The question is never just whether the diagnosis was missed. It is whether catching it sooner would have changed the outcome.
Claimant succeeded£550,000
[2026] EWHC 1284 (KB)·2026·Liability decided at trial
A patient developed life-threatening pancreatitis after a gallstone-removal ERCP. The judge found the consultant never prescribed or instructed the standard preventive diclofenac suppository, so it was not given, and entered judgment for £550,000 against him.
Failing to give a recognised prophylactic drug before a procedure can be negligent even in private care. The prescribing doctor, not the hospital, carried the liability here.
Claimant succeeded
[2026] EWCC 26·2026·Liability decided at trial
A theatre nurse with worsening palpitations saw a hospital physician who admittedly failed to arrange 24-hour ECG monitoring. The judge found monitoring would have caught her atrial fibrillation in time for anticoagulants to prevent the stroke she suffered.
Palpitations that keep coming back need proper heart-rhythm monitoring. Where a missed test would have led to blood-thinning treatment, a later stroke can be laid at the hospital's door.
Claim failed
[2026] EWHC 704 (KB)·2026·Liability decided at trial
During long spinal surgery for scoliosis and chest wall deformity the claimant deteriorated, arrested while being turned over, and was left with severe sight loss. He alleged the anaesthetist negligently failed to treat a raised potassium reading, but the judge found that reading was spurious and the arrest was caused by a pulmonary embolism, so the claim failed.
Even after a devastating complication a claim fails if the court finds the true cause was a non-negligent event, so proving the mechanism of injury is often the decisive issue.
Claimant succeeded£811,247
[2026] EWHC 657 (KB)·2026·Damages assessed at trial
The trust admitted it negligently failed to diagnose Daisy Lynch's developmental hip dysplasia at birth, so it was not picked up until she was three, by which time simple non-surgical treatment was no longer possible. She went through repeated hip operations and a total hip replacement at 22, and the court assessed her damages after an eight-day trial.
Even where liability is admitted, damages can be heavily contested, and the court can add a provisional damages order letting the claimant return for more if a specified complication later occurs. The award covered pain and suffering, lost earnings, future care and future surgery.
Claim failed
[2026] EWHC 560 (KB)·2026·Liability decided at trial
A mother's waters broke at 27 weeks and a swab grew Group B Streptococcus resistant to erythromycin; the child argued penicillin should have been given before birth to prevent infection-related brain injury. The court held that following national rather than local guidance was not negligent and that antibiotics would not, on the evidence, have prevented the injury.
Following national guidance is a strong defence even where a hospital's own local guidance says otherwise. In premature-birth cases causation often fails because the injury would have happened regardless.
Claim failed
[2025] EWHC 3402 (KB)·2025·Liability decided at trial
The claimant alleged the registrar at the Princess of Wales Hospital, Bridgend, delayed delivery after a pathological CTG in a labour complicated by pre-eclampsia and an impacted fetal head. The judge found the plan of fetal blood sampling, attempted forceps and then caesarean met the standards of the day and dismissed the claim.
A poor outcome after a difficult delivery is not enough; the claimant must show specific decisions fell below acceptable practice at the time and that earlier action would have avoided the injury. The material contribution argument does not help if no negligent cause of delay is proved.
Claim failed
[2025] EWHC 2576 (KB)·2025·Liability decided at trial
After a sleeve gastrectomy the claimant had trouble swallowing; the surgeon performed a gastroscopy and balloon dilatation, after which the sleeve leaked. The judge found no breach of duty in the post-operative care or the dilatation and dismissed the claim despite the very serious consequences.
A bad outcome after a recognised complication is not enough; the claimant must show the treatment decision fell outside what a responsible body of surgeons would do. Sympathy for the patient does not change the legal test.
Claim failed
[2025] EWHC 2597 (KB)·2025·Liability decided at trial
An orthopaedic surgeon had a second stroke and the on-call stroke consultant, assessing by telephone because the video link was broken, decided against clot-busting treatment. The judge found documentation was poor but that thrombolysis would probably not have changed the outcome, and rejected the defendants' allegation that the claimant had faked his test results.
Poor record-keeping and a remote consultation do not win a case on their own; the claimant must show the missed treatment would have made a real difference. A defence of dishonesty needs solid evidence and failed here.
Claim failed
[2025] EWHC 2025 (KB)·2025·Liability decided at trial
The claimant developed anal stenosis after a private haemorrhoidectomy and argued her haemorrhoids had been over-graded, non-surgical options were not discussed and the stenosis risk was not explained. The judge found the grading was correct, alternatives were discussed and the risk was disclosed on the consent form and in the information leaflet, so the claim was dismissed.
Documented consent, including a signed form and a written leaflet naming the specific complication, can be decisive in defeating a Montgomery consent claim.
Claim failed
[2025] EWHC 1907 (KB)·2025·Liability decided at trial
A 27-year-old flight attendant saw her GP with severe back and leg pain, having mentioned perianal numbness in a message two days earlier; she had emergency surgery for cauda equina syndrome four days after the consultation. The judge accepted that the GP asked the right red-flag questions and that the patient answered no, so there was no breach of duty.
In cauda equina cases the court looks closely at what safety-netting questions the GP actually asked and what the patient answered on the day. Contemporaneous notes and messages matter greatly for both sides.
Settlement approved
[2025] EWHC 1750 (KB)·2025·Settlement approved by the court
A mother attended at 37 weeks with two days of absent fetal movement and worrying heart tracings, but delivery was delayed and the baby suffered brain damage causing cerebral palsy. The court approved a settlement for the now 13-year-old child as being in her best interests.
Reduced fetal movements with abnormal monitoring call for urgent delivery. Court approval hearings for children often keep the settlement figures confidential.
Claimant succeeded
[2025] EWHC 1261 (KB)·2025·Liability decided at trial
Ms Hodgson saw a locum GP who suspected pelvic inflammatory disease but did not examine her or arrange urgent follow-up, and a second GP reviewing her blood results by telephone did not refer her for examination. The delay in treatment led to an abscess, removal of a fallopian tube and chronic pelvic pain.
When a GP suspects a serious infection, the court expects an examination or urgent referral to rule it out, and a telephone review of test results does not replace that. Both GPs were held liable, with damages to be decided separately.
