The Court of Appeal has today handed down judgment in the case of Reaney –v- University Hospitals of North Staffordshire NHS Trust & Mid Staffordshire Hospitals NHS Foundation Trust [2015] EWCA Civ 1119. Jonathan Heap represented the two Trusts on behalf of the NHS Litigation Authority.

The decision addresses the question of how to value a claim where the condition of an already-injured claimant is made worse by subsequent negligence. This decision is of great significance to defendants and their insurers, particularly in the realm of clinical negligence where claimants often have significant underlying conditions and associated needs.

Facts and first instance decision

Mrs Reaney suffers from transverse myelitis,  a condition which arose non-negligently and effectively left her as a T7 paraplegic.  As a consequence of both defendants’ admitted negligence, she developed extensive pressure sores, contractures, osteomyelitis and other associated complications which limited her rehabilitation.

At first instance the claimant sought, and was awarded, damages to cover the costs of all of her care, accommodation and other needs on the basis that the defendants were required to ‘take their victim as they found her’ and provide full compensation. The total award was £2.89 million and the judgment was widely reported and cited.

The first instance judge added that if the claimant had not established her case on a conventional causation approach then he would have applied Bailey –v- the Ministry of Defence [2009] 1WLR 1052 to require the defendants to compensate her in full on the basis that there had been a ‘material contribution’ to her current care needs.

On appeal, it was argued by the Trusts that, where an underlying condition has been exacerbated,  the defendant should only be liable to the extent that the condition had been worsened and that damages should not compensate for needs which would have existed in any event.

Court of Appeal judgment

The Court of Appeal has today found that the original decision was wrong in law.  In delivering the judgment, the Master of the Rolls, Lord Dyson, made the following key findings:

  • A defendant must compensate a claimant for their condition only to the extent that it has been worsened by the negligence;
  • Where a defendant’s negligence gives rise to needs which are ‘quantitatively different’, i.e. substantially of the same kind or ‘more of the same’, then the defendant should only be required to compensate for the additional needs;
  • However, where the needs consequent upon the negligence are ‘qualitatively different’, i.e. different in kind to the underlying needs, then those needs should be treated as caused in their entirety by the negligence;
  • The extent of the defendant’s liability ought not to be determined by whether or not the earlier event was negligently caused; and
  • Bailey –v- Ministry of Defence [2009] does not apply in a situation like this, where the claimant’s position but for the negligence can be established by the evidence.

The case will now be remitted to the first instance judge for re-assessment of damages based on these principles.