Zinzuwadia v Home Office

In professional negligence claims, an error of judgment is not itself negligence. The question is whether the defendant failed to act in accordance with the standard of skill and care reasonably expected, applying the principles in Bolam v Friern Hospital Management Committee and Bolitho v City and Hackney Health Authority. A trial judge may accept one of several reasonable medical approaches where supported by responsible expert evidence. An appellate court will not interfere merely because different evidence or conclusions were available. A judgment need not refer expressly to every piece of evidence, and unsupported allegations of procedural unfairness cannot found an appeal. Where the common-law negligence claim fails because reasonable care was taken, a separate claim based on article 2 of the European Convention adds nothing on the facts.

The claimant brought a negligence claim against the Home Office, alleging vicarious liability for a prison psychiatrist following her husband’s suicide in Leicester Prison. The High Court, before Hunt J, dismissed the claim on 7 December 2000. The claimant alleged that the psychiatrist had wrongly assessed the deceased’s suicide risk, adopted inadequate observation arrangements and prescribed insufficient medication. Conflicting psychiatric evidence was given about whether the treatment was within a reasonable range of professional practice.

Permission to appeal was refused on the papers by Henry LJ. The claimant renewed the application before the Court of Appeal, challenging the evidential findings, alleged procedural irregularities, the treatment of medical literature and the omission of express findings on article 2 of the European Convention.

1. Application dismissed. The renewed application for permission to appeal was refused because the proposed appeal had no real prospect of success.
2. The trial judge had applied the correct professional-negligence approach. An error of judgment was insufficient; the claimant had to establish a failure to meet the required standard of skill and care. The judge was entitled to find that the approach supported by Dr Carter was not maverick or outside the mainstream, and represented a course which a reasonable body of psychiatrists might have adopted.
3. The judge was entitled to resolve the conflict between the experts. He did not simply prefer Dr Carter’s evidence. He accepted that reasonable practitioners might have adopted the course followed by the treating psychiatrist, having regard to the information available at the time.
4. There was no proper evidential basis for allegations that the trial had been procedurally unfair. No transcript, solicitor’s affidavit or witness statement supported those allegations.
5. A trial judge is not required to refer in the judgment to every item of evidence, including all medical literature. Absence of express reference does not establish that the evidence was ignored.
6. The judge was entitled to conclude that the psychiatrist had acted reasonably. The 15-minute observations, single cell and prescribed medication were supported by the evidence, and the evidence that death occurred within seconds meant that shorter observation intervals were unlikely to have prevented it.
7. The European Convention arguments, particularly under article 2, added nothing where the negligence claim failed on the finding that reasonable care had been taken.

• Court of Appeal (Civil Division): renewed application for permission to appeal dismissed.
• High Court of Justice: Hunt J dismissed the negligence claim on 7 December 2000.
• Permission stage: Henry LJ refused permission on the papers.