Mixed outcome
[2024] EWHC 3318 (KB)·2024·Liability decided at trial
After spinal surgery the hospital failed to give Ms Tuffin the prescribed anti-clotting injection, and she developed a deep vein thrombosis and post-thrombotic syndrome; three years later her leg was amputated above the knee. The judge held the trust liable for the DVT and its after-effects but found the amputation was caused by complex regional pain syndrome from the surgery itself, not the clot.
A missed dose of thromboprophylaxis that causes a DVT is negligent, but compensation covers only the harm the clot actually caused. Where a separate condition drives the worst outcome, the claimant must show the negligence at least materially contributed to it.
Claimant succeeded
[2024] EWHC 2809 (KB)·2024·Damages assessed at trial
A GP saw Ms Cullen three times over five weeks with a persistent cough, sore throat and tiredness but did not make an urgent cancer referral; her laryngeal cancer was diagnosed at stage III about three months later. Liability was admitted, and the trial dealt with disputed care costs and the defendant's allegation that she had been fundamentally dishonest, which the judge rejected.
A delayed cancer referral claim turns on what extra treatment the delay caused; here the admitted delay meant chemotherapy, a total laryngectomy and neck dissections that earlier diagnosis would have avoided. Social media posts relied on to allege dishonesty were found not to contradict her evidence.
Claim failed
[2024] EWHC 2338 (KB)·2024·Liability decided at trial
Admitted with perforated diverticulitis, the claimant had a laparoscopic washout and deteriorated about 36 hours later, needing an emergency Hartmann's procedure with a stoma and intensive care. She alleged she had asked for a colorectal referral, was improperly moved to private care and was not properly consented, but the judge found none of this proved and dismissed the claims against both the surgeon and the trust.
Consent disputes turn on evidence of what was actually discussed; where the records and the surgeon's account show the alternative procedure was explained, a claim based on inadequate consent is likely to fail.
Claim failed
[2024] EWHC 2011 (KB)·2024·Liability decided at trial
Ms Spellman alleged a hospital radiologist missed cauda equina compression on an MRI scan taken the day after her fall, delaying diagnosis until private surgery six days later. Damages had been agreed at £300,000 if she won, but the judge found the scan showed only mild stenosis with no compression to be found, so the claim failed.
Parties sometimes agree the damages figure in advance and fight only liability, so a claimant who loses on breach of duty recovers nothing. Expert evidence on what the scan actually showed was decisive.
Claim failed
[2024] EWHC 1800 (KB)·2024·Liability decided at trial
A widower claimed that doctors at Southampton General misdiagnosed his wife's rare cerebral venous thrombosis as a stroke, gave her clot-busting drugs and delayed the correct treatment, leading to her death. The judge found the clinicians acted reasonably on the presentation and that even earlier correct treatment would probably not have saved her.
A tragic outcome after a rare condition is missed does not by itself prove negligence; the question is whether a reasonable body of doctors would have acted the same way on the information available. Causation must be proved separately.
Claimant succeeded£195,888
[2024] EWHC 1688 (KB)·2024·Liability and damages decided at trial
The patient had a hysterectomy, pelvic floor repair and incontinence tape fitted by one consultant, then mesh removal and a colposuspension by a second consultant. The court cleared the first surgeon but found the second performed the colposuspension without clinical justification, leaving the patient with severe bladder symptoms.
Performing an operation that is not clinically justified is a breach of duty even if it is technically done well. Damages are limited to the harm caused by the negligent procedure, not the patient's pre-existing symptoms.
Claimant succeeded
[2024] EWHC 615 (KB)·2024·Damages assessed at trial
The trust admitted that a misreported smear delayed the diagnosis of cervical cancer, and the claimant, who lost her fertility through treatment, asked for a further interim payment to fund surrogacy abroad. The judge refused because the evidence was not yet complete enough to be confident a trial judge would allow that cost.
Even with liability admitted, an interim payment will only be ordered for sums the court is confident will be recovered at trial. Whether overseas surrogacy costs are recoverable depends on a reasonableness test decided on full evidence.
Settlement approved£5.56M
[2024] EWHC 25 (KB)·2024·Settlement approved by the court
The baby's shoulders became stuck during delivery and manoeuvres failed, so she was deprived of oxygen and left with cerebral palsy; the Trust admitted in 2012 that it failed to deliver her with sufficient or safe speed. The court approved a settlement of about £5.56m plus lifelong periodical payments.
Shoulder dystocia claims are not only about arm injuries; a prolonged delay in freeing the baby can cause brain injury, and damages then reflect lifelong care needs. Approval judgments like this are one of the few public sources showing what such settlements are worth.
Claim failed
[2024] UKSC 1·2024·Appeal decision
Three families sought damages for psychiatric injury after watching a relative die from a condition that doctors had negligently failed to diagnose. The Supreme Court (Lord Burrows dissenting) held that doctors do not owe relatives a duty to protect them from the shock of witnessing a patient's death or medical crisis.
Relatives who develop a psychiatric illness from witnessing a loved one's death caused by medical negligence generally cannot claim as secondary victims. Their remedies are limited to the Fatal Accidents Act dependency and bereavement claims.
Claim failed
[2023] EWHC 3163 (KB)·2023·Liability decided at trial
Ms Beatty, in hospital with severe cellulitis, developed ischaemic toes; a vascular surgeon diagnosed vasculitis rather than an embolism and did not order a CT angiogram, and she later needed a below-knee amputation. The judge found the surgeon's diagnosis was supported by a responsible body of medical opinion and dismissed the claim.
A diagnosis that turns out to be wrong is not automatically negligent; if a responsible body of specialists would have reached the same view on the information available, the claim fails under the Bolam test.
Claimant succeeded£340,000
[2023] EWHC 2986 (KB)·2023·Liability decided at trial
The Trust admitted it missed an aortic dissection that emergency surgery would probably have cured, and settled the fatal claim for £340,000. When the widow and children later sued for psychiatric injury from witnessing the death, the Trust tried to strike that out but withdrew after discovering the earlier settlement had never been court-approved.
Fatal claims involving children need court approval of any settlement or it may not bind them. A missed aortic dissection in a chest-pain patient was accepted as negligent and fatal.
Claim failed
[2023] EWHC 2803 (KB)·2023·Liability decided at trial
Mr Ward's stomach was perforated during keyhole removal of a gastric band; the hole was not seen during the operation and was repaired the following morning after he deteriorated. The judge found the perforation was not visible at the time and so there was no negligent failure to identify and repair it.
