North Glamorgan N.H.S. Trust v Walters

In a secondary-victim claim for psychiatric injury after negligent medical treatment, the required horrifying event may comprise a seamless series of directly perceived events extending over a short period. The court must assess the circumstances realistically, including information given while events unfold, provided the claimant has the necessary physical and temporal proximity and the illness is caused by sudden shock rather than a gradual dawning of distress. Applying the existing control mechanisms in Alcock v Chief Constable of South Yorkshire to new facts does not itself extend liability.

The claimant’s infant son suffered an epileptic fit and irreversible brain damage following admitted negligent diagnosis and treatment by the appellant NHS Trust. Over the following 36 hours she witnessed the immediate consequences, received changing medical information, and held her son when life support was withdrawn and he died. She developed a recognised pathological grief reaction.

Thomas J awarded special and general damages in the Queen’s Bench Division and gave permission to appeal. The central issue was whether the claimant, accepted to be a secondary victim, had suffered psychiatric illness caused by the sudden appreciation by sight or sound of a horrifying event, or instead by an accumulation of gradual assaults on the nervous system.

1. Appeal dismissed. The claimant was entitled to recover damages for pathological grief reaction caused by the Trust’s negligence.
2. Ward LJ held that the relevant “event” may be identified realistically and fact-sensitively. It may comprise a series of events forming an entire event, extending over a short period and including the immediate aftermath. The court should not construe “event” narrowly as a frozen moment.
3. The relevant event was the seamless 36-hour progression from the fit caused by negligent treatment, through changing medical assessments and the decision to withdraw life support, to the child’s death in his mother’s arms. Information communicated while events were directly unfolding could be taken into account. This was distinct from being merely informed of, reading about, or hearing about an incident.
4. The claimant’s appreciation was sudden in the legally relevant sense. Each successive development was unexpected and produced an immediate assault on her mind. The evidence did not establish a gradual realisation of danger, but successive shocks occurring in close physical and temporal proximity to the primary victim and its aftermath.
5. Applying the control mechanisms recognised in Alcock v Chief Constable of South Yorkshire [1992] 1 AC 310 to new facts did not constitute an incremental extension of liability. Policy considerations could not replace the trial judge’s findings of fact. Clarke LJ agreed, adding that he would have taken an incremental step if necessary on these facts. Sir Anthony Evans agreed with both judgments and the dismissal.

• Court of Appeal (Civil Division): appeal from the Queen’s Bench Division dismissed.
• Queen’s Bench Division: Thomas J awarded £1,216 special damages and £20,000 general damages, and gave permission to appeal.