Page 64 - Pharmacy Appeals 1/4/04 to 31/3/05

40 Performance analysis

Cases of note Walsh (deceased) v. Northumbria Healthcare
NHS Foundation Trust (Newcastle County
Khan v. Meadows (Supreme
Court, 19 May 2021 - Judge Freedman)
Court, 18 June 2021)
In 2017 Mr Walsh took his own life by running
This case concerns the scope of a medical practitioner's
onto a major road into the path of oncoming
duty when consulted about a specific issue. traffic. It was alleged that security staff had been
negligent and that this led to his death.
Ms Meadows became aware that she might be a carrier
of the haemophilia gene when her nephew was born in Mr Walsh had no history of psychiatric illness, but on
2006 and diagnosed with haemophilia. She wished to 23 January 2017 he had struck one of his children and
avoid having a child with the condition and so consulted as a result was required to leave the family home. He
her GP. The GP, Dr Khan, arranged blood tests to establish then took an overdose of paracetamol, and did so again
whether she had haemophilia - the results were normal. on 4 February. He was taken by ambulance to hospital
However, the GP failed to advise her that these tests and after initial assessment was sent for a psychiatric
could not confirm whether she was a carrier of the gene. review. An hour later he told a physician's assistant that
because the hospital was not doing anything to help
Thinking that all was well, Ms Meadows became him he was going to kill himself. He ran towards an area
pregnant in 2010. Her son developed severe haemophilia. with easy access to the main road. Security officers were
She claimed that had she been given correct advice, summoned and were able bring him back to the building.
she would have chosen a termination. As well as He then had a cigarette outside the entrance and
haemophilia, her son has the unrelated condition returned to the emergency department, accompanied
of autism. Dr Khan admitted liability for the losses by the guards. He asked for water. One of the guards
arising from haemophilia but not those resulting from went to the cooler and at that point the patient made
autism, which in monetary terms were much higher. his escape. Unfortunately, the guards could not catch
him and he ran into the path of approaching vehicles.
The Supreme Court had to decide whether Dr Khan
It was claimed that the guards had failed to take
was responsible for the financial consequences of
appropriate care of the patient and it was foreseeable
the autism. Using the example of a commercial case
that if a door were left unattended even for a brief time
decided by the House of Lords in 1997, a key question
Mr Walsh might escape. Judge Freedman noted that the
was "what, if any, risks of harm did the defendant
patient had not been detained under the Mental Health
owe a duty of care to protect the claimant against?"
Act 1983 and therefore there was no statutory power
This was important because the law does not impose
to confine him to hospital. While there was a risk of
responsibility on a defendant for everything which follows
the deceased absconding, the function of the security
from his or her act or omission, even if it is wrongful. officers was not to detain him in the conventional sense
In this case the patient approached her GP surgery but rather to take reasonable steps to prevent him
from leaving. In the short period prior to him running
specifically to know if she was a carrier of the
away, there was nothing in his demeanour to suggest
haemophilia gene. Although there was a causal link
he was contemplating an escape. On the contrary, the
between the admitted negligence of Dr Khan and
evidence suggested he was calm and co-operative. It
the birth of the child, that was not relevant to the
was reasonable for one of the guards to respond to
scope of his duty. The law did not impose on Dr Khan
the request for water. To hold guards negligent in such
any duty in relation to unrelated risks that might
circumstances would be to impose an intolerably high
arise in pregnancy. It followed that he was liable burden upon them. The guards had not been negligent
only for the costs associated with haemophilia. and, in any event, causation had not been demonstrated
because it was probable that Mr Walsh would have
Comment
found another opportunity to end his life within a short
This is a very important ruling from the Supreme time, even if he had been restrained on this occasion.
Court. Those acting for the mother argued that if it
Comment
wasn't for the doctor's negligence, her child would
not have been born and therefore the defendant This was a very sad case, but it is important to bear
should be responsible for the financial consequences in mind that the patient was not detained under
of all his disabilities. The Court ruled that this was the the Mental Health Act. The claim sought to place an
wrong way to look at the situation. The GP had not unreasonably high burden upon the guards who had
been consulted about autism, which is a risk resulting no immediate reason to think the patient was going to
escape and were performing an act of kindness for him.
from any pregnancy. Consequently, he did not owe
This is a notable ruling, although as it is a County Court
a duty of care in that regard. It is a principle which
judgment it is not binding on other judges. It is clear
can be applied to other clinical negligence cases.
from the decision that the duty of security guards in such
circumstances is one of reasonable care and no higher.