Bolitho v City and Hackney Health Authority  AC 232. Search Browse; Resources. There was uncertainty about her urinary output and when blood tests were done later her bilirubin level was still significantly raised suggesting that the biliary blockage had not been cleared. I use the word 'intervention' to encompass a number of options to which I will refer below. Leaving aside other matters for the present purposes, there was no guarantee that the biliary blockage had been cleared, though Group Captain Watkins thought that the stone had 'probably' been removed. Personal Injury Clinical Medical Negligence. Group Captain Watkins obviously wanted that to be better controlled if possible before performing the ERCP. 22. The First Defendant has accepted certain criticisms of the care and treatment at the Royal Haslar Hospital, though not all levelled against it, but has argued that the Claimant cannot establish a sufficient causal link between any negligence that may have been admitted or established and the eventual cardiac arrest some two weeks later. The Claimant was indeed being fed by Total Parenteral Nutrition (TPN) and by Percutaneous Endoscopic Jejunostomy (PEJ). She was mechanically ventilated from 14 January onwards. The case received some quick comment. It is to be hoped, however, that the reasoning therein, and particularly the misleading assertion that it constitutes a modified application of the “but for” test, will not be misinterpreted in future decisions in this notoriously thorny area. Its view had been obscured by considerable bleeding during the procedure. He clarified that in a supplemental report provided shortly before the trial when he said that had she been resuscitated properly over the first twelve hours or so then, although she would have probably gone into renal failure, the periods of dialysis would have been shortened significantly and may have lasted for 3 4 days only. Bailey (by her father and litigation friend) v Ministry of Defence and another – WLR Daily. He said he felt he could have put a stent in had she become sufficiently settled and he either wanted to do that or insert another balloon to see if the bile duct had cleared. A quick discussion of: Matthews v Ministry of Defence  UKHL 4,  1 All ER 689. 11. 48. It will be necessary to spell out what this involved before investigating whether there were any further deficiencies in the treatment afforded thereafter and the overall effect on the Claimant's condition. I will have to address in due course my conclusions as to what impact, if any, those events and the build up to them had upon the Claimant's overall condition some 7-10 days later when she suffered her cardiac arrest. The doctor summoned to deal with the matter never received the summons due to a low battery on her bleep. 51 At 392. During the course of the ERCP, the conduct of which as such is not criticised, the Claimant sustained very considerable bleeding. This was one possible cause of the retrolental fibroplasia (RLF) from which he suffered and which resulted in his blindness. March 2003 Facts . View all articles and reports associated with Bailey v Ministry of Defence  EWCA Civ 883. 29. The patient is sedated and asked to swallow the first section of the endoscope (a thin flexible fibre-optic telescope). 20. Bailey v Ministry of Defence  EWCA Civ 883 Childbirth Injury: Liability issues. MENU. It concerns the problematic question of factual causation, and the interplay of the "but for" test and its relaxation through a "material contribution" test. Later in the evening of 12 January she was transferred to High Dependency Unit at the Royal Haslar Hospital where she stayed until she was transferred to the ITU at Queen Alexandra's on 14 January. They all thought that her urine output should have been monitored by the insertion of a catheter. Mr Christopher Gibson QC, representing the Claimant, explained to me at the outset of the trial that following (i) the eventual disclosure of the large ITU charts that the Second Defendants had been unable to find initially and (ii) the meeting of the experts in intensive medicine, he and the team advising the Claimant's family took the view that there was no realistic prospect of establishing the case against the Second Defendants. It hardly needs stating that this was a very major operation (incidentally by now the Claimant had been transferred to Queen Alexandra Hospital, Cosham) the outcome of which, in common parlance, was 'touch and go'. It is argued that a material contribution was indeed made here. 50 (1859) 1 E & … Whilst Mr Scurr, looking at things from the perspective of a surgeon, would have favoured an immediate surgical approach by way of laparotomy, I think that the most favoured approach in the circumstances would have been a further endoscopy under general anaesthetic. Footnote 3The Court of Appeal in Bailey v Ministry of DefenceFootnote 4stated that there was indeed a ‘material contribution rule’ that operated as a ‘modification’ to the requirement to prove but-for causation. 30. Mr Christopher Gibson QC and Mr Paul Dean (instructed by Blake Lapthorn Tarlo Lyons Solicitors) for the Claimant, Mr Derek Sweeting QC (instructed by The Treasury Solicitors) for the First Defendant. It also follows that if this had occurred, as in my judgment it should have done, on 12 January the percutaneos transhepatic cholangiogram (PTC) carried out on 15 January would not have been necessary. Rushmi Sethi | Personal Injury Law Journal | November 2017 #160. MENU. However, this would have to have been on the basis that there was, in effect, 'unfinished business' to attend to and, very significantly, that she was properly monitored and resuscitated overnight. The minister praised the bravery of the elite forces and addressed the commandoes. Gallstones occur when stones are formed in and from bile. Bailey v Ministry of Defence (2009) In the case of Bailey the Claimant aspirated vomit leading to a cardiac arrest and hypoxic brain damage. The claimant’s husband was in the Navy stationed at a remote base in Norway. The Claimant was treated negligently but also had pancreatitis. Edited by: Colm McGrath and Katherine Watt The overall working diagnosis during November and December of those who saw her at the Royal Hospital Haslar where she had been referred was of infective hepatitis. However, the balance of the expert evidence is, in my view clear: that had she been properly resuscitated overnight she would have been fit for and, if correctly cared for, would have been subjected to a further intervention on 12 January to resolve the two areas of uncertainty left over from the previous evening whether the biliary blockage had indeed been removed and whether the internal bleeding had been stopped. Dr Dickinson had (together with Dr Anderson) said that had biliary drainage been achieved, as it should have been, on 12 January the PTC would have been avoided and indeed that must be so as a matter of fact. The Court of Appeal found that both the pancreatitis and the negligence had an impact, and that the evidence did not satisfy the but-for test. 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