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The claimant’s history
The claimant’s history
The claimant has suffered from constipation since approximately 1995 which she managed with laxatives. In 2000 whilst straining to go to the toilet she found it extremely painful and felt like she was passing glass, and she would also pass mucus and blood. She had a sigmoidoscopy in 2001 to check her colon which was normal.
Between 2005 and 2006 she suffered with diarrhoea and went to the toilet 2 – 3 times per day which was unusual for her. She had another sigmoidoscopy but was again reassured that everything was normal. Her diarrhoea resolved and she had no further rectal problems until the end of 2018 to the beginning of 2019 when she had some intermittent bleeding after going to the toilet over a period of 3-4 months. At times the bleeding was heavy and at other times it was only present on wiping. The claimant’s evidence was that she did not notice anything obvious on the outside of her bottom other than a small skin tag. She was also a keen long-distance runner, and she said in evidence that she told the defendant that the bleeding had started to become troublesome because she was bleeding after a run.
- Heading
- Ms Sarah Clarke KC Sitting as a Deputy Judge of the High Court
- Haemorrhoid grading system
- The issues to be decided in this trial
- Causation
- Burden and standard of proof
- Counsel
- The applicable law In Hunter v Hanley [1955] SC 200, at [204] (“ Hunter ”), Lord President Clyde held that: “…[a surgeon] is not negligent merely because his conclusion differs from that of other professional men, nor b
- In Bolam v Friern Hospital Management Committee [1957] 1 WLR 583, at [587] (“ Bolam ”), Mr Justice McNair summarised the test as follows: “…[a surgeon] is not guilty of negligence if he has acted in a
- The House of Lords subsequently qualified the Bolam test in Bolitho v Hackney HA [1998] AC 232 (“ Bolitho ”), at [241H]-[242A] (Lord Browne-Wilkinson) by explaining that, “The use of these adjectives
- Consenting a patient to a procedure In Montgomery v Lanarkshire Health Board [2015] UKSC 11 , at [86] to [87] (“ Montgomery ”) the Supreme Court held in relation to the issue of appropriate consenting of a patient to a procedure
- Where the advice given by the doctor for the purposes of consent is informed by clinical judgment, the approach described in Hunter and Bolam remains applicable to that exercise of clinical judgment (
- Causation In Chester v Afshar [2004] UKHL 41 (“Chester”), the majority of the House of Lords held that causation will be established not only in respect of a patient who would have declined the surgery if prope
- Section 16
- The approach to witness evidence generally
- The witnesses
- The claimant
- The defendant
- Expert evidence
- The claimant’s expert witness – Mr Michael Thompson (“Mr Thompson”)
- The defendant’s expert witness – Professor Robin Phillips (“Professor Phillips”)
- Relevant facts, evidence and findings
- The defendant
- The claimant’s history
- The claimant’s appointment with the Private GP
- The GP’s referral letter
- The first consultation with the defendant
- Flexible sigmoidoscopy procedure
- The second consultation with the defendant
- The process of grading the haemorrhoids
- Advice on treatment options and risks of surgery
- The operation
- The operation note and findings
- Letter of complaint
- Causation
- Submissions
- The defendant
- Discussion
- Issues 2 - If the claimant has not proved on the balance of probabilities that the defendant’s grading of her haemorrhoids as grade 2 / 3 was incorrect, then has the claimant established on the balanc
- Issues 3 - 4 – Causation
- Conclusions