Court Awards Substantial Interim Payment in Spinal Cord Injury Negligence Case

Introduction

The case of Richard Dee v Welsh Ambulance Services NHS Trust & Ors presents a claim for damages due to alleged negligence resulting in a catastrophic spinal cord injury and severe pressure sores. The High Court’s detailed judgment provides insight into the application of legal principles relating to interim payments, breach of duty, causation, and quantum in personal injury cases. This article critically evaluates the legal principles applied and addresses the judgment in a structured format.

Key Facts

Richard Dee, the claimant, sustained injuries from a non-motorised scooter accident, leading to tetraplegia and severe pressure sores. His claim against three defendant bodies focused on alleged clinical negligence during his treatment post-accident. The case was at a relatively early stage, with expert evidence yet to be exchanged. The claimant sought an interim payment due to immediate financial needs aggravated by his living conditions. The schedule of loss totalled over £7 million, with ongoing disputes regarding breach of duty and causation.

Legal Principles

Interim Payments

The court applied Civil Procedure Rules (CPR) 25.6-9, which allow for interim payments prior to final judgment. The court must be satisfied that the claimant would likely obtain judgment for a substantial amount of money. Guidance in the White Book and case law, particularly ‘Test Claimants in F11 Group Litigation v Revenue & Customs Commissioners [2012] EWCA Civ 57’, helped elucidate that there should not be a mini-trial during interim payment applications and that the claimant must satisfy the burden and standard of proof on the balance of probabilities to a high degree.

Breach of Duty and Causation

The judgment addressed various breaches of duty from the defendants, with admissions limited to the failure to recognize spinal injury risks and inadequate treatment causing pressure sores. The court examined the importance of immobilisation of the injured spine, the management of blood pressure, and the impact of these failings on the claimant’s health deterioration. The claimant’s experts opined on the likelihood of secondary injuries relating to upper limb deterioration and pressure sore development due to poor blood pressure management and hypo-tension, supporting a breach of duty claim.

Quantum

When determining the quantum of the interim payment, the court referred to the Eeles v Cobham [2009] EWCA Civ 24 two-stage test, which includes making conservative estimates for each relevant head of loss and applying a global discount to ensure the payment amount is reasonable. There was particular focus on pain, suffering, and loss of amenity (PSLA) for the upper limbs injury and the pressure sore, without definitive guidance from the Judicial College Guidelines for pressure sores.

Outcomes

The court awarded the claimant an interim payment under CPR 25.7(1)(e), due to the inability to decide which defendant out of the three was liable. The sum totaled £109,006.96, reflecting a conservative estimate of identified losses related to the upper limb disorder and the pressure sore, discounted globally by 10%. This award was deemed substantial, exceeding the limits for damages claimed in similar personal injury cases.

Conclusion

In Richard Dee v Welsh Ambulance Services NHS Trust & Ors, the court undertook a meticulous application of legal principles associated with interim payments in the context of personal injury. The judgment reflected a careful analysis of breach of duty and causation, particularly relating to clinical negligence. Furthermore, the calculation of quantum in the absence of definitive guidelines for pressure sores reflected the court’s judicious approach in ensuring reasonable compensation. The case underscores the complex nature of proving negligence and causation while also highlighting the court’s role in safeguarding the claimant’s immediate financial needs through an interim payment.