Neutral Citation Number: [2019] EWHC 2893 (QB)
Case No: HQ17C03907
IN THE HIGH COURT OF JUSTICE
QUEEN'S BENCH DIVISION
Royal Courts of Justice
Strand, London, WC2A 2LL
Date: 04/11/2019
Before :
MASTER COOK
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Between :
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(1) Mrs Balbir Kaur Paul (on her own behalf and as Administratrix of the estate of Parminder Singh Paul) (2) Saffron Olivia Kaur Paul (A child by her litigation friend Mrs Balbir Kaur Paul) (3) Mya Paul (A child by her litigation friend Mrs Balbir Kaur Paul)
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Claimants |
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The Royal Wolverhampton NHS Trust |
Defendant |
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Laura Johnson (instructed by Shoosmiths LLP ) for the Claimants
Charles Bagot QC (instructed by Brown Jacobson LLP ) for the Defendant
Hearing date: 11 October 2019
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Judgment Approved
MASTER COOK:
The facts
a) Sadly for nine year old Mya she had had a minor argument with her father shortly before he died, so she was walking slightly in front of him. Saffron was walking slightly behind.
b) Mr Paul said he felt ill.
c) Mya turned and saw her father lean against the wall momentarily and then his eyes roll back.
d) Both girls saw him fall backwards and his head hit the floor.
e) The girls were alone with their father who was unconscious or dead in the street. They were so distressed and frightened they had difficulty calling for help.
f) Eventually a woman responded to their shouts and called an ambulance.
g) The girls contacted their mother. They were so distressed that Mya managed to call her mother but could not be understood. 12 year old Saffron broke the news to her mother that her father had collapsed.
h) Both girls saw a man holding their father’s head as he lay on the floor and there was blood on the man’s hands from the injury sustained when Mr Paul’s head hit the ground.
i) The girls were taken into a nearby church for a short time because of what they had been witnessing. Whilst they were there their mother arrived and they heard her screams, screaming their father’s name.
j) The girls went back outside and saw their father under a foil blanket receiving chest compressions from paramedics. There was a crowd of people there including the police. They were then taken away to a relative’s house.
k) The timings are: the ambulance arrived at 15.57 and left the scene 30 minutes later at 16.28. Mr Paul arrived at hospital at 16.43 but further resuscitation was felt to be futile and he was declared dead at 16.51.
l) The children therefore witnessed their father’s final event.
The parties’ submissions
11. Mr Bagot QC on behalf of the Defendant submitted that the Second and Third Claimants cannot be described as secondary victims because there is no relevant event and no proximity. Putting flesh on the bare bones of this submission he started with Lord Oliver’s classic formulation of secondary victim claims in the case of Alcock v Chief Constable of South Yorkshire Police [1992] 1 AC 310;
“Although it is convenient to describe the plaintiff in such a case as a “secondary” victim, that description must not be permitted to obscure the absolute essentiality of establishing a duty owed by the defendant directly to him — a duty which depends not only upon the reasonable foreseeability of damage of the type which has in fact occurred to the particular plaintiff but also upon the proximity or directness of the relationship between the plaintiff and the defendant…In the end, it has to be accepted that the concept of “proximity” is an artificial one which depends more upon the court's perception of what is the reasonable area for the imposition of liability than upon any logical process of analogical deduction. The common features of all the reported cases of this type decided in this country prior to the decision of Hidden J. in the instant case and in which the plaintiff succeeded in establishing liability are, first, that in each case there was a marital or parental relationship between the plaintiff and the primary victim; secondly, that the injury for which damages were claimed arose from the sudden and unexpected shock to the plaintiff's nervous system; thirdly, that the plaintiff in each case was either personally present at the scene of the accident or was in the more or less immediate vicinity and witnessed the aftermath shortly afterwards; and, fourthly, that the injury suffered arose from witnessing the death of, extreme danger to, or injury and discomfort suffered by the primary victim. Lastly, in each case there was not only an element of physical proximity to the event but a close temporal connection between the event and the plaintiff's perception of it combined with a close relationship of affection between the plaintiff and the primary victim. It must, I think, be from these elements that the essential requirement of proximity is to be deduced, to which has to be added the reasonable foreseeability on the part of the defendant that in that combination of circumstances there was a real risk of injury of the type sustained by the particular plaintiff as a result of his or her concern for the primary victim.”
