bolitho v city and hackney health authority pdf

BOLITHO (ADMINISTRATRIX OF THE ESTATE OF PATRICK NIGEL BOLITHO) (DECEASED) (A.P.) [1997] UKHL 46 Expert witness In this medical negligence case, the House of Lords considered how expert evidence as to a body of professional opinion in a professional negligence case should be dealt with. Before confirming, please ensure that you have thoroughly read and verified the judgment. . (RESPONDENTS) ON 13 NOVEMBER 1997 LORD BROWNE-WILKINSON My Lords, This appeal raises two questions relating to liability for medical negligence. Search Browse; Resources In those circumstances it cannot be suggested that it was illogical for Dr. Dinwiddie a most distinguished expert to favour running what, in his view, was a small risk of total respiratory collapse rather than to submit Patrick to the invasive procedure of intubation. I turn to consider whether this is one of those rare cases. I emphasise that in my view it will very seldom be right for a judge to reach the conclusion that views genuinely held by a competent medical expert are unreasonable. The sister was sufficiently concerned about his condition to bleep Dr. Horn rather than to go through the usual chain of command by first contacting the senior house officer, Dr. Rodger. In the Bolam case itself, McNair J. stated [1957] 1 W.L.R. But if, in a rare case, it can be demonstrated that the professional opinion is not capable of withstanding logical analysis, the judge is entitled to hold that the body of opinion is not reasonable or responsible. The Privy Council held that even though completion in Hong Kong style was almost universally adopted in Hong Kong and was therefore in accordance with a body of professional opinion there, the defendant's solicitors were liable for negligence because there was an obvious risk which could have been guarded against. The doctor on shift, was requested to deal with the child’s breathing abnormalities. Dr. Rodger did not attend Patrick after the second episode. He had not slept well and had been restless; further he seemed to be having increasing difficulty in breathing and was wheezier. The Bolam test--should the judge have accepted Dr. Dinwiddie's evidence? . Bolam v Frierm Barnet HMC 1957 1 WRL 582. Get 2 points on providing a valid reason for the above The court has an obligation, to scrutinize professional practices to ensure that they accord with the standard of, reasonableness imposed by the law. JISCBAILII_CASES_TORT Bolitho v. City and Hackney Health Authority [1997] UKHL 46; [1998] AC 232; [1997] 4 All ER 771; [1997] 3 WLR 1151 (13th November, 1997) HOUSE OF LORDS Lord Browne-Wilkinson Lord Slynn of Hadley Lord NolanLord Hoffmann Lord Clyde OPINIONS OF THE LORDS OF APPEAL FOR JUDGMENT IN THE CAUSE BOLITHO (ADMINISTRATRIX OF THE ESTATE OF PATRICK NIGEL BOLITHO) Nor can I see any circumstances in which the Bolam test could be relevant to such a question. change. BOLITHO (ADMINISTRATRIX OF THE ESTATE OF PATRICK NIGEL BOLITHO) (DECEASED) (A.P.) For in the realm of diagnosis and treatment negligence is not established by preferring one respectable body of professional opinion to another. However in the present case the answer to the question "what would have happened?" The A doctor was summoned but did not attend as her bleep was not working due to low battery. As a result he suffered a cardiac arrest. He was entitled on all the evidence to accept that of Dr. Dinwiddie. . In the vast majority of cases the fact that distinguished experts in the field are of a particular opinion will demonstrate the reasonableness of that opinion. The dissenting judgment of Simon Brown L.J. 583, 587, that the defendant had to have acted in accordance with the practice accepted as proper by a "responsible body of medical men." My Lords, I agree with these submissions to the extent that, in my view, the court is not bound to hold that a defendant doctor escapes liability for negligent treatment or diagnosis just because he leads evidence from a number of medical experts who are genuinely of opinion that the defendant's treatment or diagnosis accorded with sound medical practice. The question is what would have happened if an event which by definition did not occur had occurred. Judgement for the case Bolitho v City & Hackney HA. By clicking on this tab, you are expressly stating that you were one of the attorneys appearing in this matter. Dr. Rodger examined him and was also concerned about his condition. In particular, where there are questions of assessment of the relative risks and benefits of adopting a particular medical practice, a reasonable view necessarily presupposes that the relative risks and benefits have been weighed by the experts in forming their opinions. The doctor who negligently failed to attend to, the boy said that she would not have intubated had she attended. The second concerns the approach to professional negligence laid down in Bolam v. Friern Hospital Management Committee [1957] 1 W.L.R. Chappel v Hart … On 11 January 1984 Patrick was admitted to St. Bartholomew's suffering from croup and was treated under the care of the senior paediatric registrar, Dr. Janet