The appeal
72. In granting leave in relation to causation, the single judge noted that the test applied by the judge was whether or not Louella would have lived had she been treated in time by a medical practitioner, and observed that the material question was whether the appellant’s breach of duty had caused or made a significant contribution to the cause of death. That had to be answered by reference to a time when Louella’s condition was already clearly life-threatening. The evidence in support of the prosecution case could only come from the experts, and the evidence of Dr Morley and Ms Pagdin went to the effects of 2C-P and the other drugs that Louella had ingested, rather than to causation. Equally, Dr Delaney’s evidence did not identify when Louella’s condition would clearly have been life-threatening, or what the effect of the breach of duty to which the appellant had then become subject may have been. The critical and only evidence on those issues was therefore that of Professor Deakin. The single judge continued: “In the light of this evidence, I consider it to be reasonably arguable that the jury could not be any more certain than Professor Deakin and, that being so, causation could not be established to the criminal standard. In my judgement, the evidence in this case is at least arguably distinguishable from the evidence summarised in Misra; and Misra does not establish a principle that causation is always a matter for the jury, whether or not there is evidence to support a finding adverse to the defendant”.