Sidra Bilal & Anor v St George's University Hospital NHS Foundation Trust
[2023] EWCA Civ 605
Hazhar Shally v Imperial College Healthcare NHS Trust
1 June 2023
[2023] EWHC 1304 (KB)
High Court
A man had back surgery that went wrong, leaving him partially paralyzed. He sued the hospital, but the judge decided the surgeon didn't make any mistakes because other experienced surgeons would have done the same thing. So, the man lost the case.
Key Facts
- •Mr. Shally underwent surgery for a large calcified prolapsed thoracic disc at T10/11.
- •The surgery resulted in incomplete paraplegia.
- •The Claimant alleged negligence in abandoning the costotransversectomy, adopting the surgical approach, and in the retraction/manipulation of the spinal cord.
- •The Defendant denied negligence.
- •A costotransversectomy was initially planned, but an intraoperative decision was made to proceed with a transdural approach due to the disc's adherence to the dura.
- •Neurophysiological monitoring (MEPs and SSEPs) was used during surgery.
- •A second operation was performed to remove remaining disc material, but there was no significant improvement.
Legal Principles
A clinician is not negligent if they acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that art.
Bolam v Friern Hospital Management Committee [1957] 1 WLR 583
A court may prefer one body of opinion to another, but that is no basis for a conclusion of negligence. Differences of opinion and practice exist and will always exist in the medical profession.
Maynard v West Midlands RHA [1984] 1 WLR 634
If a professional departs from accepted methods of treatment, they must justify it if injury results. The burden of proof may shift to the defendant.
Clark v MacLennan [1983] 1 All ER 416
A court can reject professional opinion if it cannot be logically supported. The court, not medical opinion, determines the standard of care.
Bolitho v City and Hackney HA [1997] UKHL 46
Factors to consider when assessing expert opinion: good faith, responsibility/competence/respectability, and logic/reasonableness.
C v North Cumbria University Hospitals Trust [2014] Med. L.R. 189
Outcomes
Claimant's claim fails.
The defendant's actions were found to be in accordance with a responsible body of medical opinion. The intraoperative change of approach and spinal cord manipulation were deemed not negligent.