Emergency department care

The United Kingdom Supreme Court has published its decision in the matter of Darnley v Croydon Health Services NHS Trust [2018] UKSC 50.

Mr Darnley suffered a head injury and went to hospital. He was told by the A&E receptionist that it would be four to five hours before he was seen, whereas the true position was that he would be seen by a triage nurse within thirty minutes. After 19 minutes, the claimant (feeling unwell) and his friend left and he went home. He then suffered a deterioration in his condition and ultimately suffered severe disabilities.

Allowing the appeal, the Supreme Court focused on the ‘flawed’ approach of the majority in the Court of Appeal to the duty of care issue. It held that the case fell squarely within an established category of duty of care. At [16]:

While it is correct that no authority has been cited in these proceedings which deals specifically with misleading information provided by a receptionist in an A & E department causing physical injury, it is not necessary to address, in every instance where the precise factual situation has not previously been the subject of a reported judicial decision, whether it would be fair, just and reasonable to impose a duty of care. It is sufficient that the case falls within an established category in which the law imposes a duty of care.

The duty of care is owed by the hospital trust and it is not appropriate to distinguish, in this regard, between medical and non-medical staff: [17].

The court mentioned as providing great assistance a note by Professor James Goudkamp ([2017] CLJ 481) on the decision of the Court of Appeal: [23].

In relation to breach of duty, the court held that the information provided to the patient was incomplete. The The trial judge made the critical finding that it was reasonably
foreseeable that a person who believes that it may be four or five hours before he
will be seen by a doctor may decide to leave: [27].

On causation, the court noted the decision of the trial judge that judge found that, if the patient had been told that he would be seen within 30 minutes, he would have stayed in the waiting area and would have been seen before he left. He would then have been admitted or told to wait. He would have waited and his later collapse would have occurred within a hospital setting: [29].

The matter was remitted for trial to assess damages.

The UKSC decision has some similarity to the decision in Wang v Central Sydney Area Health Service [2000] NSWSC 515.