Quaatey v Guy's & St Thomas' NHS Foundation Trust

An allegation of professional negligence must be supported by appropriately qualified expert evidence addressing breach, causation and loss. A claimant’s own analysis of medical records cannot replace that evidence. An appellate court may consider additional material where appropriate, but the absence of supportive expert evidence remains a sufficient basis for striking out the claim as an abuse of process. A very substantial delay may also justify summary judgment where limitation is plainly unavailable and the delay has made a fair trial impossible.

The claimant appealed from Master Cook’s order striking out her clinical negligence claim against the defendant NHS foundation trust. The claim concerned surgery in 1995 and a rectopexy procedure in 1999. The Master concluded that the claimant’s expert reports did not support the allegations and held, alternatively, that the claim was statute-barred and prejudiced by delay.

The claimant argued that a January 2019 expert report had been omitted from the bundle and that the hearing was procedurally premature. The central issues were whether there had been a serious procedural irregularity, whether the expert evidence supported the claim, and whether the claims were unsustainable because of limitation and evidential prejudice.

1. Appeal dismissed. There had been no serious procedural irregularity within CPR 52.21(3). The claimant had served the material on which she intended to rely, had not sought an adjournment, and the January report was absent from both the court and defendant’s bundles through her own mistake.
2. The claim was properly struck out. An allegation of professional negligence requires a written report from an appropriately qualified professional providing supportive evidence. The claimant’s own interpretation of her medical records could not substitute for such evidence. The reports of Mr Springall did not support negligence, causation or loss in relation to the 1995 surgery.
3. The January report did not alter that conclusion. It stated that the sphincter division was integral to the procedure, identified no negligent injury, rejected the missed-polyp allegation, and found no basis for alleging negligence or loss arising from the 1999 procedure.
4. The alternative summary judgment conclusion concerning the 1999 procedure was also unimpeachable. The claimant knew of the alleged unauthorised mesh insertion in 1999 and had consulted solicitors and sought compensation at that time. There was no basis for a later date of knowledge under section 33 of the Limitation Act 1980. The delay was so extensive, and its effect on the cogency of the evidence so serious, that a fair trial was impossible.
5. The claimant was ordered to pay the costs of the appeal.

• High Court (Queen’s Bench Division): appeal from Master Cook’s order of 21 May 2019 dismissed. The strike-out and alternative summary judgment conclusions were upheld.