Brock & Anor v Northampton General Hospital NHS Trust & Anor

Liability for psychiatric injury as a secondary victim requires more than grief following the death of a close relative. The claimant must establish a qualifying traumatic experience, ordinarily involving the sudden perception by sight or sound of a horrifying event. A telephone call conveying bad news cannot itself found liability. The relevant event must be connected with the defendant’s negligence and must have caused the psychiatric illness. The illness need not be post-traumatic stress disorder; another recognised psychiatric condition may suffice if caused by the qualifying trauma. Where the claimant’s illness is instead attributable to bereavement and loss, the secondary-victim claim fails.

The claimants brought proceedings arising from the death of their daughter after paracetamol poisoning and subsequent treatment. The estate and Fatal Accidents Act claims were pursued against Northampton General Hospital NHS Trust. Personal psychiatric-injury claims were pursued against both defendants, although the claimants ultimately abandoned the personal claim against Northampton.

Northampton’s alleged negligence concerned advice said to have been sought from its accident and emergency department when the deceased re-presented after her overdose. Birmingham admitted that an intracranial monitoring bolt had been inserted negligently, but the claimants accepted that this caused no recoverable loss in the estate claim. The issues were whether Northampton was negligent and causative of the death, and whether the claimants had suffered recoverable psychiatric injury as secondary victims.

1. Northampton liability. The court found that the out-of-hours doctor had attended the accident and emergency department to obtain the deceased’s paracetamol blood level and inspect the chart. He had not sought advice on management. The factual foundation for imposing a duty on the accident and emergency staff was therefore not established. The estate and Fatal Accidents Act claims against Northampton were dismissed.

2. Causation in the alternative. Had the accident and emergency department taken over the deceased’s care, urgent blood testing and administration of N-acetyl cysteine would probably have occurred at about 4.30 pm. The court accepted that administration by that time would probably have avoided the need for a transplant. This alternative analysis did not alter the result because the necessary duty and breach were not proved.

3. Secondary victims. The court applied the principles in McLoughlin v O’Brien [1983] AC 410 and Alcock v Chief Constable of South Yorkshire Police [1991] 1 AC 310. A claimant must suffer psychiatric illness caused by a sudden appreciation by sight or sound of a horrifying event, rather than by the accumulation of distress or ordinary grief. A telephone call communicating deterioration or bad news cannot itself constitute the necessary event.

4. The negligence occurred when the bolt was inserted too deeply, but the claimants did not know of the error when they saw the deceased. Neither claimant identified seeing her after the later telephone call, or seeing her after the brain scan, as the event causing the psychiatric illness. Their conditions were attributable to the death and bereavement rather than a qualifying traumatic event. The claims therefore failed.

5. The claimant need not have PTSD. As explained in Vernon v Bosley [1997] PIQR P255, any recognised psychiatric diagnosis may suffice if it was caused by the relevant trauma. That requirement was not met here. The court also agreed with the observations in Ward v Leeds Teaching Hospitals NHS Trust [2004] EWHC 2106 that the death of a loved one in hospital is not ordinarily a qualifying event unless accompanied by wholly exceptional circumstances causing shock or horror.

First-instance decision. The judgment does not state any prior appellate history.