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Ward v Leeds Teaching Hospitals NHS Trust, High Court, 16 July 2004

1 October 2004
The issues

Psychiatric Injury – Post Traumatic Stress Disorder – Bereavement Reaction

The facts

The Claimant’s daughter was admitted to Leeds General Infirmary to have her wisdom teeth taken out under general anaesthetic. She was aged 22 and the Claimant’s only child. She never regained consciousness after the operation and was pronounced dead 48 hours after the operation had taken place on 26th March 1999. Liability for the death was admitted by the Defendant and a claim was brought under the Fatal Accidents Act on behalf of the estate, which was settled.

In addition, a claim was brought by the mother, Mrs Ward for damages for psychiatric injury. On the day of the operation the Claimant had taken her daughter to hospital in the morning and then left for work. She telephoned the hospital in the morning and then left for work. She telephoned the hospital as she had been told to do at about 4pm and was told by the nurse that her daughter was not back on the ward. This had made her worried. She made her way to the hospital in a state of anxiety but no more. She was told on arrival that her daughter was in the recovery room and she had to wait for some time before being allowed to see her daughter. She became anxious and angry because she did not know what was going on.

Eventually a doctor came to tell her that “there was a problem with Katherine”. She was told that she had not woken up. Mrs Ward visited Katherine in the recovery room at about 8.30 pm. At that time Katherine is likely to have looked like a patient would look in the early phase of coming out of anaesthesia. She would have been slightly propped up to aid her breathing and would have looked as though she was asleep. Mrs Ward was with Katherine for about 10 minutes stroking her face and touching her arm but without any response. The Trial Judge took the view that at the time she still thought she would be taking her daughter home although the outcome was uncertain and although she knew that at this stage there were potentially serious adverse consequences for her daughter. The Claimant saw her daughter again 5 hours later when she was told that a scan showed that her daughter had a stroke and that it was too early to say what the outcome would be.

When she saw Katherine she saw (from the description given to her by the doctor) what she expected to see apart from a wire which had been attached to a shaved part of her head. She gave evidence to the effect that she was shocked by what she had seen. She remained with her daughter all night and through most of the next day. In the morning she was told of the likelihood of brain damage. She stayed at the hospital throughout the 25th March. By 26th it was clear to the doctors that there was no hope of Katherine surviving. At 3.15 pm it was confirmed that brain stem death had occurred and Katherine was pronounced dead at 4.45 pm. Mrs Ward saw her daughter for a short time and then left the hospital “numb with grief”.

On 27th March she visited the Mortuary. She said she was not prepared for what she saw (seeing her daughter with some blood in her ear and some bruising around her neck) and told her doctor that it was this image that had “haunted her for years and still continues to haunt her”. On 30th March she saw the Coroner who told her that Katherine’s brain would have to be removed for tests. It was on the day following that visit that the general practitioner noted the beginning of a protracted psychiatric illness. The issue was whether the Claimant could claim for that illness.

The decision

The medical evidence was at odds as to the nature of the Claimant’s illness. The Claimant’s expert evidence was that the grief reaction she had suffered as a result of witnessing four shocking events (seeing Katherine motionless in the recovery unit; seeing her in the intensive care unit; seeing her in the chapel of rest bleeding from her ears; and being told that the brain would be kept for examination) had been intensified and that the events had brought about a post traumatic stress disorder. The Defendant’s expert rejected any diagnosis of PTSD. She insisted that a necessary criteria must be a clearly shocking event of a particularly horrific nature and this did not seem to encompass the death of a loved one in hospital unless accompanied by circumstances which were wholly exceptional in some way as so as to shock or horrify. Although Mrs Ward’s description of the incident that she had undergone were undoubtedly distressing, they were not shocking in that sense. On balance the Defendant’s experts diagnosis was preferred and the Court could not find any medical basis for finding that the events in the hospital or at the Mortuary constituted events which had induced a post traumatic stress syndrome in the Claimant.

The preferred opinion was that the proper diagnosis was a severe and prolonged bereavement reaction, caused by the fact of the death of her daughter rather than the events at the hospital.

Claim dismissed.

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The content on this page is provided for the purposes of general interest and information. It contains only brief summaries of aspects of the subject matter and does not provide comprehensive statements of the law. It does not constitute legal advice and does not provide a substitute for it.

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