PIBULJ
Unpicking the Patchwork Quilt: Psychiatric Injury and Secondary Victims - Vanessa Cashman, 12 King's Bench Walk

16/10/13. It is agreed by most practitioners in this field that the law on recoverability for psychiatric injury as sustained by secondary victims is extremely messy. It consists of many conflicting decisions all uncomfortably pieced together in what has been and still can be termed a patchwork quilt. This was so even in 1999 when Lord Steyn said that the law on the recovery of compensation for pure psychiatric harm “is a patchwork quilt of distinctions which are difficult to justify.” (White v Chief Constable of South Yorkshire [1999] 2 AC 455)
Since then, a great deal has happened in this field with the result that very little has actually changed.
This short article looks briefly at a few of the cases in the patchwork quilt and attempts to draw out the common thread which may provide a clue as to the approach the Courts are now taking and ultimately the likely destination of such claims in the future.
What are the criteria to be a successful secondary victim?
The five criteria, all of which have to be satisfied before a secondary victim can succeed, were most recently confirmed by the Court of Appeal in Taylor v A Novo [2013] P.I.Q.R. P15. They are:
(i) That C sustained his psychiatric injury as a result of "shock", i.e. "the sudden appreciation by sight or sound of a horrifying event, which violently agitates the mind", rather than by some more gradual process.
(ii) That the "shock" would have been sufficient to cause psychiatric injury to an imaginary person of “reasonable fortitude".
(iii) That he was close in space and time to the accident concerned or its immediate aftermath ("Nearness").
(iv) That he directly saw and/or heard the accident or its immediate aftermath ("Hearness") i.e. being told about it is not enough.
(v) That he had a close tie of love and affection with the principal victim of the trauma ("Dearness").
It will be seen however from the case law that these criteria are being stretched beyond recognition or entirely ignored.
Criterion 1: Horrifying event
In the cases soon after the Hillsborough disaster the courts were strict in their approach to this control test. In Taylorson v Shieldness Produce [1994] PIQR P329 the Claimants were the parents of a teenage boy who was crushed by a vehicle. The parents went straight to the hospital and then followed the ambulance he was in while he was being transferred to another hospital. They were not allowed to see him for some hours, although they glimpsed him in the ambulance and when he was being taken into ITU. The father saw him that evening but the mother was advised not to. They both saw their son 24 hours after the accident, when he had been placed on life support. He was unrecognisable. They stayed with him for two days before switching the machine off. The Court of Appeal upheld the trial judge’s finding that the shocking events were not sufficiently immediate.
This previous requirement is however becoming less rigid as time goes by. In Walters v. North Glamorgan NHS Trust [2003] PIQR P16, as a result of a hospital's negligent failure to diagnose a baby's acute hepatitis, the Claimant mother sustained psychiatric injury in witnessing the baby suffering a major epileptic fit and thereafter declining to death over a 36 hour period. The Defendants contended that the Claimant failed to satisfy control test (i), in that she had sustained psychiatric injury not as a result of the "shock" of a single traumatic event but by some more gradual process as a result of a series of events. The Court of Appeal rejected this contention, holding that she did suffer "shock" and that the entire 36 hour period was to be regarded as one traumatic event.
These two decisions appear to be, on the face of it, completely contradictory and do not seem to be an example of the courts stretching the boundaries to allow the meritorious claimant to succeed; both cases are horrific.
However, contrast these cases again with White v Lidl [2005] EWHC 871. Mrs White was in her car leaving a car park when the defective barrier swung out and went through her windscreen. She suffered minor cuts. Her psychiatric condition deteriorated and some six months later she hung herself. Her husband found her and tried to save her. He suffered a psychiatric reaction as a result of her death.
Mr White had argued that in the case of Walters, the focus was on the shocking event (the fit), rather than the negligent event (failure to diagnose). In his case, he argued that it was the suicide which was the shocking event, not the barrier coming down. The Defendant argued that Walters, in whichthere was a considerable interval between the actual tortious event and the death, should be distinguished on the basis that in that case there had been an inexorable progression from the failure to diagnose the hepatitis until the death of the child. Hallett J rejected the claim on the basis that the relevant event was the barrier incident, not the suicide, which were quite distinct events, and there had not been an inexorable progression from the tortious event until the death.
