December 11, 2018
Providing misleading information can be just as effective in causing injury as physical acts of negligence. The Supreme Court made that point in guaranteeing substantial compensation to an assault victim who was wrongly informed by an accident and emergency (A&E) department receptionist that he would have to wait hours before receiving medical attention.
The man was taken to hospital by a friend after being struck on the head by an unknown assailant. He told the receptionist that he was really unwell and needed urgent attention. The receptionist informed him that he would have to wait four or five hours before a clinician could see him. What she did not tell him, however, was that his condition would be assessed by a triage nurse as soon as possible and probably within 30 minutes of his arrival at A&E.
What happened next?
In ignorance of the latter piece of information, he felt that he was too unwell to remain in A&E and left just after 19 minutes. After collapsing later that night, he was returned to the hospital by ambulance. his head injuries were, however, severe and emergency surgery failed to save him from permanent brain damage. His damages claim against the NHS trust that ran the hospital was dismissed by the High Court and subsequently by the Court of Appeal.
In upholding his challenge to the latter ruling, however, the Supreme Court found that it was inappropriate to distinguish between medical and non-medical staff and that the receptionist owed him a clear duty of care. The NHS trust had charged her with the responsibility of being the first point of contact with patients attending A&E and she was obliged to provide accurate information. In giving the man misleading and incomplete advice, she had fallen below the standard of an averagely competent and well-informed person performing an important non-medical role.
It was reasonably foreseeable that the man would leave A&E on being told that it would be hours before he saw a clinician and, had he been informed that he would soon be assessed by a triage nurse, he would have waited. Had he collapsed, whilst still at A&E, he would have undergone surgery earlier and would have made a near full recovery. It had thus been established that the receptionist’s negligence caused or contributed to his injury.
The Court noted that concerns as to the social cost of imposing such a duty of care on non-medical personnel were misplaced and had been considerably overstated. However, it acknowledge that the very difficult circumstances under which A&E departments operate were likely to prove a highly influential factor in deciding whether negligence had been established in other cases. The amount of the man’s compensation, which was bound to be substantial, remained to be assessed.
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Danley v Croydon Health Services NHS Trust. Case Number: (2018) UKSC 50