Jacqueline Beatty v Lewisham and Greenwich NHS Trust
[2023] EWHC 3163 (KB)
Anne Edith Powell v University Hospitals Sussex NHS Foundation Trust
31 March 2023
[2023] EWHC 736 (KB)
High Court
A woman lost her leg after knee surgery. Her doctor didn't fully explain all her options beforehand, but the court decided that even if he had, she still likely would have had the surgery that led to the infection. So, even though the doctor was a bit careless about explaining things, he wasn't responsible for the leg amputation.
Key Facts
- •Mrs. Anne Powell, 65, underwent left revision total knee replacement surgery in November 2013.
- •Subsequent infections led to above-knee amputation of her left leg in 2016.
- •Mrs. Powell claims negligence due to inadequate informed consent, not surgical skill.
- •She alleges that had she been properly informed of risks and alternative treatments ('first stage procedure'), she would have chosen the alternative, preventing the infection and amputation.
- •The trial focused on informed consent and causation.
- •Damages were agreed at £485,000, making the trial liability-only.
- •The defendant (University Hospitals Sussex NHS Foundation Trust) conceded that Mrs. Powell should have been advised of certain risks and the alternative procedure.
Legal Principles
Informed consent; patient autonomy is paramount. Doctors must take reasonable care to ensure patients are aware of material risks and reasonable alternatives.
Montgomery v Lanarkshire [2015] UKSC 11
Negligence test for professionals (Bolam test): A professional is not negligent if acting in accordance with a practice accepted as proper by a responsible body of opinion, even if another body holds a contrary view.
Bolam v Friern Hospital Management Committee [1957] 1 W.L.R. 582
Causation ('but for' test): The fault is the cause of the damage only if the damage would not have happened but for that fault.
Barnett v Chelsea and Kensington Hospital Management Committee [1969] 1 QB 428
Thirteen axioms of fact-finding, including burden of proof, reliance on evidence, iterative analysis, limitations of memory, and assessment of credibility.
Various cases cited in section III.d
Outcomes
Claim dismissed.
The claimant failed to prove both that she would have chosen the alternative procedure if properly informed (Issue 6) and that the Staphylococcus epidermidis infection causing the amputation was present before the January 28 procedure (Issue 7). While the surgeon was found negligent in his informed consent process, this negligence did not cause the loss.