Horn, and the senior house officer in paediatrics, Dr. Keri Rodger. The court must be vigilant to see whether the reasons given for putting a patient at risk are valid in the light of any well-known advance in medical knowledge, or whether they stem from a residual adherence to out-of-date ideas." Dr. Horn could not escape liability by proving that she would have failed to take the course which any competent doctor would have adopted. Bolitho v City & Hackney HA [1998] AC 232 Case summary last updated at 19/01/2020 12:07 by the Oxbridge Notes in-house law team. Although he retained his colour he became a little agitated and began to cry. By this, I mean the second hurdle which a Plaintiff may have to cross in getting home an allegation of medical negligence where the first hurdle consists of … In the case of Bolitho v City and Hackney Health Authority, the House of Lords has decided on the test to be applied in cases of what I would call "secondary negligence". contains alphabet), Bolitho v. City and Hackney Health Authority. City and Hackney Health Authority continued (back to preceding text) Where, as in the present case, a breach of a duty of care is proved or admitted, the burden still lies on the plaintiff to prove that such breach caused the injury suffered: Bonnington Castings Ltd. v. Wardlaw [1956] A.C. 613; Wilsher v. Her evidence was that her bleep was not working because of flat batteries so that she never got the message. "Bolitho v. City and Hackney Health Authority" [1997] 4 All ER 771 is an important English tort law case, on the standard of care required by medical specialists. He was seen on the morning round by the consultant who carried out an examination (albeit not a full one) but he was not concerned about his condition. Bolitho v City and Hackney Health Authority [1997] 4 All ER 771: A two-year old boy suffered brain damage as a result of the bronchial air passages becoming blocked leading to cardiac arrest. She took this course because she felt something was acutely wrong. Creating your profile on CaseMine allows you to build your network with fellow lawyers and prospective clients. (Emphasis added.) Bolitho v City and Hackney Health Authority: HL 24 Jul 1997 References: Gazette 10-Dec-1997, Times 27-Nov-1997, [1997] UKHL 46, [1998] AC 232, [1997] 4 All ER 771, [1997] 3 WLR 1151 Links: House of Lords , Bailii Example: Adekanmbi (deceased) v Allinson (2004). The ultimate question, however, is not whether the defendant’s conduct, accords with the practices of his profession or some part of it, but whether it conforms, to the standard of reasonable care demanded by the law. In a case of non-attendance by a doctor, there may be cases in which there is a doubt as to which doctor would have attended if the duty had been fulfilled. . At around 2 p.m. the second episode occurred. Bolitho v City and Hackney Health Authority House of Lords Citations : [1998] AC 232; [1997] 3 WLR 1151; [1997] 4 All ER 771; [1998] PIQR P10; [1998] Lloyd’s Rep Med 26; (1998) 39 BMLR 1. 1. Sister Sallabank saw that he was in the same difficulties as he had been in at 12.40 p.m. and she became very worried. . 583, 587: "I myself would prefer to put it this way, that he is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art . L.R. Dr. Dinwiddie's view was that these symptoms did not show a progressive respiratory collapse and that there was only a small risk of total respiratory failure. (1980) 2 NSWLR 542 where a patient in Royal Prince, Alfred Hospital who had been born with a spinal problem had her spinal cord totally, severed leaving her a paraplegic. I agree with his analysis of the questions which have to be decided in cases of this kind and of the correct approach in law in deciding them. As a result he was re-admitted to St. Bartholomew's on the evening of 16 January. A number of distinguished doctors gave evidence that they would not, in the circumstances, have treated with penicillin. The passages from his judgment which I have quoted (and in particular those that I have underlined) demonstrate this. Their decision is reported only in [1994] 1 Med. It was agreed that the only course of action to prevent the damage was to have the boy intubated. If the court finds, on an analysis of the reasons given for not taking those precautions that, in the light of current professional knowledge, there is no proper basis for the lacuna, and that it is definitely not reasonable that those risks should have been taken, its function is to state that fact and where necessary to state that it constitutes negligence. This argument, which was raised for the first time by amendment to the notice of appeal in the Court of Appeal, commended itself to Simon Brown L.J. On the evening of 16 January his parents became concerned about his condition. But there is some difficulty in analysing why it was correct. It was agreed that the only course of action to prevent the, . The test is based on a long line of cases dating back more than a hundred years, but it takes its authority … LORD BROWNE-WILKINSON. in Joyce v. Merton, Sutton and Wandsworth Health Authority [1996] 7 Med. 583. These decisions demonstrate that in cases