Beech v Timney and Paterson [29.07.13]

High Court rejects claim that GP failed to respond to an elevated blood pressure reading causing 35 year old Claimant to suffer a serious stroke.

Implications

Mr Justice Turner found that whilst the Claimant had raised a number of areas of breach of duty, some of which he accepted, there were two central issues in the claim:

  • The Claimant had accepted that only one controversial blood pressure reading/recording could have been causatively relevant to his stroke. Accordingly, the other allegations of breach of duty had no causative impact.
  • The important medical dispute in the case could be resolved by rational scientific analysis, rather than the outcome of a forensic bullfight. For example, scientific literature was identified late in the day which resolved a central issue between two of the experts.

Increasing pressure is being placed on both claimants and defendants to limit costs of litigation. This case supports the need to identify the key causative allegations to narrow the issues, in addition to the need to identify relevant literature at an early stage, thereby reducing costs.

Background

On 6 November 2003, the Claimant, then aged 35, had a stroke, as a result of which he suffers from physical and cognitive deficits, which will be permanent.

The Claimant alleged that his stroke was caused by the negligence of the First Defendant, who was his GP. His case was that his blood pressure was probably significantly elevated when he visited the First Defendant on 21 March 2003 and that the First Defendant had recorded a falsely low blood pressure.

Decision

Turner J dismissed the claim:

  • It was inherently unlikely that an experienced GP could be so careless as to fail to respond to a blood pressure reading of about 180/100 and record it as being significantly lower than this.
  • The evidence revealed that, in some respects, the First Defendant fell short of the standard to be expected of a reasonably competent GP. However, these examples were not so serious as to cast doubt on his ability correctly to take and record a blood pressure measurement.
  • The clinical findings relied upon by the Claimant’s expert cardiologist, Dr Saltissi to support his conclusion that his blood pressure was in the region of 180/100 in March 2003 were inadequately founded in the evidence of the relevant scientific literature.
  • The evidence of the Defendants’ expert neurologist, Dr Sharma that the direct cause of the stroke was an arteriovenous malformation was ultimately compelling and was consistent with a level of blood pressure which, although elevated, was not severely so. A single low normal reading in March 2003 was not inconsistent with this picture.
  • In any event, the evidence showed that the Claimant would have suffered his stroke even if the First Defendant had found high blood pressure in March 2003 and embarked on a course of reasonable treatment. The scientific literature demonstrated that, in any given case, the chances of making any difference to the risk of a stroke after a treatment regime has been in place for no more than a few months are negligible.