A perforation missed during surgery is only negligent if there was visible evidence the surgeon should have seen. Post-operative pain that leads to timely re-operation may not give rise to a claim.
Claimant succeeded
[2023] EWHC 2155 (KB)·2023·Liability decided at trial
A skin sample taken in 2007 was reported as benign but in fact showed melanoma, which was only picked up in 2009 and caused the patient's death in 2014. His widow issued proceedings over five years late after her first solicitors let the case drift, and the court allowed the claim to proceed.
The clock can start later than the mistake itself, because it only runs once you know the injury is serious. Delay caused by former solicitors rather than by the claimant is far less likely to defeat a late claim, especially where the original slides and reports survive.
Claimant succeeded
[2023] EWHC 2719 (KB)·2023·Liability decided at trial
Two radiologists reporting a newborn's abdominal X-rays in October 2010 did not identify or report abnormal alignment of the hips that was visible on the films. The hip dysplasia was not diagnosed until 14 months later and the court found both radiologists in breach of duty.
Radiologists must report any obvious abnormality visible on an X-ray, even if it is outside the reason the scan was ordered. A missed incidental finding can found a negligence claim.
Settlement approved£9.3M
[2023] EWHC 1547 (KB)·2023·Settlement approved by the court
A low-birth-weight baby was not fed adequately overnight and his blood sugar was not checked early enough, causing hypoglycaemic brain damage; the Trust admitted liability in 2018. The court approved a £9.3m lump sum plus periodical payments and held the Trust also owed interest for accepting the offer late.
Negligence in the first days of a newborn's life, not just during labour, can produce some of the largest clinical negligence awards. If a defendant accepts a Part 36 offer late, interest for the delay can be claimed on top.
Claim failed
[2023] EWHC 1304 (KB)·2023·Liability decided at trial
During surgery for a giant calcified thoracic disc the surgeon changed from the planned approach to opening the dura, and the patient was left partially paralysed. The judge found the change of approach and the surgical technique were supported by a responsible body of neurosurgical opinion and dismissed the claim.
Changing surgical plan mid-operation is not negligent where the alternative is a recognised, logical approach. Catastrophic outcomes from high-risk spinal surgery do not by themselves establish a breach of duty.
Claimant succeeded
[2023] EWHC 1290 (KB)·2023·Liability decided at trial
A woman with long-standing back pain saw a pain consultant in 2009 and 2010 who did not order an updated MRI or examine her neurologically; a thoracic disc prolapse went undiagnosed until she became paraplegic in 2017. The court held the consultant negligent and that timely surgery would have given a full neurological recovery, but found the A&E nurse practitioner in 2017 was not at fault.
Failing to re-image or examine a patient whose back pain has changed can amount to negligence years before the catastrophic outcome. Each clinician's conduct is judged separately.
Claim failed
[2023] EWHC 1911 (KB)·2023·Liability decided at trial
A woman attended a GP drop-in clinic with groin pain after an injection had missed the vein; the GP diagnosed a haematoma and sent her away with painkillers, and days later she was admitted with necrotising fasciitis and her right leg was amputated at the hip. The judge found the GP's examination and diagnosis were ones a reasonable body of GPs would support, so the claim failed despite the defendant accepting that referral would have saved her leg.
Even where a devastating outcome and causation are accepted, a claim fails unless the clinician's decision fell outside what a responsible body of practitioners would have done. A properly documented history and examination that reasonably excluded infection was a complete defence.
Claim failed
[2023] EWHC 156 (KB)·2023·Liability decided at trial
A three-year-old was diagnosed with tonsillitis by a GP registrar, deteriorated over the next two days and was then referred to hospital, where meningococcal meningitis was diagnosed. The court found no causative breach of duty and dismissed the claim.
Meningitis claims against GPs often fail because early symptoms genuinely resemble common childhood infections; the claimant must show both that the GP fell below a reasonable standard and that earlier referral would have changed the outcome.
Claimant succeeded
[2023] EWHC 19 (KB)·2023·Liability decided at trial
The mother of twins asked for a caesarean during labour and was refused; the second twin was delivered 6.5 minutes later than she should have been and suffered damaging oxygen deprivation. Ritchie J found the Trust negligent for the delay and held that without it the whole of her brain injury would have been avoided.
A delay of only a few minutes in delivery can be negligent and can be enough to cause the entire injury. A mother's reasonable request for a caesarean during labour should be properly considered and explained, not simply refused.
Claim failed
[2022] EWHC 2981 (KB)·2022·Liability decided at trial
Mr Middleton's acutely ischaemic leg was diagnosed at lunchtime but bypass surgery did not happen until after midnight, about 14 hours later. The judge found it was reasonable to obtain CT imaging first and that surgery by mid-afternoon was not mandatory, and that earlier surgery would not have prevented the nerve injury in any event.
Obtaining imaging before emergency vascular surgery can be reasonable practice, and a claim fails unless earlier treatment would probably have avoided the injury.
Claim failed
[2022] EWHC 2735 (KB)·2022·Liability decided at trial
A man with end-stage kidney failure was given a single 400mg gentamicin dose for a chest infection and suffered permanent balance and hearing damage. His sister's claim failed because the judge accepted that a high dose was a reasonable choice for a worsening infection with sepsis risk, despite his renal impairment.
A drug dose that causes known side-effects is not automatically negligent if it was a reasonable clinical judgement in the circumstances. Departing from a hospital guideline is not itself proof of negligence.
Claimant succeeded£4.68M
[2022] EWHC 2417 (KB)·2022·Damages assessed at trial
A 20-year-old motorcyclist with leg fractures developed compartment syndrome which the trust admitted it treated too late, so his right leg had to be amputated below the knee. Liability was admitted and the court assessed damages at £4,676,442 covering lifelong prosthetics, care, adapted housing and lost earnings.
Where a hospital admits that quicker treatment of compartment syndrome would have saved a limb, the case becomes about valuing lifelong needs, and prosthetics, accommodation and care can each run to six or seven figures for a young claimant.
Claim failed
[2022] EWHC 949 (QB)·2022·Liability decided at trial
A former lorry driver with a history of pulmonary embolism attended A&E and clinics in 2015 with chest pain and calf symptoms; the Trust admitted it should have done a Wells score and imaging at the first visit. The judge found he did not actually have a clot on that date and that the later reduction of his apixaban was not negligent, so the claim failed.