a) It must be reasonably foreseeable that a person of “ normal fortitude ” or “ ordinary phlegm ” might suffer psychiatric injury by shock: per Lord Lloyd in Page v. Smith [1996] AC 155 at [197F]. In addition, there must in fact have been a recognised psychiatric injury suffered.
b) There must be a close relationship of love and affection between the person killed or injured (“the primary victim”) and the Claimant (“the secondary victim”) (Lord Oliver in Alcock [411F]).
c) The Claimant must be in close proximity in space and time to the relevant event (if there is one) or its immediate aftermath: Lord Oliver in Alcock [411G].
d) The psychiatric injury must result from a “ sudden and unexpected shock ”: Lord Oliver in Alcock at [411F]. Lord Ackner in Alcock [ 401F] defined it as: “ (5) “Shock”, in the context of this cause of action, involves the sudden appreciation by sight or sound of a horrifying event, which violently agitates the mind. It has yet to include psychiatric illness caused by the accumulation over a period of time of more gradual assaults on the nervous system.” The definition of “shock” has also been clarified in the case of Liverpool Women’s Hospital NHS Foundation Trust v Ronayne [2015] PIQR P20 (“ Ronayne ”) where the Court of Appeal underlined that in secondary victim cases, the shock must be shown to be: (a) horrifying; and (b) sudden; but also (c) exceptional [8; 14; 33; 41 per Tomlinson LJ].
e) The psychiatric injury must be caused by the “ sudden and unexpected shock ”. Lord Ackner in Alcock (400F): “ Even though the risk of psychiatric illness is reasonably foreseeable, the law gives no damages if the psychiatric injury was not induced by shock. Psychiatric illnesses caused in other ways, such as by the experience of having to cope with the deprivation consequent upon the death of a loved one, attracts no damages.” Also, per Lord Oliver in Alcock [416G]: “ Grief, sorrow, deprivation and the necessity for caring for loved ones who have suffered injury or misfortune must, I think, be considered as ordinary and inevitable incidents of life which, regardless of individual sensibilities, must be sustained without compensation.”
f) The psychiatric injury must be caused by seeing or hearing the relevant incident or its immediate aftermath, rather than being told about it: Lord Wilberforce in McLoughlin v. O’Brian at [422H-423A], as cited with approval, amongst others, by Lord Keith in Alcock at [398B].
“There are two notions implicit in this exception cautiously introduced and cautiously continued by the House of Lords. They are of:
(i) an external, traumatic, event caused by the defendant's breach of duty which immediately causes some person injury or death; and
(ii) a perception by the plaintiff of the event as it happens, normally by his presence at the scene, or exposure to the scene and/or to the primary victim so shortly afterwards that the shock of the event as well as of its consequence is brought home to him.
There was no such event here other than the final consequence of Mr Taylor’s progressively deteriorating heart condition which the health authority, by its negligence many months before, had failed to arrest. In my judgment, his death at work and the subsequent transference of his body to the hospital where Mrs Taylor was informed of what had happened and where she saw the body do not constitute such an event.”
16. Mr Bagot QC submitted that there are two distinct meanings of proximity, firstly legal proximity (the overall legal test for whether there is a duty of care at all); and secondly physical proximity, as explained by Lord Dyson MR in Taylor v. A.Novo (UK) Ltd. [2014] QB 150 at paras. 25 to 27:
26. I accept the submission of Mr Cory-Wright that, in order to succeed, Ms Taylor must show that there was a relationship of proximity between Novo and herself. The word "proximity" has been used in two distinct senses in the cases. The first is a legal term of great importance in the law of negligence generally. It is used as shorthand for Lord Atkin's famous neighbour principle. Used in this sense, it is a legal concept which is distinct from and narrower than reasonable foreseeability. It describes the relationship between parties which is necessary in order to found a duty of care owed by one to the other. In his speech in Alcock Lord Oliver refers to proximity in this sense more than once in the passages which I have cited above. Lord Atkin's neighbour principle itself is concerned with the relationship between parties. You must take reasonable care to avoid acts or omissions which you can reasonably foresee would be likely to injure "persons who are so closely and directly affected by my act that I ought reasonably to have them in contemplation as being so affected when I am directing my mind to the acts or omissions which are called in question." Lord Bridge made the same point in Caparo v Dickman [1990] 2 AC 605 at 617H:
"What emerges is that, in addition to the foreseeability of damage, necessary ingredients in any situation giving rise to a duty of care are that there should exist between the party owing the duty and the party to whom it is owed a relationship characterised by the law as one of 'proximity' or 'neighbourhood'…."
