Stuart Runciman v University Hospital Southampton
[2024] EWHC 1800 (KB)
Rebecca Thorp & Ors v Dr Harinder Mehta
26 March 2024
[2024] EWHC 652 (KB)
High Court
A woman died from a stroke. Her family sued her doctors for not giving her blood pressure medication sooner. The court decided the doctors did what a reasonable doctor would have done, even though they made some mistakes. Even if they had given her more options for treatment, it's unlikely she would have chosen differently, so the doctors were not responsible for her death.
Key Facts
- •Amanda Thorp died from a stroke on 4 January 2018 at age 42.
- •Claimants (administrators of her estate) allege negligence by Dr Chua and Dr Mehta of Ash Trees Surgery.
- •Central issue: Should antihypertensive drugs have been prescribed sooner to control Amanda's high blood pressure?
- •Amanda's blood pressure was consistently elevated on multiple occasions prior to her death.
- •Following pregnancy in 2017, she was prescribed labetalol, which initially lowered her blood pressure.
- •Dr Chua's alleged negligence included failing to access her blood pressure history and misinterpreting a normal reading after labetalol.
- •Dr Mehta's alleged negligence included failing to immediately prescribe antihypertensives and not discussing treatment options with Amanda.
- •NICE Guideline CG127 on hypertension management was relevant but not strictly mandatory.
Legal Principles
Bolam/Bolitho test for medical negligence: A doctor's actions are not negligent if supported by a responsible body of medical opinion. However, that opinion must be defensible.
Bolam v Friern Hospital Management Committee [1957] 1 W.L.R. 582 and Bolitho v City and Hackney Health Authority [1998] A.C. 232
Montgomery duty of informed consent: Doctors must take reasonable care to ensure patients are aware of material risks and reasonable alternatives.
Montgomery v Lanarkshire Health Board [2015] A.C. 1430
Causation in negligence: The claimant must prove, on the balance of probabilities, that the defendant's negligence caused the harm.
Sections discussing causation throughout the judgement.
Outcomes
Claim against Dr Chua dismissed.
While Dr Chua made errors, his decision to defer antihypertensive prescription pending ABPM was not unreasonable considering the NICE guidelines and lack of severely elevated readings.
Claim against Dr Mehta dismissed.
Dr Mehta's continuation of Dr Chua's treatment plan was reasonable. Although he breached his duty under Montgomery by not discussing treatment options, this breach was not causative of Amanda's stroke.
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