Practice Overview

Caroline specialises in clinical negligence and medical law (especially concerning research & genetics; and including data protection and issues regarding medical records); complex personal injury litigation; related professional indemnity insurance; and health and safety claims. Her principal work involves neo-natal and adult brain damage; spinal injury; death; psychiatric injury; chronic pain and a broad range of diagnostic and treatment errors in primary and tertiary care. Her professional indemnity work usually relates to under-settlement or mismanagement of medical claims. The majority of Caroline’s work involves very complex medical or legal issues.

Caroline is adept at getting the best out of clients and experts in conference, and is known for her empathetic approach and commitment to her clients. She is an experienced and talented advocate and negotiator, who is equally at home whether leading from the front, or performing her role in a team. Caroline acts for both claimants and defendants in all areas of her work.

In addition to her brain damage, stroke and spinal injury work, Caroline’s recent cases have included the following medical issues: microbiological causation in septic arthritis; Wegener’s Granulomatosis (a rare auto-immune disease with rarer cardiac involvement resulting in premature death); autoimmune disease causing vascular insufficiency and amputation; acute liver failure leading to transplant; allergic drug reactions; drug-management of in chronic renal failure; short-term action of heparin in context of symptomatic pulmonary embolus; near-fatal bacterial lung infection; psychiatrically mediated blindness; psychiatric causation in borderline personality disorder; delayed diagnosis of various cancer types.

Caroline’s areas of special interest are complex medical issues and medical research, especially involving genetics and mental health; and difficult legal problems such as causation. Caroline was a member (and later co-chair) of the Gene Therapy Advisory Committee for ten years, and a Human Genetics Commissioner for eight years until the Commission was wound up. She was involved in the regulation of general medical research at both local and national level for many years. As an HGC Commissioner, she chaired the working group on genetic discrimination and was heavily involved in the Commission’s work on insurance-related issues. She was personally invited to give expert evidence on these matters to the House of Lords Science & Technology Committee. Her evidence was specifically referred to in the Committee’s final report. Caroline’s interest in the frontiers of medical knowledge and research are of particular value in life and health policy claims.

Caroline has very extensive advocacy experience in Inquests, trials and appeals (see selected cases below). She is a Grade A advocacy trainer for Lincoln’s Inn, and is regularly invited to teach at the South Eastern Circuit Advanced Advocacy course at Keble College, Oxford. She is a Bencher at Lincoln’s Inn, and elected vice-chair of the PNBA executive committee.

Caroline has recently led the defence teams in two permanent health claims with a combined value around £4m. At the trial of the first matter, the claimant discontinued immediately after being cross-examined for two days. The case raised issues of deliberate exaggeration and the reliability of psychiatric evidence supporting the claim. The second case is continuing, and the defence is that the claim is fraudulent. Other issues include construction of a group PHI policy, and the regulation of exclusion clauses.

Selected inquests:

Re Flanaghan[12-days, Worcester CC, Feb 2011] (fatal impact with tramcar, issues included possible homicide by a serving police officer, possible suicide, accident, exact timing & causation of injuries)
Re Pearce [3-days, Nov 2011, Essex CC] (allergic reaction to penicillin; system neglect in A&E triage & allergy warning)
Re Douglas[10-days, Mar 2008, Plymouth CC] (death of naval officer from diabetic acidosis)

Selected other cases:

Miley v Aviva(ongoing. QBD London, April 2017). £2.5m PHI claim
Wilsher v Friends Life(unreported. QBD London, November 2013). £1.75m PHI claim. Discontinued at trial after 2 days of evidence
Williams v Bermuda Hospital Board[2016] UKPC (Material contribution causation in medical claims)
EG & JG v Somerset CMHT[2016] EWHC … (QBD Bristol, Jan 2016) (adolescent suicide in the context of eating disorder. Issues of causation)
Lyons v Chief Constable of Kent Police[2012] EWHC 364 QB (causation in supervening psychiatric disability)
Reid v Ministry of Defence & ors [settled Mar 2009] (novel issue of conflicting standards of care between UK-trained GPs and German hospital clinicians in near-fatal lung injury)
Whitehead v S & Hibbert, Pownall & Newton[2008] All ER(D)80, EWCA Civ.285 (solicitor’s negligence case arising from failed wrongful birth claim. Novel points included relevance of events after date of notional trial & duties owed to fathers)
Williams v Williams & ors.[unrep. 2006 & 2007 Turks & Caicos Islands Supreme Court & Caribbean Court of Appeal respectively] (RTA causing paraplegia. Construction of terms in motor insurance policy with pan-Caribbean ramifications)
Berry v Calderdale HA[1998] Lloyds L.R. (Med) P179 CA (limitation & scope of lawyer’s duties)

Caroline specialises in catastrophic injuries or cases raising particularly difficult causation or quantum issues. Her recent work has included supervening psychiatric disability; orthopaedic causation in successive traumas; severe multiple injury compensation; Blamire or multiplier-multiplicand approach to lost earnings; chronic headaches and chronic pain.

Caroline’s work in this area principally relates to mis-managed or under-settled medical claims. Her recent cases have covered the following contexts: an employer’s liability claim resulting in below-the-knee amputation; wrongful birth – multiple complex issues of scope of duty of care, effect of post-notional trial suicide of mother, whether hospital could owe duty to father; spinal injury and neuro-radiology; extreme case of chronic pain; brain damage claims for children.

Caroline has extensive experience of medical and other inquests, including with juries.

Recent Cases:

Re Flanaghan [12-days, Worcester CC, Feb 2011]
Fatal impact with tramcar, issues included possible homicide, possible suicide, accident, exact timing & causation of injuries, braking capacity of tramcar;
Re Pearce [3-days, Nov 2011, Essex CC]
Allergic reaction to penicillin; system neglect in A&E triage & allergy warning;
Re Peacock [July 2011, Hatfield CC]
Pulmonary embolus secondary to leg fracture – failure to apply standard protocol for anticoagulant management;
Re El-Shaboury [June 2011, West London CC]
drug regime in chronic renal failure;
Re Douglas [10-days, Mar 2008, Plymouth CC]
Death of naval officer from diabetic acidosis several days after consulting MO.

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