202403291 B4 - [2025] EWCA Crim 1135

The jury’s question:

No criticism is made of the judge’s directions of law to the jury, or as to any aspect of his summing up.

The jury retired to consider their verdicts on 28 August 2024. On 29 August, they asked two questions. The first of those questions is irrelevant for present purposes. The second asked:

“What medical notes did Dr Bunn see, were they only from [the E hospital], what date were the notes?”

Submissions were made by counsel as to how that question should be answered. The judge took the view that it would be misleading to answer it by simply reading the answer given in cross-examination which we have quoted at paragraph 24 above. Having considered the competing submissions, the judge brought the jury into court, answered their first question, and continued:

“Now, second question, 'What medical notes did Dr Bunn see? Were they only from the [E hospital]? What dates were the notes?' So, she gave evidence about her notes on a number of occasions. Firstly, when she first gave evidence, the first time she gave evidence in very general terms about what she saw, and I will remind you of that. 'I have seen the medical records', pause, 'the hospital system that included all the entries from her hospital admissions, and I also saw the notes made by all the doctors and nurses that dealt with her during her admission in 2019'. Now, just to expand on that slightly, and give you exact dates, she was shown e-notes from 7 July 2017 to 21 February 2022, from the [E hospital]. And that is 307 pages, though some of that may have been repetition. She was also shown e-patient records from June 2019 to June 2022, that was 636 pages, though again some of that may be repetition. She was not shown notes from the [D hospital], and she also said and was shown copies, various discharge letters from outpatients. She was asked about that in cross-examination, and I am going to remind you of precisely what she said, but that is the - it is agreed that is what she was shown. So, there are two parts to this: Cross-examination it was on Wednesday, 14 August, morning and afternoon, so cross-examination by defence counsel: 'Would you accept you have not seen the entire medical history of the child?' 'Yes, I absolutely accept that. I've only seen the medical history from the time she presented to the [E hospital] on 29 November, I've seen letters - some letters about her previous history, but not the actual medical records'. So, question, 'This child has been seen by many doctors and hospitals over her short life by the time she came to the [E hospital] on the 29th, agreed?' 'I agree'. 'Do you agree on each of the occasions that she was brought to the hospital this was a result of a parent, whether mother or father, bringing the child to the attention of medical professionals?' Answer, 'Like I said, I've not seen the medical records from the other hospitals, so I can't comment on that'. Later that afternoon, 'And that brings me to the second area that you're giving an opinion on, and that's the gastric losses, now again your analysis has really been in a window, a small window, of [C’s] life between 29 November until December some time'. We know it is a little bit wider than that. 'You have not, as I understand it, familiarised yourself with the medical records of her gastric losses prior to that period, have you?' She answered, 'I've not been given any documentation about her gastric losses prior to that period'. Well, you know the periods that she was shown material from, but that is what she said in cross-examination.”

On 30 August 2024 the jury returned guilty verdicts on both counts. Sentencing was adjourned.