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The second consultation with the defendant
The second consultation with the defendant
On 20 April 2019, the claimant had a further consultation with the defendant. Again, the defendant’s note of this consultation is his clinic letter dated 23 April 2019, which he dictated immediately following the consultation and which was sent to the GP and copied to the claimant. The letter states:
I saw this lady following her flexible sigmoidoscopy on the 21st March 2019. This was normal to the splenic flexure.
She does have 2nd and 3rd degree haemorrhoids, and she takes Movicol which does improve her bleeding symptoms. We had a discussion about haemorrhoid surgery and she is keen to proceed. I have listed her for a ligasure haemorrhoidectomy on the 13th June and have warned her of all the usual risks, but in particular post-operative pain. I have given her an EIDO information sheet with regards to this.
- 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