Philippa Caroline Deakin-Stephenson v Nebil Behar
[2024] EWHC 2338 (KB)
Deborah Biggadike v Kamilia El Farra & Anor
2 July 2024
[2024] EWHC 1688 (KB)
High Court
Two doctors operated on a patient. The first doctor did nothing wrong. The second doctor did an extra operation that wasn't needed, so the patient got some money.
Key Facts
- •Deborah Biggadike underwent surgery by two consultant urogynaecologists: Kamilia El Farra (first defendant) and Sohier El-Neil (second defendant).
- •The first defendant performed a TVT-Abbrevo tape implantation and posterior prolapse repair in 2017.
- •The second defendant performed mesh excision procedures in 2018 and a colposuspension procedure.
- •The claimant alleged negligence in pre-operative care, informed consent, and the necessity of the mesh excision and colposuspension.
- •The total agreed quantum was £500,000, subject to liability and apportionment.
Legal Principles
The professional practice test for medical negligence: a doctor acted in accordance with a practice accepted as proper by a responsible body of medical opinion (Bolam test, qualified by Bolitho).
McCulloch and Others v Forth Valley Health Board [2023] UKSC 26, Bolam v Friern Hospital Management Committee [1957] 1 WLR 582, Bolitho v City and Hackney Health Authority [1998] AC 232
NICE guidelines do not have the force of law but carry authority; departures require explanation.
Price v Cwm Taf University Health Board [2019] EWHC 938 (QB)
Montgomery duty on informed consent: doctors must take reasonable care to ensure patients are aware of material risks and alternatives.
Montgomery v Lanarkshire Health Board [2015] UKSC 11
Causation of damage: apportionment considered, but ultimately only one defendant found liable.
Sections 27, 32
Outcomes
Claim against the first defendant dismissed.
The claimant failed to prove breach of duty regarding pelvic floor exercises, urodynamic studies (UDS), or informed consent. The court preferred the first defendant's evidence regarding the consultations and the claimant's choice for a surgical solution.
Judgment for the claimant against the second defendant for £195,887.66.
The second defendant's mesh excision was deemed within reasonable treatment options, but the colposuspension was unjustified due to the claimant's asymptomatic status and normal urodynamics. The court found the second defendant's annotation on the UDS report to be contrived and false, undermining the justification for the colposuspension. The lack of informed consent regarding the colposuspension was also a factor.