West Law Report


Posted in Clinical negligence, Westlaw Reports by mrkooenglish on May 15, 2008

Last Updated: 11:46PM BST 14/05/2008
Queen’s Bench Division Henriques J April 25, 2008
Queen’s Bench Division

Henriques J

April 25, 2008

Clinical negligence – Diagnosis – General practitioners – Medical treatment – General practitioner’s failure to diagnose meningitis at consultation


The claimant infant (C) claimed damages for personal injury based on the alleged negligence of the defendant general practitioner (W) in failing to properly examine and diagnose her. C’s mother (L) and grandmother (G) had taken C to be examined by doctors on several occasions over a period of two weeks, complaining that C was suffering from symptoms not dissimilar to a cold.

The symptoms had not dissipated by the time G took C to be examined by W. W diagnosed C as suffering from a viral infection and prescribed a course of Calpol. W’s note of his examination recorded that C had been suffering from acute nasopharyngitis and that he had conducted a chest and ear examination. C’s condition deteriorated and G took her to hospital. Once admitted to hospital C was intubated with inotropic support and diagnosed as suffering from meningococcal septicaemia.

Although C was eventually stabilised she had suffered significant scarring and physical injury and there remained the possibility that her mental development would be impaired as a result. C submitted that at the time she had been taken to be examined by W, she was manifesting symptoms which after a scrupulous and careful examination would and should have mandated an immediate admission to hospital, and that W had failed in his duty to properly examine and diagnose C.

W submitted that if C had been in the condition described by L and G in their evidence, he could not have failed to observe and note such symptoms and properly act on them.

W argued that his note disclosed no more than a common minor childhood upper respiratory tract infection and there was nothing to suggest that he had negligently discharged his duties on that basis such that L and G must have exaggerated their claims as to C’s state of health.


Whether W was liable in negligence to C for his failure to properly examine her during a consultation.

HELD (judgment for claimant)

Having considered all the material in relation to L and G’s evidence there was no reason to doubt the veracity of their claims regarding C’s state of health at the time she was examined by W.

G’s evidence was consistent and transparently honest. Furthermore, in view of the expert evidence in relation to the proper examination of patients suffering from meningitis, W had failed to take sufficient steps to assess C’s responsiveness.

In light of those findings, W’s note of the consultation was inadequate and should have recorded the history of the duration of the illness and the additional symptoms as described to him by L and G during the consultation.

On the balance of probabilities W had failed to exercise the ordinary skill of an ordinary competent general practitioner in carrying out the consultation.

Robin Oppenheim QC (instructed by Parlett Kent) for the claimant. John Grace QC (instructed by Medical Defence Union) for the defendant.

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