Bolitho v City and Hackney Health Authority [1996]
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Bolitho v City and Hackney Health Authority [1996] 4 All ER 771 is a notable English tort law case that established a significant precedent concerning the standard of care required of medical specialists. The case follows the Bolam test for professional negligence, addressing the interplay with the concept of causation.
Two-year-old Patrick Bolitho, suffering from croup, was admitted to St Bartholomew's Hospital and placed under the care of Dr Horn (senior registrar) and Dr Rodger. Despite concerns about Patrick's condition, Dr Horn did not attend to him after two respiratory episodes. Subsequently, Patrick experienced respiratory and cardiac arrests, leading to severe brain damage and eventual death. Patrick's mother, as the administratrix of his estate, sued the local health authority for negligence. The central argument was whether Dr Horn's breach of duty, by not attending to Patrick, caused his death.
The House of Lords held that a defendant could not evade liability by asserting that damage would have occurred even with another breach of duty. It was crucial to determine whether the hypothetical decision not to intubate Patrick would have constituted a breach of duty. The Bolam test, stating that an action is not a breach of duty if it aligns with a reasonable body of professional opinion, was applied. However, the professional opinion relied upon must not be unreasonable or illogical. The court emphasised that only in a rare case would it find the body of opinion unreasonable.
Eight medical experts testified during the trial, with a split opinion on whether intubation would have been warranted. The original judge, Mr Justice Hutchinson, found that Dr Horn's failure to attend to Patrick did not cause his death. Even if she had attended, her decision not to intubate would have been supported by a reasonable body of professional opinion.
The House of Lords' decision in Bolitho marked a departure from the traditional Bolam test, established in Bolam v Friern Hospital Management Committee [1957]. While the Bolam test shielded doctors from negligence claims if their actions aligned with a professional consensus, the Bolitho case introduced a more nuanced approach. The court did not explicitly outline the circumstances under which adherence to professional opinion could still constitute a breach of duty, stating only that such cases would be rare.
The House of Lords' decision in Bolitho introduced a shift from the strict application of the Bolam test. It acknowledged that a practice supported by a body of professional opinion might still be considered negligent in certain rare cases. This decision added complexity to the determination of medical negligence, emphasising the need for reasonableness and logic in professional opinions.
Two-year-old Patrick Bolitho, suffering from croup, was admitted to St Bartholomew's Hospital and placed under the care of Dr Horn (senior registrar) and Dr Rodger. Despite concerns about Patrick's condition, Dr Horn did not attend to him after two respiratory episodes. Subsequently, Patrick experienced respiratory and cardiac arrests, leading to severe brain damage and eventual death. Patrick's mother, as the administratrix of his estate, sued the local health authority for negligence. The central argument was whether Dr Horn's breach of duty, by not attending to Patrick, caused his death.
The House of Lords held that a defendant could not evade liability by asserting that damage would have occurred even with another breach of duty. It was crucial to determine whether the hypothetical decision not to intubate Patrick would have constituted a breach of duty. The Bolam test, stating that an action is not a breach of duty if it aligns with a reasonable body of professional opinion, was applied. However, the professional opinion relied upon must not be unreasonable or illogical. The court emphasised that only in a rare case would it find the body of opinion unreasonable.
Eight medical experts testified during the trial, with a split opinion on whether intubation would have been warranted. The original judge, Mr Justice Hutchinson, found that Dr Horn's failure to attend to Patrick did not cause his death. Even if she had attended, her decision not to intubate would have been supported by a reasonable body of professional opinion.
The House of Lords' decision in Bolitho marked a departure from the traditional Bolam test, established in Bolam v Friern Hospital Management Committee [1957]. While the Bolam test shielded doctors from negligence claims if their actions aligned with a professional consensus, the Bolitho case introduced a more nuanced approach. The court did not explicitly outline the circumstances under which adherence to professional opinion could still constitute a breach of duty, stating only that such cases would be rare.
The House of Lords' decision in Bolitho introduced a shift from the strict application of the Bolam test. It acknowledged that a practice supported by a body of professional opinion might still be considered negligent in certain rare cases. This decision added complexity to the determination of medical negligence, emphasising the need for reasonableness and logic in professional opinions.
