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Anna Hughes successfully represented the Defendant NHS Trust in the case of Spellman v Portsmouth Hospitals University NHS Trust [2024] EWHC 2011 (KB)

Posted: 31/07/2024

This clinical negligence claim arose out of the reporting of an MRI scan to assess for cauda equina compression when the Claimant attended the Defendant’s hospital on 6th June 2017. The Claimant alleged that there was a negligent failure to report cauda equina compression, and that the failure to do so meant she missed the opportunity to undergo urgent surgery to treat her condition. The Defendant maintained that the scan did not show compression of the cauda equina and that, in any event, it had been reported in a reasonable manner.

Mr Justice Sweeting agreed that the legal test that was to be applied in this “pure diagnosis” case was that set out by the Court of Appeal in Penny v East Kent Health Authority [2000] Lloyd’s Rep Med 41, and confirmed by the High Court in Brady v Southend University Hospital NHS Foundation Trust [2020] EWHC 158 (QB): namely that the Court first had to determine what, as a matter of fact, was there to be seen on the imaging, and then apply the Bolam test in order to determine whether, notwithstanding what was in fact present, the scan had been reported in line with a reasonable and logical body of radiology opinion.

It was held that, as a matter of fact, the MRI scan did not show an acute cauda equina compression, so that it could not be said that there had been an unreasonable failure to report the same. In reaching this conclusion, Mr Justice Sweeting noted that the Claimant’s radiology expert had “made a number of errors in his interpretation of the scan including identifying pathology at the wrong level”. The Judge indicated that this “did not inspire confidence” in the opinion of the Claimant’s expert and, as a result, he accepted the evidence of the Defendant’s radiology expert on all points of dispute.

Accordingly, the claim was dismissed.

The case confirms that the approach adopted by the Court in Brady (in which Anna also appeared for the successful Defendant) is indeed the correct approach to adopt in “pure diagnosis” cases. The case further emphasises the need for experts to ensure that their reviews of imaging are accurate from the outset, as unforced errors are likely to undermine the credibility of the expert.

Anna was instructed by Dominic Samson of DAC Beachcroft LLP.

Authors

Anna Hughes

Call: 2008

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