An admitted failure to investigate only leads to compensation if the investigation would have found something. Normal D-dimer results were decisive evidence against a missed clot.
Claim failed
[2022] EWHC 148 (QB)·2022·Liability decided at trial
A 29-year-old with sudden facial droop, speech problems and arm weakness was told by a junior A&E doctor she had migraine and was not referred to the TIA clinic, which the Trust admitted was a breach. Ritchie J found her March symptoms were in fact hemiplegic migraine, not mini-strokes, so the missed referral did not cause her later stroke.
Admitted breach of duty is not enough; the claimant must prove the correct pathway would have prevented the injury. Detailed findings about the exact sequence of symptoms decided this case.
Claim failed
[2022] EWHC 100 (QB)·2022·Liability decided at trial
After routine day-case removal of a scrotal cyst, the claimant returned in the early hours in severe pain; intravenous antibiotics were not started when they should have been and an ultrasound request was delayed, and he was later diagnosed with Fournier gangrene, needing repeated surgery and losing both testicles. The judge found breach of duty but held the claimant could not prove the delays changed the outcome.
Proving that care fell below standard is only half the case: the claimant must also show the negligence made a difference. Where surgery would have happened at the same time anyway, delayed antibiotics or scans may not be shown to have caused the injury.
Claim failed£1.4M
[2021] UKSC 21·2021·Appeal decision
A GP negligently failed to arrange proper testing, so a woman wrongly believed she did not carry the haemophilia gene and went on to have a son with haemophilia who also had autism. The Supreme Court held the GP was liable only for the haemophilia-related costs, because the purpose of the advice was to guard against that risk, not the unrelated risk of autism.
Damages are limited to losses falling within the scope of the duty the doctor undertook. Even where negligence clearly led to a child's birth, unrelated conditions that the advice was never meant to address are not recoverable.
Claim failed
[2021] EWHC 643 (QB)·2021·Liability decided at trial
The executors of Mrs Neill argued her surgeon should have enlarged the aortic root to fit a larger valve rather than implant a 19mm mechanical valve, and failed to warn her about that option. Eady J found the valve choice was not negligent and, although the possibility of root enlargement should have been mentioned, it would have made no difference to her decision.
A consent failure only leads to compensation if the patient would have made a different choice with proper information. Surgical decisions supported by a responsible body of opinion are not negligent just because another surgeon would have done differently.
Claim failed
[2021] EWHC 323 (QB)·2021·Liability decided at trial
A teacher with a back injury attended A&E and was referred for a routine MRI; the scan two weeks later showed a disc prolapse and she had emergency surgery but was left with permanent damage. The court found the registrar was not negligent in not suspecting cauda equina at that visit, and that her condition had not materially worsened during the delay.
Not every back-pain patient with some red-flag features must be scanned urgently; the court looks at the full picture presented at the time. Claimants must also prove the delay itself made the outcome worse.
Claimant succeeded
[2021] EWHC 169 (QB)·2021·Liability decided at trial
Mrs Davies was admitted to Wexham Park Hospital with pneumococcal meningitis; the trust admitted intravenous antibiotics should have started by 10.40 but were not given until 13.20, and she died two days later. After a causation trial the judge found she would probably have survived with timely antibiotics.
In sepsis and meningitis claims a delay of even a few hours in giving IV antibiotics can be negligent, and the key dispute is often whether the delay changed the outcome. Here the family succeeded, with damages already agreed.
Claim failed
[2020] EWHC 3445 (QB)·2020·Liability decided at trial
A two-and-a-half-year-old girl seen at a Badger out-of-hours centre was diagnosed with a sore throat and sent home; two days later scans showed hydrocephalus and brain abnormalities needing emergency neurosurgery, leaving her profoundly disabled. This judgment decided only whether the NHS commissioning body was legally responsible for the nurse practitioner's alleged negligence, and held it was not.
When an NHS body contracts an outside provider to run out-of-hours services, the NHS body does not automatically carry a non-delegable duty for that provider's clinicians. Claims must be brought against the clinician and the out-of-hours provider themselves.
Claim failed
[2020] EWHC 3333 (QB)·2020·Liability decided at trial
After removal of a spinal cord tumour, nursing charts appeared to show neurological deterioration two days post-op, but the surgeon was not alerted; four days later the patient suffered sudden permanent paralysis. The court accepted the clinicians' assessments that there was no real deterioration until the final day, so earlier escalation would not have changed the outcome.
Nursing observation charts alone may not prove deterioration if contemporaneous clinical examinations showed improvement. Even a failure to escalate must be shown to have changed the outcome.
Claimant succeeded£2.85M
[2020] EWHC 3269 (QB)·2020·Appeal decision
After a 10-hour facial reconstruction the claimant developed compartment syndrome in both legs in intensive care and was left with permanent damage; the trust settled 70 days before trial for a £2.85 million lump sum plus annual payments of £48,000 rising to £85,000. This later judgment dealt only with the lawyers' success fee and dismissed the claimant's appeal on that point.
Compartment syndrome arising from post-operative monitoring failures can attract multi-million-pound settlements with periodical payments for lifelong care, although this figure comes from a costs judgment rather than a damages judgment.
Claimant succeeded
[2020] EWHC 2902 (QB)·2020·Liability decided at trial
A 79-year-old with macular degeneration was persuaded to have an intraocular lens implant in her better eye without proper informed consent, then developed raised eye pressure that the surgeon left untreated for five weeks. Stacey J found the surgeon negligent both in consenting and in delaying laser treatment, causing total blindness in that eye.
Private eye surgeons must obtain genuinely informed consent and act promptly on post-operative complications. A delay that materially contributes to permanent damage is enough for liability even if some harm had already occurred.
Claimant succeeded£40,000
[2020] EWHC 2914 (QB)·2020·Liability and damages decided at trial
Ms Leach, alone at home with a brain haemorrhage, waited nearly two hours for an ambulance, of which the trust admitted 31 minutes was negligent delay; she went on to develop PTSD. The judge held that the negligent delay made a material contribution to her PTSD, that PTSD cannot be apportioned, and awarded the agreed £40,000.
Where a negligent ambulance delay materially contributes to a psychiatric injury like PTSD, the trust is liable for the whole injury and cannot reduce damages by arguing only part of the wait was its fault.
