QB-2022-000824 - [2025] EWHC 1610 (KB)

This is my judgment in relation to quantum in a clinical negligence claim brought by the Claimant, Ms Philipa Hodgson, a patient at the Brighton Station Health Centre against two general practitioners, Dr Daniel Hammond and Dr Andre Dieleman. I handed down judgment on breach of duty on 20 May 2025 (Hodgson v Hammond & Dieleman [2025] UKHC 1261 (KB)) in which I found that each of the Defendants was liable in negligence (causation no longer being disputed) and this judgment should be read in conjunction with that. I will not repeat the matters which are set out in that judgment, save that I will expand on my summary of the experts’ agreed position on causation as I consider it provides the background to understand condition and prognosis, and is relevant to my consideration of quantum.

The First Defendant refers to the judgment of Swift J in Leo Whiten (A Protected Party) v St George’s Healthcare NHS Trust [2011] EWHC 2066 (QB) at [4]-[5], which in turn refers to the well-known guidance of Lord Woolf M.R. in Heil v Rankin et al [2001] 2 QB272 at [22], [23] and [27]. To paraphrase, full compensation should be provided; this must remain fair, reasonable and just to both claimant and defendant(s), and should not be “out of accord with what society as a whole would perceive as being reasonable”.

I have read the Claimant’s witness evidence, and heard her oral evidence about the pain which she has suffered arising from her PID since August 2016, and the pain and her difficulties in recovery following her laparoscopy surgeries in January 2017 and in April 2018. I accept that evidence. For the January 2017 surgery she spent 5 days and 4 nights in hospital and was discharged on oral antibiotics. She stayed with her mother who looked after her. As past care is agreed I will not summarise the evidence of the care she received but I note it. She returned to work around 2 to 3 weeks after the surgery, but says she should have taken more time off. She travelled to Australia with her partner for six months between September 2017 and February 2018. On her return to the UK, in April 2018, she was woken by severe abdominal pain and attended A&E. She had the second laparoscopy on 24 April 2018, and describes the post-operative pain as being not quite as severe as after the first surgery. She remained in the hospital until 26 April 2018, and again on discharge went to her mother’s house to recover for the first week. She felt the recovery was easier and less painful than previously. She again went back to work after two weeks.

She had a further attendance in A&E due to right sided abdominal pain and fever in June 2019. A scan revealed a cystic mass on the right side of her uterus so she was admitted, placed on intravenous antibiotics, and offered a laparoscopy or continued medical management. She chose the latter.

Her son was born in July 2020 following emergency caesarean section. She describes that she initially refused to sign the consent form “as I could not face the trauma of having to recover from yet another surgery and I was crying on the midwife saying I couldn’t recover again and look after a baby this time.” She said she agreed because she was told she had to do it to save the baby.

The Claimant says that she has had pain when she opens her bowels, but not every day, and when it happens she knows it is the beginning of a flare up of her chronic PID. She says she gets very bloated and cannot exercise. She has provided a description of the pain of the dyschezia and also of her flare ups. She had one in July 2023 which brought her to hospital because of the pain, and had another in October 2023.

The Claimant says that has had pain on sexual intercourse since 2017, but the last time she had sex (as at the date of her witness statement in October 2023) was September 2022 when she became pregnant. She and her partner split up in April 2023 and she has been single since then. She says that she would love to have more children, as she has always wanted a large family. She is now 35 years old. In her witness statement she said that she would probably have them on her own if she was getting older and didn’t have a partner, but in her oral evidence she said that what she really wanted was a partner and to have more children with them as a family. She said, “Having one more child would be amazing, but four is my ideal number”.

The parties each had an expert gynaecologist to opine on matters of causation and condition & prognosis. Those were Mr Nicholas Raine-Fenning MBChB, FRCOG, PhD, MAE for the Claimant, who is a Consultant Gynaecologist and Reader in Reproductive Medicine and Surgery at the University of Nottingham School of Medicine; Mr Alexander Slack MBBS MRCOG for the First Defendant, who is a Consultant in Gynaecology with a sub specialty in Urogynaecology at the Maidstone and Tunbridge Wells NHS Trust and who is the lead for gynaecology and urogynaecology at that Trust; and Mr Adam Magos BSc, MB, BS, MD, FRCOG for the Second Defendant, who was a Consultant/Honorary Senior Lecturer in the University Department of Obstetrics and Gynaecology at the Royal Free Hospital, London, until he retired from that position in 2021. He stopped clinical practice on 1 January 2023 but remains on the GMC register.

Mr Raine-Fenning produced a causation report dated December 2023, a condition and prognosis report dated 30 March 2022 and an addendum condition and prognosis report dated 11 November 2023. The three gynaecologist experts met and produced a joint statement dated 10 November 2024. Mr Raine-Fenning attended Court and was cross-examined by Mr Gibson and Ms Campbell-Clause.

Mr Slack produced a causation report dated November 2023 and a condition and prognosis report dated July 2024 as well as the joint statement of 10 November 2024. He attended Court and was cross-examined by Mr Dufficy and Ms Campbell-Clause.

Mr Magos produced a causation report dated 23 November 2023 and a condition and prognosis report dated 24 April 2024 as well as the joint statement of 10 November 2024. He attended Court and was cross-examined by Mr Dufficy and Mr Gibson.

No criticisms have been made that any of these experts lack the experience or expertise to proffer their opinions to the Court as Part 35 experts in gynaecology, and I am satisfied they are well-qualified to do so. However, in their answer to question 4.3 of the agenda for the joint meeting, relating to in vitro fertilisation, and in their oral evidence, both Mr Magos and Mr Slack proffered their opinions but said they would defer to an expert in reproductive medicine, which each accepted they were not. I am satisfied that Mr Raine-Fenning is an expert in reproductive medicine, as Mr Slack accepted in cross-examination.