Key Facts
- •Claimant alleged negligence by Nurse Jabeen and the St George's University Hospital NHS Foundation Trust.
- •Claimant alleged failure to adequately address extreme pain and failure to refer to a senior physician.
- •Defendant admitted negligent failure to discuss the claimant with a senior member of the Emergency Department and to refer to surgeons.
- •Nurse Jabeen's witness statement challenged the Claimant's account of experiencing extreme pain.
- •Witness statements from Dr. Glazebrook and Mr. Vesely (a consultant plastic surgeon) were challenged by the Claimant.
- •Dr. Glazebrook's statement addressed what would have happened if a referral had been made to a senior A&E physician.
- •Mr. Vesely's statement addressed potential surgical interventions and the level of amputation.
- •The court considered the admissibility of the witness statements in the context of CPR 16.5.
Legal Principles
Admissibility of opinion evidence in witness statements of fact in clinical negligence cases.
CPR Part 32
Requirements for pleadings under CPR 16.5, including dealing with every allegation in the particulars of claim.
CPR 16.5
The 'Bolitho' question: what would have happened but for an omission, and was that also negligent?
Bolitho case (not explicitly cited but implied)
Balancing the defendant's right to put matters in issue with the claimant's right to a fair trial and avoiding 'stonewalling defences'.
API North Ltd v Swiss Post International (UK) Ltd [2019] EWCA Civ 7 (cited in commentary to White Book at 16.5.2)
Article 8 rights (right to private life) in relation to disclosure of information about a witness's illness.
Article 8, ECHR
Outcomes
Nurse Jabeen's witness statement excluded.
The Defendant failed to properly plead the issue of the Claimant's pain, and should have sought information from Nurse Jabeen earlier.
Parts of Dr. Glazebrook's witness summary admitted; parts excluded.
System-related evidence admitted, but evidence on what he would have done was excluded due to uncertainty about his availability on the day in question.
Parts of Mr. Vesely's witness statement admitted; parts excluded.
Evidence on general surgical approaches admitted. Opinion on the Claimant's condition at the time of surgery excluded as it encroached on the experts' remit.
Defendant must amend their defence to admit or deny the Claimant's account of experiencing extreme pain.
The court found the defendant's pleading insufficient, requiring amendment to address the issue of the Claimant's pain properly.