Mixed outcome
[2020] EWHC 1504 (QB)·2020·Liability decided at trial
A baby born breech by caesarean should have had a hip ultrasound within six weeks, but the appointment was not arranged until nine weeks and, after rescheduling, the scan at 17 weeks showed hip dysplasia in both hips, needing surgery. The Trust admitted breach but, shortly before trial, sought to blame the mother's missed appointment; the judge refused the late amendment.
Babies born breech need a timely hip scan, and a trust's failure to arrange one within its own protocol was admitted as negligent. Defendants cannot raise new causation arguments on the eve of trial without good reason.
Claim failed
[2020] EWHC 310 (QB)·2020·Liability decided at trial
Ms Pepper argued she had only agreed to a Whipple's operation if an intra-operative biopsy proved cancer, and the biopsy was negative. The judge found she had consented to surgery if the biopsy was positive or the pancreas looked suspicious, that intra-operative biopsies are known to be unreliable, and dismissed the claim.
Consent disputes turn on what was actually agreed before surgery, and courts give weight to contemporaneous notes and what a reasonable patient would have decided. A negative result on an unreliable test does not by itself make surgery negligent.
Claim failed
[2020] EWHC 359 (QB)·2020·Appeal decision
A 65-year-old inpatient who became confused at night fell out of bed and hurt her knees, and she argued that bed rails should have been fitted. The trial judge found that rails had not been recommended and would have been removed anyway, and the High Court refused to disturb those findings.
Bed rails are not automatically the safe option, because they can create their own risks for a confused and mobile patient. An appeal court will rarely overturn a trial judge's findings about what nursing staff decided or would have decided.
Claim failed
[2020] EWHC 158 (QB)·2020·Liability decided at trial
After an appendectomy a woman developed an abdominal mass that scans labelled a harmless omental infarction; it was actually a rare bacterial infection that later formed an abscess needing surgery. The judge accepted an early biopsy would have avoided this but held the doctors were not negligent in not doing one.
Hindsight showing that a test would have helped is not the same as proving it was negligent not to do it. Unusual infections that mimic benign findings on scans are a recognised trap for both clinicians and claimants.
Claim failed
[2019] EWHC 2488 (QB)·2019·Liability decided at trial
The claimant was discharged two days after a sleeve gastrectomy despite nausea, vomiting and pain, and weeks later developed severe sepsis from a leak. The judge found the discharge and follow-up were not negligent and that earlier action would not have changed the outcome.
Early discharge after bariatric surgery is not negligent if symptoms at the time were within the expected range. Claims fail if the leak would have developed and been treated the same way regardless.
Claim failed
[2019] EWHC 2280 (QB)·2019·Liability decided at trial
The mother argued the consultant should not have confidently reported a normal brain structure on the anomaly scan when the images were unclear. The judge accepted the consultant had scanned carefully and that a responsible body of specialists would have reached the same view, so negligence was not proved.
A missed abnormality on an antenatal scan is not automatically negligence; the claimant must show no responsible specialist would have reported as the clinician did. Careful, well-documented scanning is a strong defence.
Claim failed
[2019] EWHC 1043 (QB)·2019·Liability decided at trial
A 4.93kg baby's shoulder became stuck at delivery and the registrar used moderate downward traction to free her, causing a permanent brachial plexus injury. The judge found that traction of that kind was accepted practice in 1992, even though it is now avoided, so the claim failed.
Negligence is judged by the standards at the time of the birth, not today's guidance, which is decisive in many historic Erb's palsy claims. An agreed damages figure is worth nothing unless breach of duty is proved.
Mixed outcome
[2019] EWHC 1276 (QB)·2019·Liability decided at trial
Mrs Arksey attended Addenbrooke's with a warning bleed from a brain aneurysm but was discharged without a CT scan and suffered a catastrophic re-bleed the next day. The court held she had not proved that admitting her would have avoided the re-bleed, though she succeeded on an admitted delay in fitting a shunt for hydrocephalus.
Proving breach of duty in A&E is only half the battle; the claimant must also show that the correct treatment would have prevented the injury in time, which failed here for the main allegation.
Claimant succeeded
[2019] EWHC 520 (QB)·2019·Liability decided at trial
Two days after a back injury, Mrs Shaw attended an out-of-hours GP with severe low back pain, numbness and tingling in both legs, difficulty walking and a urinary accident. The judge found these red-flag signs of cauda equina syndrome were present and were missed, so the GP should have sent her straight to hospital.
An out-of-hours GP who fails to pick up cauda equina red flags (bilateral leg symptoms, bladder problems, leg weakness) and does not refer to hospital falls below the standard of a reasonable GP. A doctor's belief that he would not have missed it carries little weight if the records do not support it.
Claimant succeeded£150,000
[2018] EWHC 3461 (QB)·2018·Liability decided at trial
A woman with learning difficulties lost her arm and leg to blood clots in 2012 after several doctors and a hospital failed to spot a blocked artery. Martin Spencer J found only Dr Jackson negligent and causative, and only for the arm, awarding the agreed £150,000.
Where several clinicians see a deteriorating patient, the court examines each contact separately. Compensation was limited to the injury that the negligent consultation could actually have prevented.
Claimant succeeded
[2018] UKSC 50·2018·Appeal decision
A man with a head injury was told by an A&E receptionist he would wait four to five hours, left after 19 minutes, and collapsed at home with a brain bleed. The Supreme Court held the hospital owed him a duty not to give misleading information about waiting times and that his leaving did not break the chain of causation.
An NHS trust's duty of care in A&E starts at the reception desk, and wrong information given by non-clinical staff can found a negligence claim.
Claimant succeeded
[2018] EWHC 1917 (QB)·2018·Liability and damages decided at trial
A 40-year-old had gastric bypass surgery and developed a leak that was not diagnosed until a day after clear warning signs. Yip J found the trust liable for several failings and assessed general damages at £100,000 plus care and therapy costs.
After weight-loss surgery, signs of a leak need to be acted on promptly; delayed diagnosis can turn a treatable complication into life-changing injury. General damages reflect the whole picture of pain, disability and psychological harm.
Claim failed
[2018] EWHC 1345 (QB)·2018·Liability decided at trial
A man with back pain and new groin numbness phoned his GP, who told him to go to A&E rather than ringing the hospital orthopaedic team directly. Master Cook found the GP had credible expert support for that approach and struck out the claim against him.
Sending a suspected cauda equina patient to A&E by ambulance can be a defensible GP response. A GP claim will fail at an early stage if a responsible body of GPs would have done the same.
