Manzi v King's College Hospital NHS Foundation Trust

A court is not obliged to determine hypothetical quantum after dismissing a claim on liability, even where the trial covered both liability and quantum. It may nevertheless give an indicative assessment where this would assist the parties and promote procedural efficiency. Such an assessment creates no further order and does not alter the dismissal of the claim. In a hypothetical assessment, damages must reflect proven causation and must exclude losses attributable to unrelated symptoms, ordinary post-partum consequences, or intervening circumstances.

The claimant brought a clinical negligence claim against the defendant arising from alleged retained products of conception after childbirth. The court had previously dismissed the claim because the claimant failed to prove that a substantial piece of placenta had been retained. After judgment was handed down, the claimant requested an indication of the damages that would have been awarded had liability been established, to assist any possible appeal. The court therefore considered, hypothetically, pain and suffering, psychiatric injury, care, loss of earnings, therapy and miscellaneous expenses.

1. Disposition. The claim had already been dismissed. No damages were payable. The court’s subsequent assessment was hypothetical and gave rise to no further order.
2. The court was not obliged to decide quantum merely because the trial had addressed both liability and quantum. The overriding objective did not require a further judgment consisting entirely of hypothetical findings.
3. If liability had been established, the claimant would have chosen removal of substantial retained placenta under regional anaesthetic. The resulting haemorrhage would probably have occurred in hospital, and total blood loss would not have been materially greater. Damages for additional pain and suffering before the later operation would have been about £3,000, excluding pain from the perineal tear and ordinary consequences of vaginal childbirth.
4. The psychiatric evidence supported two periods of Adjustment Disorder caused by the retained-products problems: approximately nine months after the birth of Harry, valued at about £9,000, and at least six months during the later pregnancy, valued at about £5,000.
5. Past care would have been assessed at no more than £1,500, allowing for ordinary parental care, assistance required by unrelated pain, and the gratuitous nature of the care. No loss of earnings was recoverable because the alleged negligence did not sufficiently cause the failure to return to work. Cognitive behavioural therapy was also not recoverable because the claimant had recovered and any future vulnerability was unrelated to the index events. Miscellaneous expenses of £468 and appropriate interest would have been allowed.

The judgment records that the claim had been dismissed in an earlier judgment handed down on 12 May 2016. This judgment provided only a hypothetical indication of quantum and did not vary the dismissal or make any further order.