Jurisdiction(s):
United Kingdom

Clinical negligence trials: causation, court expectations of experts, pitfalls and CPR 35 compliance - lessons from Arksey and Smith (England and Wales)

Published on: 03 September 2019

Published by a LexisNexis PI & Clinical Negligence expert

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Article summary

Arksey v Cambridge University Hospitals NHS Foundation Trust [2019] EWHC 1276 (QB) Smith v Royal Liverpool Hospitals NHS Trust [2019] Lexis Citation 89

What were the background facts to the cases?

Arksey v Cambridge University Hospitals NHS Foundation Trust

The claimant experienced a sentinel bleed from a cerebral aneurysm at home and attended the hospital for assessment. The defendant NHS Trust accepted that sending her home, instead of admitting her, amounted to a breach of duty. The next day she suffered a major subarachnoid haemorrhage (SAH), collapsed, and sustained permanent brain damage. In the High Court, she contended that, because the hospital had a pre-operative protocol for SAH patients awaiting placement of a coil in the aneurysm, she should have been admitted to the ward and that protocol implemented, comprising bed rest, blood pressure monitoring and appropriate hydration throughout the period of waiting for coiling on the ward under routine clinical observation. Her expert, a consultant neurosurgeon, stated that rebleeding in hospital while awaiting coiling was uncommon; in his clinical experience such events represented 2–3% of neurosurgical SAH cases and, therefore, had she remained as an in-patient it was highly unlikely that she would have suffered a further bleed before...

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