Criterion 2: Reasonable fortitude
This criterion is not controversial. The only oddity might be why the requirement does not also apply to primary victims.
Criteria 3 and 4: Nearness and Hearness
In Tranmore v T.E. Scudder Ltd (Court of Appeal 28.4.1998), the Claimant’s son was working on a demolition site when the building collapsed. He was covered by rubble and by a large machine which fell in the collapse. The Claimant heard of the accident and arrived about an hour after it occurred. He saw the rubble and was told that his son had been buried under it. About two hours after his arrival at the scene he was told that his son had died. He did not see his son’s body. The Court of Appeal rejected his claim as he had not seen his son’s body.
However Judge Seys –Llewelllyn in Jones v Ramshaw (2011, unreported) took a rather different approach. The father of a young woman killed in a road traffic accident brought a claim in respect of his psychiatric injuries sustained as a result of her death. She had been one of a group of young people from a small village who had all been travelling together in the same car. When the car crashed, word spread that there had been a terrible accident and the residents of the area including the Claimant and his wife attempted to go to the scene. They were stopped by the police at a barrier a little over a mile away from the scene of the accident. From this position the Claimant was unable to see the scene of the accident. What he could see was the police helicopter hovering over the scene of the accident illuminating it with a searchlight and the flashing blue lights of a number of rescue vehicles. A police officer came to the barrier and informed everyone there that four young women had been killed in the accident. All those at the barrier were distraught. Later the Claimant and his wife attended the local police station where they were told that there was one female survivor. However, a short time later they were told that the survivor was male. At least 8 hours after the accident the claimant and his wife went to the hospital mortuary. The Claimant did not identify the body of his daughter. His wife carried out that task and she reported to him that their daughter’s face was badly swollen and that her tongue sticking out.
On the face of it the Claimant failed to meet four of the five criteria for success, satisfying only the test of love and affection. It is difficult to see why Tranmore v Scudder did not provide the answer to the claim. The judge none the less found in favour of the Claimant. In effect the judge seems to have applied, despite saying that he was not doing so, a quite different test. He seems to have concentrated on the horror of the occasion and the foreseeability of psychiatric injury.
Jones v Ramshaw has similarities with Galli-Atkinson v. Seghal [2003] EWCA Civ 697. In that case the Defendant's car mounted the pavement and struck and seriously injured a 16 year old girl who was walking to a ballet class. Despite efforts by a paramedic and subsequently a doctor to save her, the girl died. About half an hour later, her mother, the Claimant, came to the edge of the Police cordon and was informed for the first time that her daughter had been involved in an accident and was dead. The Claimant became hysterical and collapsed. About an hour later, the Claimant cradled her daughter's body in the mortuary. The Court of Appeal held that the Claimant was entitled to recover damages for her psychiatric injury, since it was sustained as a result of "shock" in reaction to the sight of the cordon, what she was told there, and the visit to the mortuary, all of which constituted a single incident and its immediate aftermath.
Again, the unfairness of the decision in Taylorson when contrasted with Galli-Atkinson does indicate that the courts are taking a more lenient approach now to the control criteria.
Where the courts are retaining a degree of inflexibility is in respect of the horrifying event having to be the tortious event complained of. White v Lidl (above) is one such example. The most recent example is Taylor v A Novo [2013] P.I.Q.R. P15, which is the first Court of Appeal case on secondary victims for ten years; interestingly, it does not deal with the usual issues which arise in these cases but instead looks at what constitutes the tortious/horrifying event.
The claimant was the daughter of a woman who sustained injuries when a stack of racking boards fell on her at work. The claimant was not present at the accident but was present at her mother’s death some three weeks later and suffered PTSD as a result. The cause of death was an embolism, a result of the injuries sustained in the accident. The argument on appeal was whether the relevant shocking event was the death or the original negligent accident and it was held that the relevant event was the latter. There was no question of it being one long drawn-out seamless tale but it was in fact two separate events. The Court of Appeal commented that if the claimant had been present at the accident and suffered PTSD then she would have been able to recover as a secondary victim. However, if she arrived shortly after the accident, outwith the immediate aftermath, her claim would fail. Accordingly, it could not be correct that she could recover for PTSD caused by the death some three weeks later as that would allow claimants to recover damages for witnessing the consequence of a negligent act potentially years later.