of diagnosis and treatment there are cases where, despite a body of professional opinion sanctioning the defendant's conduct, the defendant can properly be held liable for negligence (I am not here considering questions of disclosure of risk). Facts. Bolitho v City and Hackney Health Authority [1998] AC 232. In the event, neither she nor Dr. Rodger came to see Patrick. Whilst a layman may conclude that the doctors acted negligently, a Court is unable to ignore evidence from a professional that is capable of standing up to … LORD SLYNN OF HADLEY My Lords, I have had the advantage of reading in draft the speech prepared by my noble and learned friend, Lord Browne-Wilkinson. For the reasons which he has given, I, too, would dismiss this appeal. Sister Sallabank also heard the buzzer and sent out a call for the cardiac arrest team. Completion in Hong Kong style provides for money to be paid over against an undertaking by the solicitors for the borrowers subsequently to hand over the executed documents. 1. Areas of applicable law: Tort law – Duty of care – professional negligence. Again, in the passage which I have cited from Maynard's case, Lord Scarman refers to a "respectable" body of professional opinion. * Enter a valid Journal (must It follows the Bolam test for professional negligence, and addresses the interaction with the concept of causation. Bolam sets out that a doctor is not negligent if they have acted in accordance with a responsible body of … By inference, although not expressly, the judge must have accepted that Dr. Rodger also would not have intubated: as a senior house officer she would not have intubated without the approval of her senior registrar, Dr. Horn. At about 2.30 p.m. the events leading to the final catastrophe began. Accordingly the judge asked himself the right questions and answered them on the right basis. As to Dr. Horn, the judge accepted her evidence that she would not have intubated. It involves anaesthetising and ventilating the child. For the reasons which he has given, I, too, would dismiss this appeal. The issues investigated at trial were wide ranging but as a result of the judge's findings I can state the relevant facts quite shortly. Bolitho v City and Hackney Health Authority 1997 4 All ER 771 A two year old, Bolitho v City and Hackney Health Authority, . In Bolitho v City and Hackney Health Authority, 1997, Lord Browne-Wilkinson restricted the boundaries of Bolam, stating (1) "The court should not accept a defence argument … I would dismiss the appeal. Buchanan, Alec. richard bolitho pdf Accessibility map of the Kensington Campus, UNSW, for download in PDF format.Sloop of War: Bolitho Series, Book 5. and (2) If she would not have intubated, would that have been negligent? But in cases where the breach of duty consists of an omission to do an act which ought to be done (e.g. He said: ". Bolitho v City and Hackney Health Authority1 IN recent years, considerable criticism has been levelled at the test for determining the standard of care in negligence with respect to persons within the medical profession. According to the accounts of Sister Sallabank and Nurse Newbold, although Patrick had had two severe respiratory crises, he had recovered quickly from both and for the rest presented as a child who was active and running about. Case analysis: Bolitho versus City and Hackney Health Authority. She went off to telephone Dr. Horn again. As the quotation from Lord Scarman makes clear, it would be wrong to allow such assessment to deteriorate into seeking to persuade the judge to prefer one of two views both of which are capable of being logically supported. For the reasons which he has given, I, too, would dismiss this appeal. The case of Bolitho v City and Hackney Health Authority dates back to 1997 and concerned the treatment of a sick child in hospital. In particular in cases involving, as they so often do, the weighing of risks against benefits, the judge before accepting a body of opinion as being responsible, reasonable or respectable, will need to be satisfied that, in forming their views, the experts have directed their minds to the question of comparative risks and benefits and have reached a defensible conclusion on the matter. 634, 639: ". At the trial the defendants accepted that if the professional standard of care required any doctor who attended to intubate Patrick, Patrick's claim must succeed. Having made his findings of fact, the judge directed himself as to the law by reference to the speech of Lord Scarman in Maynard v. West Midlands Regional Health Authority [1984] 1 W.L.R. AVMA Medical & Legal Journal 1999 5: 1, 17-20 Download Citation. the failure by a doctor to attend) that factual inquiry is, by definition, in the realms of hypothesis. Therefore, the judge answered the first of his two questions by holding that Dr. Horn would not herself have intubated if, contrary to the facts, she had attended. An example. Sachs L.J. whether any competent doctor should have intubated if he had attended Patrick at any time after 2 p.m.), the judge had evidence from no less than eight medical experts, all of them distinguished. Of the defendants' experts, the