Matthew Riley v Salford Royal NHS Foundation Trust

The defendant admitted breach of duty in the clinical management of the claimant following a 2015 road-traffic accident which resulted in a below-knee amputation. The central legal issues at trial concerned causation (the claimant's "but for" position), quantum of damages and the appropriate form of award for future losses.

The court preferred and accepted the claimant's orthopaedic evidence (Mr Britten) over the defendant's expert, finding that but for the breach the claimant's tibial fractures would have healed without delayed union and that he would largely have recovered within about 12 months, albeit with permanent restrictions (eg avoidance of prolonged standing or heavy lifting and inability to be a physical education teacher). The court found no satisfactory evidence to reduce the claimant's life expectancy and applied the full life multiplier (63.60).

The judge held that future losses should be paid as a lump sum rather than by periodical payments and applied the Ogden methodology and Facts & Figures Table A5 for repeat expenditure, including adjustments for a negative discount rate where appropriate. The court made detailed findings on future prosthetic provision, care and case management, accommodation and vehicle needs and allowed substantial awards for past and future losses, arriving at a total award of 4,676,442 (inclusive of interest on general damages).

The claimant, born in 1995, was involved in a solo motorcycle accident in July 2015 and sustained complex fractures and a subsequent compartment syndrome which, after delay in treatment at Salford Royal Hospital, led to a below-knee amputation. The defendant accepted breach and that appropriate treatment would have avoided amputation; the trial therefore concerned quantum and some residual causation questions about the claimant's likely "but for" condition.

Nature of the claim/application: A first-instance clinical negligence personal injury trial to determine damages (past and future losses) following admitted breach causing below-knee amputation.

Procedural posture: First instance; defendant admitted liability and causation as to amputation; trial focused on quantum.

Issues framed by the court:

• What would the claimant's condition have been but for the negligence (causation)?
• Whether and to what extent life expectancy should be reduced.
• Whether future losses should be paid as a lump sum or by periodical payments.
• The nature and extent of past and future losses: loss of earnings, pension loss, past and future care and case management, prosthetics (types, replacement cycles and sockets), surgeries, therapies, accommodation and adaptation, transport and equipment, and miscellaneous costs (holidays, shopping etc.).

Court's reasoning and findings: The court accepted the claimant's orthopaedic expert (Mr Britten) as the more persuasive witness on complex tibial fractures; on that basis the judge found the claimant would have largely recovered in about 12 months and the tibial fracture would have healed without delayed union. The claimant would nevertheless have had lasting restrictions (eg avoidance of prolonged standing/walking/heavy lifting).

On life expectancy the court found there was no satisfactory evidence to justify a reduction and applied the full life multiplier of 63.60. The court decided a lump sum award best met the claimant's needs. The Ogden approach (multiplicand/multiplier) was applied for future earnings rather than a Smith/Blamire lump-sum approach, because the judge considered the claimant's future earning trajectory could reasonably be estimated.

The court made detailed findings on the types and replacement cycles of prostheses (including allowance for a Kinnex foot to age 75 and snowboarding provision), future care needs (including periods when the claimant cannot use a prosthesis), accommodation losses (Swift v Carpenter methodology applied to capital cost difference), transport (vehicle and WAV needs), aids and equipment (including powered wheelchair from approximately age 75), future surgeries (myoplasty and joint replacement risks), therapies, and miscellaneous losses. Discounts for gratuitous care (Housecroft v Burnett principle) and contingency deductions using Ogden tables were applied where appropriate.

The judge quantified past losses at 323,426 and made extensive future awards across heads of loss, culminating in an overall award of 4,676,442 (including 120,000 general damages and interest on that head), with supporting reasoning set out for each head.

The claim succeeded. The court accepted the defendant's admission of breach but conducted a full quantum assessment. It accepted the claimant's orthopaedic and many other experts as more persuasive, concluded the claimant should be treated as having normal life expectancy, ordered a lump sum award for all future losses, and made detailed awards across heads of loss resulting in a total award of 4,676,442.