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The claim was brought on behalf of Mrs Miller’s estate together with a claim by her husband and her half-brother, as dependents under the Fatal Accidents Act 1976 after Mrs Miller was involved in a serious road traffic accident in 2016.
In the accident, Mrs Miller suffered multiple orthopaedic injuries, including multiple fractures. Following arrival at the hospital by air ambulance, Mrs Miller underwent surgery for the fractures and was admitted to the ICU. Several weeks later, by which time Mrs Miller’s condition appeared to have stabilised, a CT scan of her abdomen and pelvis was carried out. The Defendant Trust admitted that it was negligent in failing to have the scan reviewed by the on-call radiology consultant within 24 hours. The Defendant also admitted that, if this review had taken place, the appearances on the scan would have been properly reported, leading to the general surgeons recognising the probable presence of ischaemia and the need for surgery by way of laparotomy to investigate this. In fact, no such surgery took place, Mrs Miller’s bowel condition deteriorated, and she died from peritonitis due to bowel perforation several days later. The Defendant contended that, even with surgery at this time, Mrs Miller would probably have died in any event within days or weeks and would not have survived in the long term. The issues to be determined by the trial judge, HHJ Sadiq, concerned causation as well as some aspects of quantum.
In relation to the causation issues, the judge noted that this was a case “which turns on its facts and [judicial] assessment of the expert evidence…[making] decisions as to which evidence to accept on a range of relevant issues”. One of the main issues was the extent of bowel ischaemia which would have been found at surgery, if this had taken place shortly after the CT scan. The judge accepted the Claimant’s case that on the balance of probabilities a more limited extent of ischaemic bowel would have been found at surgery, rejecting the Defendant’s experts’ “low flow state hypothesis” which was suggestive of “wider ischaemia in other areas of the bowel”; and in turn, finding on the balance of probabilities that the outcome from surgery at this time would have been successful. The judge preferred the evidence of the Claimant’s experts and in particular the evidence of Professor Winslet, an expert in general surgery, over that of Professor Scholefield, who was instructed for the Defendant in this discipline.
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