss claimed must be within the “ scope of duty “. The Appellant had not undertaken to provide any information or advice about the risks of autism, and the negligence had not contributed to the autism.
The leading judgment was give by LJ Nicola Davies DBE.
The Court of Appeal determined that the SAAMCO “ scope of duty “ test was relevant and determinative of the issues in the case. Given the limits of the advice sought by the Respondent and the appropriate testing ,Mr Maskrey QC on behalf of the Appellant , identified three questions that it was for the court to address :
Davies LJ found that :
The scope of the Appellant’s duty did not extend to all the risks of pregnancy and the continuation with pregnancy. The Appellant had no duty to prevent FGN’s birth. This was a decision that could only be made by the Respondent taking into account a multiplicity of factors, such as her ethical views, her willingness to accept the risks associated with pregnancy and was outside the limits of any advice/treatment sought from the Appellant. It had not been part of the Respondent’s case that the Appellant had a duty to advise more generally in relation to the risks of any future pregnancy. The risk of autism was not increased by the Appellant’s advice, “ the purpose and scope of her duty was to advise and investigate in relation to haemophilia in order to allow the Respondent the opportunity to avoid the risk of a child being born with haemophilia “.
In reaching the conclusion that she did namely that the Appellant should be liable for a type of loss that did not fall within the scope of the Appellant’s duty to protect the Respondent against , Mrs Justice Yip was said to have reverted the “ but for “ causation test and not the appropriate SAAMCO “ scope of duty test “. The SAAMCO test required there to be an adequate link between the actual breach of duty and the loss claimed. In this context Davies LJ stated that “ It is insufficient for the court to find that there is a link between the breach and the stage in the chain in causation, in this case the pregnancy itself , and thereafter to conclude that the Appellant is liable for all the reasonably foreseeable consequences of the pregnancy “. In finding that the Respondent was deprived of the opportunity to terminate the pregnancy , reference was had to one of the chains of causation , whereas SAAMCO required that the link had to be between the scope of duty and the damage sustained. “ In the context of this case the development of autism was a coincidental injury and not one within the scope of the Appellant’s duty “ .
The most appropriate analogy of the co-incidental injury and not one within the scope of the Appellant’s duty is that identified by Lord Walker in Chester v Afshar [ 2005 ] 1 AC 134 where he stated :
“ If a taxi driver drives too fast and the cab is hit by a falling tree , injuring the passenger, it is a sheer coincidence. The driver might equally well have avoided the tree by driving too fast, and the passenger might have been injured if the driver was observing the speed limit ….. “.
Mrs Justice Yip had reverted to the “ but for “ test of causation when in fact she ought more properly to have applied the “ scope of duty “ test applied in SAAMCO. The scope of the duty was narrow . It was limited to whether the Respondent was a carrier of the haemophilia gene and did not extend beyond that .The distinction as between this case and Parkinson and Groom was that there was no duty to prevent the pregnancy. The case has important ramifications as to the scope of duty to be applied in wrongful birth cases.