18. On behalf of the Second and Third Claimants Ms Johnson submits the law concerning secondary victim claims is complex and developing and where this is so, the court cannot be satisfied that the claim is bound to fail, see Hughes v Colin Richards & Co [2004] PNLR 35 CA.
“first that there was no event on the facts of this case to which the proximity test could be applied. He maintained that the test required some external, traumatic, event in the nature of an accident or violent happening. Here, he said, Mr. Taylor's death long after the negligence which had caused it was the culmination of the natural process of heart disease, and the death, however unexpected and shocking to Mrs. Taylor when she learned of it, was not in itself an event of the kind to which the immediate aftermath extension could be attached.”
“Mr. Hart submitted secondly that, if Mr. Taylor's death at work could be considered an event of the kind to which the immediate aftermath extension can be attached, Mrs. Taylor's discovery of it at the hospital from a doctor and subsequent identification of the body did not satisfy the third of the three elements of constraint upon the extension expounded by Lord Wilberforce in McLoughlin v. O'Brian , namely as to the means by which the shock is caused. Such means, he submitted, lacked the immediacy or directness required to come within that extension.”
23. Ms Johnson then referred to the case of S ion v Hampstead Health Authority [1994] 5 Med LR 170 , which she said was important because it addresses, obiter, issues raised in this case and is one of the few cases in which there is a discussion of the application of the Alcock principles to negligent omission cases. It was a strikeout application. A father claimed damages against the defendant health authority in respect of psychiatric illness allegedly caused to him by the negligence of hospital staff in caring for his son. The son was injured in a motorcycle accident. He was taken to hospital and his father stayed with him for 14 days watching him deteriorate, fall into a coma and die. The claim alleged that the son's death was caused by the negligent failure to diagnose internal bleeding. The judge struck the claim out as disclosing no cause of action. Claimant's appeal was dismissed by the Court of Appeal. Staughton LJ held that there was no trace in the plaintiff's medical report that the plaintiff had suffered a shock at all. On an application of Alcock , the claim was therefore bound to fail. Waite LJ agreed that the appeal should be dismissed for the reasons stated in the judgments of Staughton and Peter Gibson LJJ. Peter Gibson LJ agreed that the claim was bound to fail because there was no evidence of nervous shock. Nonetheless he also dealt with Defendant's submission that the claim could not succeed because the injuries and/or death of Claimant's son did not qualify as a relevant event for the purposes of a valid secondary victim claim. The Defendant relied on the decision of Auld J in the Taylor case. Peter Gibson LJ said that he was not persuaded by this argument. He acknowledged that in most of the decided cases there had been a sudden and violent incident resulting from a breach of duty but he said at p 176, “it is the sudden awareness, violently agitating the mind, of what is occurring or has occurred that is the crucial ingredient of shock”. He then said:
“I see no reason in logic why a breach of duty causing an incident involving no violence or suddenness, such as where the wrong medicine is negligently given to a hospital patient, could not lead to a claim for damages for nervous shock, for example where the negligence has fatal results and a visiting close relative, wholly unprepared for what has occurred, finds the body and thereby sustains a sudden and unexpected shock to the nervous system.”
24. Ms Johnson referred to W v Essex County Council [2001] 2 AC 592 to support her submission that the categories of secondary victims are not closed . In this case parents signed an agreement with the council to become foster parents. Following assurances from the council that they would not place a sexual abuser with them and following a false representation by the council's social worker that G was not a known sexual abuser, they agreed to foster him. The parents later discovered that G had sexually abused their children. They alleged that as a result of the abuse of their children, they had suffered psychiatric illnesses. They commenced proceedings claiming damages in negligence. The judge struck the claim out and the Court of Appeal upheld the decision. The House of Lords allowed the parents' appeal. Lord Slynn of Hadley gave the only substantive speech. He reviewed the leading authorities relating to secondary victims. At p 600B, he noted that in McLoughlin v O'Brian [1983] AC 410, 430C–E Lord Scarman recognised the need for flexibility in dealing with new situations not clearly covered by existing decisions and that in this still developing area the courts must proceed incrementally. At p 601A, he said:
“the categorisation of those claiming to be included as primary or secondary victims is not as I read the cases finally closed. It is a concept still to be developed in different factual situations.”
