[2025] EWHC 2025 (KB)

If the claimant has not proved that the defendant’s grading of her haemorrhoids was incorrect, but has proved that he did not advise her of the risks and benefits of a surgical haemorrhoidectomy (including the risk of anal stenosis) and / or that he failed to advise of alternative non-surgical treatment options, then I must decide whether the claimant has proved on the balance of probabilities that whilst surgery was indicated, if she had been advised of alternative treatments and risks of surgery, the claimant would have opted for non-surgical treatment options first. In this event, the parties’ experts agree that non-surgical treatment options would be unlikely to be successful such that the claimant would have required a surgical haemorrhoidectomy up to 2 years later.

If I decide that the claimant has proved on the balance of probabilities that she would (some 2 years later) have continued to opt for non-surgical treatment options, then the parties agree that causation is established because the claimant would not have suffered the surgical complication that she did. If the claimant fails to prove this, then the parties agree that damages would be limited to the acceleration of her symptoms arising from her surgical complication by up to 2 years.