Hazhar Shally v Imperial College Healthcare NHS Trust
[2023] EWHC 1304 (KB)
Karen Spellman v Portsmouth Hospitals University NHS Trust
31 July 2024
[2024] EWHC 2011 (KB)
High Court
A patient sued a hospital radiologist because she believed her MRI scan showing back problems was misread. She claimed the radiologist missed a serious condition called Cauda Equina Syndrome (CES) which required urgent surgery. Expert doctors disagreed about whether the scan actually showed CES. The judge decided the scan didn't show it, so the radiologist wasn't at fault, and the case was dismissed.
Key Facts
- •Claimant alleges Portsmouth Hospitals University NHS Trust failed to identify Cauda Equina Syndrome (CES) on her June 6, 2017 MRI scan.
- •Claimant had a history of back problems and surgeries.
- •Claimant reported back pain, numbness, and urinary issues after a fall on June 5, 2017.
- •MRI scan showed moderate central canal stenosis at L2-3 and L3-4, a facet joint cyst at L2-3, and a small disc extrusion at L3-4.
- •Radiologist's report described findings as 'mild stenosis'.
- •Claimant underwent private surgery on June 12, 2017, for cauda equina compression.
- •Claimant continues to experience urinary, bowel, and neuropathic pain.
- •Expert radiologists disagreed on the interpretation of the MRI and the adequacy of the report.
Legal Principles
Bolam/Bolitho test for clinical negligence: A doctor's actions are not negligent if they are supported by a responsible body of medical opinion, subject to the Bolitho qualification that the opinion must be logically defensible.
Bolam v Friern Hospital Management Committee [1957] 1 WLR 583, Bolitho v City and Hackney Health Authority [1998] AC 232
Two-stage approach to radiology negligence claims: 1. Factual determination of image content; 2. Assessment of whether the report was reasonable (non-negligent) according to the Bolam test.
Penny v East Kent Health Authority [2000] Lloyd’s Rep Med 41, Brady v Southend University Hospital NHS Foundation Trust [2020] EWHC 158 (QB)
Outcomes
Claim dismissed.
The court found no radiological evidence of cauda equina compression on the June 6, 2017 MRI. The radiologist's report, while perhaps using less strong terminology than some experts preferred, was considered reasonably accurate and did not constitute a breach of duty. Even if there had been a breach, the court found no causal link between the alleged negligence and the Claimant's ongoing problems.
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