Cara Guthrie

Clinical Negligence

Cara specialises in clinical negligence. She is instructed by claimants and defendants in complex and serious cerebral palsy, brain injury and spinal injury cases, either with a leader or on her own. Cara is also instructed in other clinical negligence cases covering the full spectrum of medical issues. Recent or ongoing cases involve obstetrics, neurosurgery, neonatal care, delayed diagnosis of cancer, psychiatry, general surgery, ophthalmology and gynaecology.

Cara regularly represents both families and NHS Trusts in inquests which means that she has a unique perspective on the requirements and needs of both parties in such cases.

Cara has experience of claims involving private hospitals and doctors, as well as GPs, the Ministry of Defence and NHS trusts. Many of her claims involve more than one defendant so she has first-hand experience of the tactical issues which commonly arise in such cases. A number of her cases have had an international element because, either the cause of action accrued overseas or, the claimant lives overseas. She has a particular interest in conflicts of laws issues.

As a member of the Ogden Working Committee, Cara has a detailed understanding of issues such as multipliers, discount rates and periodical payments which she uses for the benefit of her clients.

She is highly numerate.

Cara is highly ranked as a leading junior (Band 1) in clinical negligence in both Chambers & Partners and Legal 500.

Selected Cases

• R (2020): Represented Claimant who sustained head injury after absconding from a psychiatric hospital.
• B (2020): Acted for Defendant in a very complicated tetraplegia case.
• M (2020): Led in £18m cerebral palsy case acting for the Claimant.
• W (2020): Represented Defendant in a cauda equina case.
• B (2020): Acted for Claimant seeking damages for brain injury from meningitis.
• RS (2019): Represented Claimant in long running case concerning general surgery and neurology/ITU care.
• C (2019): Defended against against high value clinical negligence claim.
• EG (2019): Acted for Claimant in a case where Claimant’s husband committed suicide after absconding from mental health facility.
• DV (2019): Represented Defendant in a case concerning the delayed diagnosis of cancer.
• AH (2019): Acted for the Claimant in a surgical negligence case.
• IXH (2018): Acted as junior for the Claimant in a high value cerebral palsy claim. Complex issues of accommodation arose as C had divorced parents and the claim was presented on the basis that she needed two homes and would move in her lifetime. Case prepared for trial. Claim settled for c. £18 million days before trial.
• MB v Colchester Hospital NHS Trust (2018): Acted for Defendant in a case in which C alleged that negligent handling of the claimant caused her spinal cord injury to deteriorate from incomplete to complete. Claimant represented by leading and junior counsel. Case prepared for trial. Liability compromised at 50% only 2 days before trial, C having previously been resolute about accepting no less than 80%.
• CJ v Barking & Redbridge NHS Trust (2018): Acted for the Defendant in a case in which D had made partial admissions of breach of duty but denied causation of C’s spinal cord injury. C represented by leading counsel. It was a complicated claim from a medical perspective as the Claimant was suffering from two separate spinal cord pathologies. The claim settled for £450,000 about two weeks before the liability trial.
• LC v Dr Patel (2018): Acted for the Claimant (from the earliest stage) in claim against a GP for failure to visit the Claimant and refer her for small bowel obstruction. Breach of duty, causation and quantum remained in dispute until the case settled very shortly before trial. Causation was particularly complex with D arguing that earlier referral would have made no difference to the outcome as the experts agreed that C’s bowel had already perforated. The Claimant required careful and firm handling at times. Case settled for £400,000 at an RTM.
• JM v Luton & Dunstable Hospitals NHS Trust (2018): Fatal Accident Act claim by the widow of a young man (aged 36) who died from a heart condition. I was instructed at an early stage in the case. D subsequently admitted liability and the claim proceeded as a quantum only claim. Issues such as the deceased earning capacity and his health but for the negligence required careful consideration. Case settled for £560,000 at an RTM.
• DA v Cambridge University Hospitals NHS Foundation Trust (2017): Acted as junior for the Defendant in a cerebral palsy quantum claim. The case was far more complicated than normal because the Claimant lived in New York and claimed damages in excess of $50 million. There were numerous UK and US experts. Issues about US education, US tax, the appropriate discount rate, accommodation, lost years, loss of earnings and care. Case settled for a combination of a lump sum and PPs with a capital value of £18 million.