Claim failed
[2018] EWHC 343 (QB)·2018·Liability decided at trial
Five days after surgery to reverse his ileostomy the 60-year-old claimant developed sepsis and his whole colon had to be removed because its blood supply had failed. He alleged the surgeon had damaged the marginal artery, but Yip J was not satisfied that the injury was caused by negligence rather than a naturally occurring clot.
A serious complication after bowel surgery is not itself proof of negligence; the claimant must show on the balance of probabilities that a surgical error, rather than an unavoidable event, caused the harm.
Claim failed
[2017] EWCA Civ 1711·2017·Appeal decision
A man treated in the early 1980s sued in 2014, saying no one followed up his hormone condition until a new doctor restarted treatment in 2011. The Court of Appeal found he had known enough back in 1983 and that a 28-year delay had destroyed the records needed to defend the case.
Where very long delay means the records that would show what actually happened no longer exist, the court will usually hold the claimant to the deadline. Realising only years later that better treatment existed does not by itself restart the clock.
Claim failed
[2017] EWHC 1900 (QB)·2017·Liability decided at trial
After a heart attack and angioplasty, Mrs Lane developed a blocked artery in her right arm; it was diagnosed at 02:30 but she was not transferred to the vascular unit until the morning and thrombectomy was done that evening. The judge found the delays and surgery were not negligent and that, in any event, the arm was successfully reperfused so the later amputation was not caused by any delay.
Delay alone is not enough: a claimant must show both that the delay fell below a reasonable standard and that earlier treatment would have changed the outcome. Deferring surgery for an unstable cardiac patient can be a reasonable clinical judgment.
Claimant succeeded£68,742
[2017] EWHC 863 (QB)·2017·Damages assessed at trial
Swabs taken after childbirth showed chlamydia but neither the patient nor her GP was told, and it went untreated for about a year; she suffered repeated pain and an ectopic pregnancy requiring removal of a fallopian tube. The trust admitted breach; the court accepted the ectopic pregnancy and a period of pain disorder were caused by the negligence but rejected the claim that her later chronic widespread pain was.
Failing to pass on an abnormal test result is a clear breach, but the claimant still has to prove which later problems flowed from it. Long-term pain conditions are hard to attribute to a delayed diagnosis.
Claimant succeeded£16,500
[2017] EWHC 128 (QB)·2017·Liability and damages decided at trial
A biopsy of a non-healing foot wound was reported by a histopathologist as scar tissue when it was in fact melanoma. The judge held the signs of malignancy were plain on the slides and found the Trust liable, but awarded only £16,500 because the cancer had probably already metastasised.
A misread biopsy can be negligent even though pathology involves judgement. Damages depend on what the delay actually changed, which can be modest where the disease had already spread.
Claimant succeeded
[2017] EWHC 88 (QB)·2017·Liability decided at trial
Repeated scans showed the baby's head growth dropping away along with other warning signs, but the mother was never referred to a specialist fetal medicine centre. The judge found the care at two of the scans fell below a reasonable standard because no reasonable clinician could have missed the risk of microcephaly.
Scan findings must be read together and over time, not in isolation; a pattern of concerning measurements calls for referral. This judgment decided breach only, so causation and damages were left for later.
Claim failed
[2016] EWHC 1729 (QB)·2016·Liability decided at trial
After a radical hysterectomy for cervical cancer the patient developed an abscess and a narrowed ureter, and later lost a kidney; she alleged the bowel was perforated at surgery and that urologists should have been involved in a second operation. The judge preferred the hospital's explanation for the infection and found no negligence in either operation.
Ureteric and kidney damage after pelvic surgery is not automatically negligent; the court will examine the most likely mechanism. Expert evidence on the cause of infection is often decisive.
Claimant succeeded
[2016] EWHC 1604 (QB)·2016·Liability decided at trial
A man with known arterial disease and prior strokes developed severe foot pain and was treated for months by an orthopaedic surgeon, a pain specialist and a rheumatologist, none of whom checked for a vascular cause or felt for foot pulses. By the time critical ischaemia was diagnosed the leg could not be saved; the court found each of the three consultants negligent and held the leg was salvageable earlier.
Clinicians treating limb pain in a high-risk arterial patient must exclude a vascular cause, which starts with checking pulses. Multiple specialists can each be liable for the same missed diagnosis.
Claim failed
[2016] EWHC 1101 (QB)·2016·Liability decided at trial
A mother alleged that a registrar negligently failed to spot on an ultrasound that a substantial piece of placenta had been left behind after birth, leading to infection and an emergency operation two weeks later. The parties agreed the claim depended on proving a substantial (about 7 cm) piece was retained, and the judge was not persuaded of that on the evidence.
Retained placenta claims often turn on what the scan would actually have shown; if the retained tissue was small, a missed scan finding may not be negligent. Agreed thresholds for success can decide a case.
Settlement approved£50,000
[2016] EWHC 500 (QB)·2016·Settlement approved by the court
The Trust admitted it negligently failed to diagnose the claimant's torn aorta for 20 days, but disputed that this caused his later stroke; the claimant accepted a £50,000 offer just before trial, months after it had expired. This ruling decides who pays the legal costs, applying the normal rules so the claimant pays the defendant's costs for the period after the offer lapsed.
Accepting a settlement offer late can cost a claimant heavily in legal costs even when negligence is admitted. A missed aortic dissection was accepted as negligent, but the disputed stroke was never proved.
Claimant succeeded
[2016] EWHC 407 (QB)·2016·Liability decided at trial
A GP who fell downstairs and was found vomiting and confused was admitted to Manchester Royal Infirmary A&E at about 6.52 am in December 2007, but his CT head scan was not done until 1.12 pm. The court found the scan should have been performed by about 10 am and that the delay was negligent.
A patient with a head injury and reduced consciousness needs a CT scan urgently; an unexplained delay of several hours in A&E can amount to negligence.
Claim failed
[2016] EWHC 351 (QB)·2016·Liability decided at trial
A woman with cystitis took a leftover antibiotic, vomited for days and drank large amounts of water; she saw two GPs on the same day and collapsed with seizures early the next morning with a sodium level of 105. Hickinbottom J held neither GP was required to admit her to hospital on what they saw, and the claim was dismissed.
A GP is judged on the symptoms presented at the time, not on what a later blood test revealed. Persistent vomiting alone did not oblige hospital admission on these facts.
