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D -v- East Berkshire Community Hospital Trust and Others

3 October 2002
The issues

Munchausen by Proxy – duty of care owed to mother by diagnosing Doctors.

The facts

The Claimant gave birth to a boy. The boy was prone to suffering allergic reactions and was referred to a Specialist when he was 6. He was assessed by the Specialist over 4 days in hospital. The mother went with the boy, and although she did not know, the Specialist also made an assessment of her. He believed she was exaggerating the boy’s symptoms and that the boy needed the protection of a Social Services referral. He did not pursue the matter as much as he could have done at the time. 2 years later, another Specialist took over the case and re-reading the file notes from 2 years before, started investigations again into the Claimant mother’s role. The first Specialist wrote to Social Services, mentioning the possibility of Munchausen by Proxy. A Case Conference was held, at which the Claimant and both Specialists attended. The boy was put on the Child Protection Register. Subsequently, the boy was assessed by an Allergy Specialist, who confirmed that the problems were genuine. As a result the boy was taken off the Child Protection Register. The Claimant sued the Hospital Trusts, who were the employers of the two Specialists, alleging the diagnosis of Munchausen by Proxy had been made negligently and that as a consequence she had suffered a severe psychiatric illness. The Defendants argued that they owed no duty of care to the Claimant. The issue as to duty was tried as a preliminary issue.

The decision

1. The injury to the Claimant was reasonably foreseeable.

2. Public policy considerations militated against the existence of a duty owed to the parent in these circumstances.

3. There was a potential conflict of interest between the child – patient and the parent. The protection of the child was a vital importance and the case gave rise to similar issues that arose in the sexual abuse cases – X -v- Bedfordshire County Council – which could not be distinguished. (The House of Lords declined to find that the maker of a diagnosis of sexual abuse in respect of a child owed any duty of care to the alleged abuser).

4. Consequently, the claim failed and it was not necessary to consider whether there was sufficient proximity between the Claimant and the Doctors under the test in Caparo.

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