202403291 B4 - [2025] EWCA Crim 1135

Dr Bunn’s evidence:

In her report, Dr Bunn listed materials under 11 categories: for example, electronic patient records from the E hospital. It was initially intended that she would give her evidence in two parts, first dealing with C’s history and condition, and then secondly (later in the trial) presenting and explaining her conclusions regarding the pump malfunctions, gastric secretions and the effect of Gabapentin. In the event, she was recalled to give evidence on a third occasion, in order to give her opinion in respect of video recordings of C, taken at home before her admission to the E hospital, which the appellant had adduced. The appellant relied on these recordings, one of which was said to show C having dystonic spasms, in support of her case, that the pump alarms were caused by C’s dystonia.

The defence challenged the reliability of Dr Bunn’s evidence, in particular on the ground that her analysis was based only on what had happened from 29 November 2019 and did not take account of the factual position before that date. In cross-examination after the second part of her evidence, Dr Bunn was asked to confirm that the only hospital notes which she had seen were those relating to the period from the time of C’s admission to the E hospital. She replied:

“I have only seen medical history from the time she presented to the [E hospital] on 29 November. I’ve seen some letters about her previous history, but I’ve not seen the actual medical records.”

After Dr Bunn had given evidence, further Agreed Facts were put in by the defence. These set out, amongst other things, episodes of increased gastric secretions and pump alarms, all of which had been taken from the medical notes disclosed in the evidence and noted in Dr Bunn’s report.

In her closing speech to the jury, Miss Wass KC emphasised that Dr Bunn’s knowledge of C’s medical history was incomplete, and that Dr Bunn had not considered medical materials relating to C’s earlier admissions to hospital. The jury were invited to conclude that Dr Bunn’s opinions and conclusions were therefore unreliable.