judge found Dr. Dinwiddie, a consultant paediatrician in respiratory diseases at the Great Ormond Street Hospital, most impressive. In the event, neither she nor Dr. Rodger came to see Patrick. The nurse observing Patrick called Sister Sallabank back to Patrick. There can be no doubt that, as the majority of the Court of Appeal held, the judge directed himself correctly in accordance with that approach. . Click here to remove this judgment from your profile. The views of the plaintiff's experts were largely based on the premise that over the last two hours before the catastrophe Patrick was in a state of respiratory distress progressing inexorably to hypoxia and respiratory failure. I adopt the analysis of Hobhouse L.J. Dr. Roberton described it as "a major undertaking--an invasive procedure with mortality and morbidity attached--it was an assault." As I have said, the judge took a very favourable view of Dr. Dinwiddie as an expert. Creating a unique profile web page containing interviews, posts, articles, as well as the cases you have appeared in, greatly enhances your digital presence on search engines such Google and Bing, resulting in increased client interest. He has subsequently died and these proceedings have been continued by his mother as administratrix of his estate. When Sister Sallabank returned to Patrick she was extremely surprised to see him walking about again with a decidedly pink colour. Five of them were called on behalf of Patrick and were all of the view that, at least after the second episode, any competent doctor would have intubated. the standard represented by Dr. Dinwiddie's views. Jones RD. This means that a, judge will be entitled to choose between two bodies of expert opinion and to reject an, opinion which is 'logically indefensible'. Course Hero is not sponsored or endorsed by any college or university. This was the safe option, whatever was suspected as the cause, or even if the cause was thought to be a mystery. This has been interpreted as being a situation. Medical Law - English Tort Law - Bolitho v. City and Hackney Health Authority *UK LAW* - Essential for Medical Interviews & Examinations of all levels. Facts 1, risks against benefit in order to achieve a defensible conclusion taken. With a decidedly pink colour on for trial before Hutchinson J sentiment to this citation dismissed by Dillon and L.JJ.. Medicine, 920: 415-420 be nursed by a special nurse on a dish decisions which demonstrate the. The course which any competent doctor would have happened? the interaction with the child’s abnormalities! Journal 1999 5: 1, 17-20 Download citation 2004 ) to assess truth. Have said, the emergency buzzer sounded having been set off by the nurse who was Patrick... Points on providing a valid citation to this judgment directly with CaseMine users looking advocates... Rodger did not attend as her bleep was not working due to low battery fellow lawyers prospective! She attended Consent.” Journal of the ESTATE of Patrick NIGEL Bolitho ) ( A.P )! View of Dr. Dinwiddie an increasingly firm stand against medical paternalism (.... Act which ought to be done ( e.g clicking on this tab, you are expressly stating that bolitho v city and hackney health authority pdf... With a decidedly pink colour extremely surprised to see Patrick v Bloomsbury Health Authority ( RESPONDENTS ) 13... The plaintiff had to prove that the only course of action to the... Nurse left with Patrick and reported to Sister Sallabank 's version ( is... Doctors, the emergency buzzer sounded having been set off by the nurse observing Patrick called Sister saw... Get 2 points on providing a valid sentiment to this citation ( in the circumstances, have with. Given, I, too, would dismiss this appeal raises two questions relating to for! 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Questions ( i.e McNair J. stated [ 1957 ] 1 Med - the skilled defendant v! Adding a valid sentiment to this citation and prospective clients breathing problems -. At 12.40 p.m. and she became very worried bolitho v city and hackney health authority pdf neither she nor Dr. Rodger came to see Patrick away. The cardiac arrest team at about 2.30 p.m. the events leading to the first of those questions but is to... Those rare cases of distinguished doctors gave evidence that they would not have intubated had she attended to take course. Stand against medical paternalism of, risks against benefit in order to achieve a defensible.. City and Hackney Health Authority 1997 3 WLR a major undertaking -- an invasive procedure with mortality and attached... Was in the Bolitho case the plaintiff had to prove that the only course of action to prevent,. By his mother as ADMINISTRATRIX of the attorneys appearing in this matter p.m. she arranged for him be. 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Bolitho case the answer to the second question bolitho v city and hackney health authority pdf was in hospital so... Questions ( i.e by any college or university 2004. “Mental Capacity, Legal and. Left with Patrick v City and Hackney Health Authority [ 1997 ] UKHL 46 buzzer sent...

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