Brown v Hamid, Re Estate of Ronald Brown Deceased

Where clinical negligence accelerates the severe symptoms of a pre-existing disease, damages are assessed for the period of acceleration proved on the balance of probabilities. Loss of expectation of life is not itself recoverable, but the claimant’s awareness that life expectancy has been reduced may be relevant when assessing pain and suffering. Damages must reflect the additional loss caused by the negligence, rather than losses that would have occurred shortly afterwards in any event. A separate award for loss of consortium may be available in principle, but should not be made where it substantially overlaps with bereavement damages and other awarded losses.

The claimant, the widow and executrix of Ronald Brown’s estate, pursued a clinical negligence claim against Dr Hamid. Liability was admitted for failing in April 2007 to diagnose pulmonary embolism and prescribe Warfarin. The trial therefore concerned consequential damages.

The principal dispute was whether the breach caused years of reduced life expectancy and severe symptoms, or merely accelerated symptoms and death by a short period. The court also considered claims for bereavement, loss of earnings, DIY services, expenses and loss of special consortium.

1. Causation and duration. The court accepted the evidence of Professors Geddes and Hall. By April 2007 Mr Brown had established pulmonary hypertension, which caused progressive damage. Earlier Warfarin treatment had not prevented the underlying condition. The failure to prescribe Warfarin probably caused some further emboli and accelerated the onset of severe symptoms, but did not cause the pulmonary hypertension itself or extend the disease by years. The period of acceleration was assessed at about 12 months.
2. Pain, suffering and loss of amenities. Damages were assessed by comparing the severe symptoms caused during the accelerated period with the milder symptoms that would otherwise have been suffered. Loss of expectation of life was not recoverable under section 1(1)(a) of the Administration of Justice Act 1982. However, under section 1(1)(b), the claimant’s awareness that life expectancy had been reduced could be taken into account in assessing suffering. General damages were awarded at £8,500.
3. Other losses. Bereavement damages of £11,800 were recoverable under section 1A(3) of the Fatal Accidents Act 1976. Funeral expenses under section 3(5) were refused because the relevant expenditure would have been incurred shortly afterwards in any event. Loss of earnings and DIY services were awarded for the accelerated period, in the sums of £2,000 and £2,500. The first two consultations with Dr Hamid were recoverable at £250, but other claimed expenses and dependency losses were not established.
4. Loss of special consortium. The court recognised that such a claim could in principle be available in a husband and wife relationship, referring to Regan v Williamson [1976] 1 WLR 305, Mehet v Perry [1977] 2 All ER 529, Beesley v New Century Group Ltd [2008] EWHC 3033 and Devoy v William Doxford & Sons Ltd [2009] EWHC 1598. No separate award was appropriate because of the short period, overlap with bereavement, and the award for lost DIY services.