Source: http://ukhealthcarelawblog.co.uk/rss-feed/74-the-ten-rules-of-nervous-shock-2
Timestamp: 2019-04-18 10:14:03+00:00

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31. This scenario is probably the most difficult. It is where a couple attend an appointment together and are given an incorrect diagnosis, for example of cancer. I don’t see why in principle, if the facts are right, you should not argue that a duty is owed to both of those attending and receiving the incorrect diagnosis.
32. There is some support for this argument in the context of private consultations, where a duty exists in contract rather than just tort. In Less v. Hussain  EWHC 3513 (QB) a woman received negligent pre-conception advice from a private gynaecologist. She became pregnant and lost the baby at 26 weeks. She established breach of duty but failed on causation, the court finding that she would have chosen to become pregnant even with non-negligent pre-conception advice. HHJ Cotter QC went on to deal with the father’s claim for psychiatric injury. There was a dispute as to whether he had suffered psychiatric injury rather than ‘distress’ at the bereavement and the judge found that in any event there was no shocking event in the Alcock sense.
33. He went on to accept Katie Gollop QC’s submission for the Claimants that in principle damages for mental distress could have been awarded in contract to the father – because the consultation had been intended to seek peace of mind, by analogy with holiday and home improvement cases. On the facts he found that there was not in fact a contract between the father and the doctor, but did accept that circumstances might have been different. He relied heavily on the approach of the Court of Appeal in Yearworth v. North Bristol NHS Trust  EWCA 37 – where claimants were awarded damages for mental distress after frozen sperm that they had stored prior to chemotherapy was inadvertently destroyed.
36. Once you read this you might be forgiven for packing up and going home.
37. It begs the question how bad do things have to get to qualify as horrifying in hospital. Looking back at the list of recent cases we can see that out of brain haemorrhage, stroke, unsuccessful resuscitation of newborn babies, the death of babies, none is sufficient. You might think of this as a scale from 1 to 10. Scores of 1 to 3 are events so minor we would never have brought a secondary victim claim even before the recent tightening of approach. Scores 4 to 7 were probably enough in the old days but no longer. All the unsuccessful cases in recent years have been somewhere 4 and 7. What we are looking for now is a score of 8, 9 or 10. To get to this end of the scale you need some extra ingredient which takes the case out of the ordinary.
38. I think that if Walters were being decided today by a differently constituted appeal court, that which decided Ronayne for example, then the defendant’s appeal would probably have succeeded.
40. The simple point is that the start of the ‘seamless tale’ was the mother waking to find her baby stiff. He was not convulsing or shaking, or frothing. There was a small amount of vomit (coffee grounds) on the cot sheet. Neither she nor the nurse thought there was much wrong at the time. The real shock comes after transfer to London when she is described as seeming ‘stunned’ when she is told that his chances are 50/50. He has a further CAT scan the following day and a decision is made to switch off the life support machine. I don’t underestimate any of the ‘shock’ involved but this was, to borrow the phrase of Tomlinson LJ in Ronayne, hardly unexpected in context.
41. I think we have to accept the reality that there has been a stiffening of resolve in the High Court and the Court of Appeal. Walters has become a mythical fairy tale which allows it to be justified as something exceptional.
45. You will all know about Taylor v. Novo  EWCA Civ 194 which in March 2013 heralded the firestorm that has all but destroyed secondary victim claims. Crystal’s mum injured her foot when some shelving fell on her at work. 21 days later she collapsed in front of Crystal at home with a PE caused by a clot from her injured ankle. She suffered PTSD and won at first instance. The Court of Appeal accepted the Defendant’s argument that there was insufficient proximity between the breach of duty and the daughter’s injury. It would have been different if the collapse had taken place at the same time as the original injury.
47. This ‘Walters gap’ is just not addressed in Taylor v. Novo. There are no cases of which I am aware where this point has been tackled head on within a clinical negligence context but you can see how it might arise in cases where there has been a failure to diagnose a DVT and then injury occurs to both primary and secondary victim three weeks later (i.e. unlike Taylor v. Novo there is no initial injury); or with a failure to diagnose an acute coronary disease and the primary victim drops dead after several months.
49. Given the approach of the courts, the likelihood of the NHSLA fighting any nervous shock case to trial, the expense of issuing a claim and the reality that you will only be paid for winning I would not blame anyone who placed a blanket ban on their firm pursuing any secondary victim claim.
50. At the same time, if we wanted only to do easy cases we would not have become clinical negligence lawyers. In my view despite all the problems identified there remains a glimmer of hope. These cases go in cycles and we may be in a death spiral for secondary victim claims but this will not continue for ever. Our hope must be that it doesn’t take as long for the recovery to start as it did after the Coultas case of the Victorian railway.
51. So where is the hope? It lies in recognising that no one has banned secondary victim cases. The bar has not been placed impossibly high. If you pick the right case, a real stomach churner, where you have supportive expert evidence then your appeal to the court can be that yours is a Walters case.
52. I think the way forward is best demonstrated in Galli Atkinson. There a mother had been told that her 16 year old daughter had been killed in a road accident, she went with her husband and other daughter to the mortuary and saw her daughter there. At first instance the claim failed because the recorder considered that her injury had been caused by being told of her daughter’s death, rather than seeing it herself and because seeing her daughter at the mortuary did not constitute the aftermath.
55. I think one reason why so many nervous shock claims have failed in recent years is that they have been brought, understandably, as ‘bolts-ons’ to the main event. Their value and importance has not justified the same rigorous approach as we would normally apply to a clinical negligence claim.
56. My suggestion is that whilst 9 out of 10 potential secondary victim claims should now not be pursued for the 1 out of 10 that are you need to go full throttle.
You need to identify the factual, legal and expert basis for your claim before you notify the defendant of the potential claim.
You need to make sure that even your C&P evidence is consistent with your nervous shock argument – you don’t want to be vulnerable to the argument that you have tightened up the argument later in response to a defendant’s Alcock argument.
You need to make sure that in every communication with the defendant, every witness statement and your expert evidence you are emphasising the horror of what happened.
You should acknowledge that such claims will normally fail and make clear that you see your claim as different and explain why. The Defendant needs to be made to feel at risk.
You need to emphasise ‘exceptionality’ – the court will only find for you if you can persuade the judge that he/ she is not in any way diluting the ‘party line’ or ‘we don’t do secondary victim claims’.
You need to develop a ‘narrative’ or to use LJ Ward’s phrase a ‘seamless tale’. In both Walters and Galli-Atkinson it is clear that the court wanted to find for the claimant, you have to make the court want to find for you and then give the judge the necessary ingredients.
You should make a properly costs-protective part 36 offer.

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