Claimant succeeded£39,000
[2016] EWHC 330 (QB)·2016·Liability decided at trial
A woman hurt her wrist playing football and was seen at Ysbyty Gwynedd A&E in April 2009, where the doctor did not properly carry out all three standard clinical tests for a scaphoid fracture. The fracture went undiagnosed and she later needed a bone graft and further surgery; the court found the examination fell below a reasonable standard.
A&E doctors are expected to perform and record all the recognised tests for a scaphoid fracture when a wrist injury is suspected. Skipping part of the examination can amount to negligence even if the X-ray itself is not at fault.
Claim failed
[2016] EWHC 331 (QB)·2016·Liability decided at trial
A teenager with back pain had a lumbar microdiscectomy and afterwards developed cauda equina syndrome. She argued the surgeon should have sought a second opinion and consented her properly; the court rejected the criticisms and found the CES was a non-negligent complication.
Cauda equina syndrome can be a recognised complication of spinal surgery rather than evidence of negligence. Consent claims fail if the court accepts the surgeon gave adequate advice.
Claim failed
[2016] EWHC 251 (QB)·2016·Liability decided at trial
After surgery for a broken femur at St Richard's Hospital, Chichester, the patient was discharged in April 2008 without arrangements to repeat his inflammatory-marker blood tests, and a deep infection was diagnosed later. The court found this discharge and a four-day debridement delay were breaches of duty, but there was no evidence they made his condition materially worse, so the claim was dismissed.
Discharging a patient without arranging follow-up blood tests can be a breach of duty, but compensation depends on showing the delay actually worsened the outcome.
Claimant succeeded
[2016] UKPC 4·2016·Appeal decision
A patient with appendicitis waited hours for a CT scan and surgery; by the time his appendix was removed it had ruptured and sepsis had damaged his heart and lungs. The Privy Council held the hospital was liable because its delay materially contributed to the injury, even though some harm would have occurred anyway.
Where negligent delay makes an existing condition worse in a cumulative way, a claimant need not prove the whole injury would have been avoided, only that the delay made a more-than-negligible contribution. This is often relied on in sepsis and delayed-treatment claims.
Claimant succeeded£459,758
[2015] EWCA Civ 1244·2015·Appeal decision
During surgery to repair a bladder-vagina fistula caused by an earlier hysterectomy, the surgeon damaged the femoral nerve while dissecting the sigmoid colon. The trial judge awarded £459,758 and the Court of Appeal upheld the finding that the injury was caused by negligent direct injury rather than retractor pressure.
Where a nerve is damaged in an area the surgeon was working on, a court may infer negligence from the mechanism of injury and the expert evidence. Appeal courts rarely overturn a trial judge's factual findings on how an injury occurred.
Claimant succeeded
[2015] EWHC 3540 (QB)·2015·Liability decided at trial
Mr Crammond went to A&E with four days of central chest pain radiating to both arms, but an A&E doctor streamed him to the same-day treatment centre on the strength of an essentially normal ECG without taking a history, and a GP there diagnosed gastritis. The judge held that a competent A&E doctor would have taken a short history and ordered tests that would have revealed his heart disease, avoiding the severe heart problems he suffered four years later.
An A&E doctor cannot rely on a normal ECG to send a chest-pain patient away without taking a proper history. Redirecting a patient to a lower-acuity service without assessing their risk factors can itself be negligent.
Claim failed
[2015] EWHC 2627 (QB)·2015·Liability decided at trial
A diabetic electrician's eye pressure rose to 40-56 mmHg in the days after retinal surgery and was managed with drugs rather than urgent further surgery. The judge held that continuing medical treatment was a logical clinical judgment supported by a responsible body of eye surgeons and dismissed the claim, including the late-raised consent argument.
Choosing medical management over urgent surgery is not negligent if a responsible body of specialists would have done the same. A Montgomery-style consent argument will fail if the patient would have followed the specialists' recommendation anyway.
Claim failed
[2015] EWHC 1311 (QB)·2015·Liability decided at trial
Mr Choudhury called 999 twice in the early hours with dizziness, sweating and head pain; paramedics left him at home both times, he collapsed with a stroke and lay unattended for over eight hours, and at hospital his CT scan was wrongly read as normal and aspirin was delayed. Both defendants admitted these breaches, but the judge found the claimant could not prove that earlier treatment would have prevented the deterioration that left him locked-in.
Admitted failings by an ambulance crew and hospital are not enough on their own; the claimant must prove that proper treatment would probably have avoided the injury. With rare, severe strokes the medical evidence on what treatment would have achieved can defeat the claim.
Claim failed
[2015] EWHC 268 (QB)·2015·Liability decided at trial
A man seen at Medway Maritime Hospital A&E in January 2010 with neurological symptoms was discharged without a CT scan or TIA clinic referral, and a brain tumour was diagnosed seven months later. The court held the triage nurse and A&E doctor acted within acceptable practice, so the claim failed.
An A&E doctor who makes a reasonable assessment and relies appropriately on specialist input is not negligent just because the diagnosis later proves wrong.
Claim failed
[2015] EWHC 276 (QB)·2015·Liability decided at trial
A four-year-old with fever, headache and vomiting was seen at an out-of-hours walk-in centre on New Year's Day and sent home with advice to return if he did not improve; the next evening he was admitted with meningitis and was left severely disabled. The judge held the GP's management was within the range of acceptable practice and dismissed the claim.
A feverish child sent home with safety-netting advice is not automatically a negligent consultation; the court asks whether a reasonable GP could have acted the same way. Hindsight about a devastating outcome does not prove breach of duty.
Claimant succeeded£522,379
[2014] EWHC 286 (QB)·2014·Liability and damages decided at trial
Ms Leigh dislocated her kneecap boarding a bus and was trapped in severe pain for about 50 minutes before an ambulance arrived; the trust admitted 17 minutes of that delay was negligent. The judge found the negligent delay made a material contribution to her PTSD, that her dissociative seizures were part of the PTSD, and assessed damages at £522,379 plus interest.
Even a short negligent ambulance delay can found a substantial claim where it materially contributes to a serious psychiatric injury. Damages can include lost earnings and pension where the injury ends the claimant's career.
Claim failed
[2013] EWHC 4088 (QB)·2013·Liability and damages decided at trial
A widower and four children claimed after Mrs Shah, who had collapsed with leg weakness days after giving birth, died from an undetected arterial tear. The court found the A&E doctor's failure to check leg pulses was not negligent and would not have changed the outcome, so the claim failed.
