Judgment has been handed down by Mrs. Justice Lambert following a two week trial in AB v East Lancashire Hospitals NHS Trust [2019] EWHC 3542 (QB).  The Claimant suffered a perinatal arterial ischaemic stroke at about the time of her birth and sustained significant disabilities, including a right hemiplegia, as a result. She alleged that she should have been delivered some weeks earlier and that, if she had been, the stroke would have been avoided.  The Trust, represented by John Whitting Q.C., denied any negligence in her antenatal care and said that, even if she had been delivered earlier, she would still have suffered the stroke.

The Court dismissed the claim, finding for the Trust on both breach of duty and both medical and legal causation.  Of wider significance was Mrs. Justice Lambert’s consideration of the distinction, in the medicolegal context, between a recognised association and a cause.  She found:

‘…as Mr Whitting submitted, a belief, however strong, of an association or possible causal link between placental pathology and PAIS which has not been scientifically demonstrated is not proof of causation in general and certainly not in the particular case.  Likewise, a widely held hypothesis, or presumption, is not proof on the balance of probabilities of cause, or in the legal context, of causation.’

This echoes a similar finding, in a different clinical context, by Mrs. Justice May in Clements v Imperial College Healthcare NHS Trust [2018] EWHC 2064 (QB), in which John Whitting Q.C. also appeared for the Defendant Trust.

John Whitting Q.C. was instructed by Judith Baxendale of Hempsons (Manchester)