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Causation is key

4 November 2015
The recent Court of Appeal decision in the case of Reaney v University Hospitals of North Staffordshire NHS Trust provides welcome clarity on the extent of a defendant’s liability where a negligent act results in the exacerbation of a claimant’s underlying condition.

The fundamental issue was whether the well-established principle that a defendant must take the claimant as he finds him (the ‘eggshell skull’ rule) extended to imposing a liability to pay full compensation where the negligent act worsened a pre-existing condition. The Court of Appeal concluded that a defendant’s liability to a claimant is restricted to compensate only to the extent that the claimant’s condition was exacerbated by the negligent act. It followed that where a defendant’s negligence gives rise to needs that are 'quantitatively' different (so substantially of the same kind as pre-existing needs) the liability is limited to any additional requirements; where-as if the needs are 'qualitatively' different (beyond that which would have existed in the absence of the negligent act), then those needs would be treated as being caused entirely by the defendant’s negligence.


This common-sense decision reinforces the principles that underpin personal injury litigation - whilst a defendant cannot seek to limit its liability simply because a claimant has a particular vulnerability, there must be a causal link between an index event and the loss. In the absence of that link there will be no compensation.

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