Fatal claims need proof both that care fell below a reasonable standard and that better care would probably have saved the patient. The judgment nonetheless shows how dependency damages for a spouse and children are built up from the deceased's earnings and services.
Claim failed
[2013] EWCA Civ 547·2013·Appeal decision
A six-week-old premature baby was seen at an out-of-hours clinic, diagnosed with colic and not referred to hospital; he developed bacterial meningitis and was left severely disabled. The trial judge accepted the GP's contemporaneous note over the mother's recollection of symptoms and found no negligence, and the Court of Appeal upheld that decision.
Even where earlier hospital referral would have prevented the injury, the claim fails if the court accepts the GP's record of what the child looked like at the consultation. Contemporaneous clinical notes can outweigh a parent's later recollection.
Claimant succeeded£7,500
[2013] EWHC 600 (QB)·2013·Liability and damages decided at trial
A woman with months of bloating and bowel symptoms was urgently referred by her GP, but the judge found he never told her and the hospital lost the letter, so nothing happened until she was diagnosed with advanced ovarian cancer seven months later. The GP was liable for the delay but only £7,500 was awarded because the delay was not shown to have shortened her life.
A GP must tell the patient an urgent referral has been made so it can be chased. Damages for delayed cancer diagnosis are limited to what the delay actually caused, which may be modest.
Claimant succeeded£92,391
[2013] EWCA Civ 117·2013·Appeal decision
Mrs Thomas's bile duct was injured during keyhole gallbladder removal and the surgeon also failed to arrange fluid and kidney monitoring when she was readmitted unwell. The trial judge found both failures negligent and awarded £92,391; the Court of Appeal dismissed the surgeon's appeal.
Bile duct injury during gallbladder surgery is not automatically negligent, but a court can find negligence where the anatomy was recognised and the injury still occurred, and separately for inadequate monitoring afterwards.
Claimant succeeded
[2012] EWHC 3063 (QB)·2012·Liability decided at trial
A man showed his GP an itchy, bleeding growth in his groin and was told it was a harmless wart; seven months later it was found to be a thick, ulcerated melanoma. Bean J rejected the claim that earlier treatment would have cured him but found the delay cut his life expectancy by three years.
An itching or bleeding skin lesion should prompt specialist referral, not reassurance. Even where cure cannot be proved, compensation can be recovered for a proven shortening of life.
Claim failed
[2012] EWHC 2335 (QB)·2012·Liability decided at trial
Mrs Clements alleged that during bowel cancer surgery the surgeons twisted the bowel's mesentery before rejoining it and failed to check, causing obstruction, a second operation and catastrophic complications. The judge found the join was properly formed and the later obstruction was caused by adhesions, so there was no negligence.
Serious complications after surgery do not by themselves prove the operation was done negligently. The court will weigh the operating surgeons' evidence against what was found at the second operation.
Claimant succeeded
[2011] EWHC 219 (QB)·2011·Liability decided at trial
A GP re-examined a nine-week-old baby's hips after a colleague had noted they were stiff, recorded them as seeming fine and did not refer her to an orthopaedic specialist; the dislocated right hip was only discovered when she was seven and needed major surgery. The judge found the GP should have detected the limited hip movement and referred immediately, and that early referral would have led to simpler treatment.
When an infant hip check raises concern, a GP must refer for specialist assessment rather than arranging a distant re-check. Missing a dislocated hip in infancy turns a condition treatable with a splint into one needing major surgery.
Claimant succeeded
[2011] EWHC 13 (QB)·2011·Liability decided at trial
A fourteen-year-old with days of high fever, vomiting and lethargy was not admitted to hospital by her GP on the Saturday, and the out-of-hours doctor that night managed her by phone instead of visiting; by the time she reached A&E the next morning she deteriorated and suffered irreversible brain damage. The judge found both doctors liable but dismissed the claim against the hospital because it could not be proved when the damage occurred.
A GP who recognises a possible pneumonia in a seriously unwell child but defers investigation for two days, and an out-of-hours doctor who does not visit despite worrying symptoms, can both be held liable when earlier admission would have avoided the injury. A hospital's breach does not lead to liability unless the timing of the damage can be linked to it.
Claimant succeeded
[2008] EWHC 1011 (QB)·2008·Liability decided at trial
A woman with a spinal abscess was sent home from A&E and left with lasting spinal cord damage. Her first claim was issued in time but thrown out when her solicitors served it a day late, and this second, out-of-time claim was allowed to proceed.
If solicitors miss a court deadline, the law does not automatically leave the claimant with only a claim against them. The court can let a fresh, late claim run against the original defendants where a fair trial is still possible.
Claim failed
[2006] EWCA Civ 1028·2006·Appeal decision
A five-year-old whose overnight glucose pump failed had a hypoglycaemic fit; the GP who came to the house gave suppositories rather than the intravenous glucose he was carrying, and the boy suffered fatal brain damage. The trial judge found the GP negligent but not that IV glucose would have saved him, and the Court of Appeal upheld that decision and refused to admit new evidence.
Proving a doctor was negligent is not enough; the claimant must also prove that correct treatment would have changed the outcome. The court also held that an expert's undisclosed link to the defendant's medical defence organisation did not by itself make his evidence inadmissible.
Mixed outcome
[2006] EWCA Civ 1131·2006·Appeal decision
A woman who hurt her ankle ice skating attended University Hospital Cardiff A&E in May 2001, where an X-ray showed a fibula fracture but associated ligament ruptures went undiagnosed for a week. The trial judge dismissed her claim, but the Court of Appeal found the judgment flawed and sent the case back for a fresh trial.
An X-ray showing one fracture does not end the assessment; associated ligament injuries visible from the alignment need to be considered. A flawed first-instance judgment can be reopened on appeal.
Claim failed
[2006] EWHC 1238 (QB)·2006·Liability decided at trial
A baby born at 34 weeks developed severe jaundice; it was alleged doctors should have started an exchange transfusion sooner and that the laboratory should have phoned through a dangerously high bilirubin result. The judge found no breach in the doctors' decisions and, although the lab should have telephoned the result, concluded the damage could not have been prevented by then.
Neonatal jaundice claims depend on exactly when bilirubin reached a toxic level and whether earlier action could have prevented it. A proven communication failure still needs to be shown to have changed the outcome.