MEDICO LEGAL M A G A Z I N E
A NEW APPROACH TO CAUSATION IN CLINICAL NEGLIGENCE CLAIMS CASE REPORT [2016] EWHC 1604 (QB) JOHN RAGGETT V KINGS COLLEGE HOSPITAL NHS FOUNDATION TRUST AND OTHERS By Judith Kelbie LLP, Managing Partner, 7 Solicitors LLP This medical negligence case explores the cause or causes of the above-knee amputation of the claimant, Mr John Raggett (deceased), arising from the failures of three medical professionals. In summation, all three professionals failed to consider a vascular explanation for Mr Raggett’s pain, instead adamantly pursuing neuropathic solutions. This case provides an interesting perspective on causation within a medical negligence claim, as one must determine whether the responsibility for Mr Raggett’s substandard treatment lay solely with one defendant or if it was a coincidental and consistent chain of medical negligence. From the age of 36, Mr Raggett had suffered two strokes resulting in left sided hemiplegia and significant eyesight issues. Mr Raggett was thus identified as an ateriopath, a prime candidate for peripheral artery disease (PAD).
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After intense foot pain and a diagnosis of Achilles Tendonitis by his GP, Mr Raggett was referred to the Second Defendant, Mr F, an orthopaedic consultant, for an investigation into the source of pain. Mr F’s negligence lay with the ambiguity surrounding a pedal pulse test. The judge criticised the ‘slapdash attitude to his practice of medicine’ and his lack of note-taking, thus doubting the occurrence of any pedal pulse test. Mr F’s alleged claim of the presence of a pulse in the foot meant that he discounted the possibility of vascular ischaemia causing the pain, kick-starting a total misdiagnosis. If Mr F had excluded the possibility of vascular ischaemic causes, it seemed inevitable that he would have passed this onto Dr H, a pain specialist and consultant anaesthetist, during referral. Additionally, when questioning his medical competency, expert witnesses highlighted that the claimant’s unrelenting pain on five occasions should have indicated an incorrect diagnosis. This multitude
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