• EC v Kings College Hospital NHS Foundation Trust (2017): A fiercely contested claim in which C suffered psychiatric injury as a result of clinical negligence. This case concerned the still birth of C’s baby conceived by IVF. D contending that C was not a primary victim. Also factual causation dispute. Unsuccessful strike out application by C just prior to RTM set the ground for very robust negotiations at RTM. Case settled for £237,500.
• D v Sandwell & West Birmingham Hospitals NHS Trust (2017): Acted for the Claimants in a Fatal Accident Act claim arising out of a two month delay in the diagnosis of cervical cancer. The Deceased was a 32 year old mother of four children. Delighted to have achieved a settlement of £215,000 shortly before trial given the high risk of not establishing causation.
• RH v North Devon Healthcare NHS Trust (2017): Acted as junior for Claimant in a cerebral palsy quantum claim. The Claimant was a nine year old girl with severe physical difficulties, good cognitive ability but no verbal communication. Case required requantifying when the discount rate changed. Advised on the issue of recovery of damages for the cost of buying suitable accommodation and the evidence required. Settlement achieved at RTM for a combination of a lump sum and PPs with a capital value of £20 million.
• TS v Barking, Havering & Redbridge Hospitals NHS Trust (2017): Acted for the Defendant in a claim arising out of the repair of a grade 2 tear. Advised in conference with the clinicians on several occasions. Advised that the claim had very little merit and client resolved to defend the case at trial. Claimant discontinued claim shortly before trial.
• W v Colchester Hospital University Trust (2015): Acted as junior for Claimant in an assessment of quantum. C suffered from cerebral palsy and had appalling behaviour which gave rise to difficulties managing the case from a practical perspective and also complicated quantum. There were issues about whether she would have (and be permitted to keep) children. The case concluded at an RTM for a lump sum and PPO worth a total of £9.0 million.
• SM v Homerton University Hospital (2015): Claim for damages arising from delayed diagnosis of appendicitis. C claimed for loss of earnings based on C’s loss of a chance of promotion to Partner at a firm of solicitors. Case proceeded to trial but settled on the 3rd day for £750,000.
• H v Kings College Hospital (2015): Represented D in a case in which an elderly C had been rendered tetraplegic whilst undergoing surgery to decompress his cervical spine. Breach of duty involved consideration of the following issues: positioning of the patient, the standard of surgery, what could be seen on the imaging before and after surgery and the management of C after the operation. There were numerous factual and expert witnesses. Liability was hotly contested. Settlement of damages and costs reached at an RTM. The damages settlement included periodical payments and was worth c. £780,000.
• SBF v Buckingham Healthcare NHS Trust (2015): Represented Claimant in clinical negligence claim in which liability had been admitted. C had had a colostomy and also suffered from chronic pain, which was very disabling. Case settled at RTM for £900,000.
• U v University Hospitals of Leicester NHS Trust (2014): Represented D in a quantum only case; D had admitted liability for causing C’s brain injury. Settled at RTM for a lump sum and PPOs worth £4.1 million.
• Gomez v Royal Hospitals Cornwall NHS Trust (2014): Represented Claimant in a surgical negligence case. Liability admitted. Most of the claim was for loss of earnings. RTM at which D offered only £400,000. Case prepared for trial but settled 1 working day before trial for £587,500.
• Elton v MOD (2012): Instructed as a junior for the Claimant who had sustained vascular injury following a wakeboarding accident and underwent an above-knee amputation. The case concerned provision of emergency vascular surgery to servicemen based in Cyprus – the MoD used a Republic of Cyprus hospital. Issues of the extent of the duty of care arose, as well as arguments about causation. Settled at a round table meeting.
• Pendreich v James Paget Hospital NHS Trust (2012): Instructed by the Claimant in a case concerning failure to inform GP of C’s high blood pressure and prevent stroke. Quantum only. Issue about treatment of ongoing receipts of permanent health insurance. Settled for £2 m following a round table meeting.
• DB v Surrey & Sussex NHS Trust (2012): Instructed by the Claimant in a Fatal Accident Act case arising out of the death of his common-law wife from cervical cancer. Issues of causation and quantification arose. Settled at a Round Table Meeting.
• BW v Norfolk & Norwich NHT Trust (2011): Instructed by the Defendant in a case concerning the standard of breast reconstruction surgery and the management of an exposed implant. C claimed approx. £150,000. 4 day contested High Court trial on breach of duty, causation and quantum. Four factual witnesses and four expert witnesses. Judgment in favour of the Defendant.