Sion v Hampstead Health Authority

For a secondary victim to recover for psychiatric illness caused by negligence, the illness must be induced by nervous shock: a sudden, direct sensory appreciation of a horrifying event or its immediate aftermath. Grief, distress, stress, strain, gradual observation of deterioration and retrospective realisation of negligence do not satisfy that requirement. Other requirements include reasonable foreseeability, sufficient proximity in time and space, and a sufficiently proximate relationship. The Court of Appeal must apply the law fixed by Alcock [1992] 1 AC 310, even if its boundaries appear illogical or may later develop. At strike-out stage, a claim may be dismissed where it is obviously doomed to fail. Here, the medical evidence showed expected death and prolonged grief rather than sudden shock.

Mr Sion attended hospital while his son deteriorated following a motorcycle accident. The son died after fourteen days. Mr Sion alleged that negligent medical treatment caused his son’s deterioration and death, and that prolonged attendance at his bedside caused him psychiatric illness.

The claim was transferred from the Westminster County Court to the High Court. Brooke J struck it out on 18 December 1992 as disclosing no cause of action. The Court of Appeal considered the proposed amendment, the use of the served psychiatric report, the limitation-period amendment issue and whether a secondary victim had to prove sudden shock. The central issue was whether the pleaded facts disclosed an arguable claim under the law of nervous shock.

1. Disposition. The appeal was unanimously dismissed. The proposed amendment was considered as if allowed, but the amended claim remained obviously doomed to fail.
2. Strike-out and amendment. Applying the test in Lonrho PLC v Fayed (1992) 1 AC 448, the defendant had to show that the claim was obviously doomed to fail. Order 20 rule 5(5), read with section 35 of the Limitation Act 1980, permitted an amendment after limitation where the new cause of action arose from the same or substantially the same facts as an alleged cause of action already pleaded. Staughton LJ expressed no concluded view on whether Order 18 rule 19 supplied a wider route.
3. Medical evidence. A medical report served with a personal-injury pleading operates as particulars and may be considered on strike-out as a general outline of the case. The claimant is not rigidly confined to it, but, absent a sufficient indication of a further report, the court may decide the application on the pleadings and served report.
4. Secondary victims. Under Alcock v Chief Constable of South Yorkshire [1992] 1 AC 310, the claimant must prove psychiatric illness, illness induced by sudden shock, propinquity in time or space, reasonable foreseeability and a sufficiently proximate relationship. Shock requires sudden and direct sensory appreciation of a horrifying event or events, rather than gradual assaults on the nervous system or grief.
5. Meaning of suddenness. Gibson LJ rejected the additional submission that the underlying incident itself had to be violent or sudden. The crucial feature was sudden awareness of what was occurring or had occurred. A non-violent breach, such as administering the wrong medicine, could in principle cause qualifying shock. This clarification did not assist Mr Sion, because he had suffered no sudden shock.
6. Application. The report described prolonged observation of deterioration, an expected death, later doubts about treatment and an abnormal grief reaction. It disclosed no sudden sensory appreciation of a horrifying event. The claim therefore could not succeed under the established law of nervous shock. The order dismissing the claim was upheld, with legal aid taxation.

• High Court (Queen’s Bench Division): Brooke J struck out the claim on 18 December 1992 as disclosing no cause of action. No citation for that decision was stated.
• Court of Appeal (Civil Division): unanimously dismissed the appeal. The court considered the proposed amendment but held that the amended claim was obviously doomed to fail.