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Cause & effect

23 November 2012 / Chris Pamplin
Issue: 7539 / Categories: Features , Expert Witness
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Chris Pamplin looks back at clinical negligence case law and finds a relaxation in the burden of proof

Causation in negligence cases has traditionally been determined by the “but for” test. However, in complex cases, while the experts might agree that a clinical practitioner fell short of the standard of competence expected of the profession, they might be unable to agree that it was this negligence that caused the claimant’s injury. Three cases offer insights to how the courts deal with such a situation.

Telles v SW Strategic Health Authority

In Telles v South West Strategic Health Authority [2008] EWHC 292 (QB), a one-day-old child was found to have a heart defect and a high level of metabolic acidosis. Following the diagnosis, the child was admitted to the Bristol Children’s Hospital for treatment. She subsequently underwent three operations. Following the enquiry into the cases of children’s heart surgery at the Bristol Royal Infirmary, a claim was brought, on behalf of the child, maintaining that:

  • the surgeons had been negligent in the first operation;
  • there had been further negligence in the clinical care
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