And at p 601:
“Whilst I accept that there has to be some temporal and spatial limitation on the persons who can claim to be secondary victims, very much for the reasons given by Lord Steyn in the Frost case, it seems to me that the concept of ‘the immediate aftermath’ of the incident has to be assessed in the particular factual situation. I am not persuaded that in a situation like the present the parents must come across the abuser or the abused ‘immediately’ after the sexual incident has terminated. All the incidents here happened in the period of four weeks before the parents learned of them. It might well be that if the matter were investigated in depth a judge would think that the temporal and spatial limitations were not satisfied. On the other hand he might find that the flexibility to which Lord Scarman referred indicated that they were.”
25. Ms Johnson then came to case of North Glamorgan NHS Trust v Walters [2002] EWCA Civ 1792; [2003] PIQR P16 ; [2003] Lloyd's Rep. Med. 49. This is a case of negligent omission and central to her submissions. The defendant negligently failed to diagnose the claimant's baby as suffering from acute hepatitis. The negligence occurred on or around 17 June 1996 when the baby was noted to be jaundiced and admitted to hospital (para 11). The consequence of that negligence manifested itself some weeks later on 30 July 1996 when the baby had a seizure, from which followed a 36-hour period beginning with the claimant who was sharing a hospital room with her baby, being wakened by the baby having the fit. Misdiagnosis then delayed treatment for brain damage and the facts culminated with the mother being told that the brain damage was severe and agreeing to termination of the baby's life support. The Court of Appeal regarded this as a single horrifying event in which “there was an inexorable progression from the moment when the fit causing the brain damage occurred as a result of the failure of the hospital properly to diagnose and then treat the baby [to] the dreadful climax when the child died in her arms. It is a seamless tale” as a result of which the mother “reeled under successive blows [to her nervous system]”.
26. Ms Johnson also referred to the case of Galli-Atkinson v Seghal [2003] EWCA Civ 697, in which the Court of Appeal also considered what was meant by appreciation of an “event or its immediate aftermath” At paragraph 25 Latham LJ said:
“In approaching that question, I do not consider that we are restricted by what Lord Ackner said in Alcock to a frozen moment in time. As Lord Wilberforce in McLoughlin recognised from the passage that he cited from Benson v Lee, an event itself may be made up of a number of components. This was accepted by the Court in the case of [ Walters ]. Likewise, in my judgment, can the aftermath, provided that the events alleged to constitute the aftermath retain sufficient proximity to the event…”
“In my judgment the law as presently formulated does permit a realistic view being taken from case to case of what constitutes the necessary “event”… It is a useful metaphor or at least a convenient description for the “fact and consequences of the defendant’s negligence”, per Lord Wilberforce, or the series of events which make up the entire event beginning with the negligent infliction of damage through to the conclusion of the immediate aftermath whenever that may be…”.
31. Lastly, and alternatively Ms Johnson submitted that even if the court were to consider there is some merit in the Defendant’s application, the lack of clarity over the application of secondary victim criteria in clinical cases and, in particular, those involving negligent omission that gives rise to injury that becomes evident sometime later, militates in favour of allowing this matter to be dealt with at trial following a full investigation of the facts. She referred to the remarks of Swift J in Shorter v Surrey and Sussex Healthcare NHS Trust [2015] EWHC 614 (QB):
Discussion and Decision
It is apparent from paragraph 17 of the judgment in Walters that the judge at first instance approached the facts in this way:
“… It seems to me that the period of 36 hours from the moment at which the epileptic fit started, the misdiagnosis by the Prince Charles Hospital, the correct diagnosis by King's College Hospital and the decision to turn off the life support machine because of the irreparable damage caused by the fit can be looked on in law as a horrifying event properly so called.”
In other words, the events from the misdiagnosis in Walters could be seen as one event connected in space and time. This finding was not challenged in the Court of Appeal.