Perhaps a contrasting decision with this thinking is the earlier case of Froggatt v. Chesterfield & North Derbyshire Royal Hospital NHS Trust 2002 EWHC 3027, a hospital negligently misdiagnosed a woman's benign cyst as breast cancer. Her son sustained psychiatric injury as a result of overhearing his mother telling a friend on the telephone that she had cancer. The woman then had a mastectomy, and her husband sustained psychiatric injury as a result of seeing her for the first time without a breast. Forbes J allowed both the claims. It is however difficult to see how either the father or son were close in time and space to the negligent act i.e. the giving of the misdiagnosis.
Criterion 5: Dearness
This requirement has of course been tested and in particular in the Hillsborough cases. Although relatives will usually be the category of persons who will recover, a mere blood tie is not enough to satisfy the test; cogent evidence is needed to show love and affection.
A particularly unsatisfactory caseisFarrell v. Avon H.A 08/03/2001. The Claimant had sex with a woman on one occasion. He had no continuing relationship with her. She became pregnant. When she gave birth she telephoned the claimant to tell him that their baby was not well. The claimant went to the hospital immediately and was told that his baby had died. He held the dead baby. In fact, there had been a mix-up and he had been given the wrong baby; his baby had not died and he was told this good news a few minutes later. He spent a few minutes with his own baby and then left never troubling to see him again. He developed a psychiatric injury and claimed for it successfully.
Had he been a secondary victim, say if his child had actually died, there was no way he could have succeeded in proving a close tie of love and affection. However, the trial judge concluded that he must be a primary victim because there was no other primary victim. He found that the Claimant was involved directly and immediately in the incident.
So where are we now?
The general approach taken by the courts now is to apply the control criteria far less rigidly. There is a suggestion amongst academic lawyers that the English courts would do well to follow the approach taken in Australia (for example, see Annetts v. Australia Propriety and Tame v. The State of New South Wales[2002] HCA 35 (5th Sept 2002).) The Australian courts have largely abandoned the control criteria and simply look at whether it was reasonably foreseeable that a person of ordinary fortitude would suffer psychiatric injury as a result of a defendant’s negligence.
Lord Justice Denning in King v Phillips [1953] 1 QB suggested that what the courts were doing was drawing lines “where in the particular case the good sense of the judge decides”. That seems to apply as much today as it did in 1953.
Vanessa Cashman
12 King's Bench Walk
Image ©iStockphoto.com/kati1313
PI Practitioner, October 2013

16/10/13. Each issue a particular topic is highlighted, citing some of the useful cases and other materials in that area. You can also receive these for free by registering for our PI Brief Update newsletter. Just select "Free Newsletter" from the menu at the top of this page and fill in your email address.
Accidents at work
The Defence in Ginty v Belmont Building Suppliers Ltd and Boyle v Kodak
Ginty v Belmont Building Suppliers Ltd [1959] 1 All ER 414
The Claimant was replacing asbestos when he fell through a roof. The Defendant employer had instructed the Claimant to use boards because the roof was unsafe but the Claimant had failed to do so. Both parties were in breach of the Building (Safety, Health and Welfare) Regulations 1948 which placed obligations on the employer and employee.
Pearson J held that "the actual wrongful act was the [Claimant's] wrongful act, but in one aspect it constitutes a breach by himself and in another aspect it constitutes a breach by his employer". The court must ask "whether the fault of the employer under the statutory regulations consists of, and is co-extensive with, the wrongful act of the employee. If there is some fault on the part of the employer which goes beyond, or is independent of the wrongful act of the employee, and was a cause of the accident, the employer has some liability." The defence applies where the act or omission of the Claimant himself has the legal result that the Defendant is in breach of a statutory duty.
Boyle v Kodak [1969] 2 All ER 439
The Claimant fell off a ladder which had not been properly secured and was therefore in breach of regulation 29(4) of the Building (Safety, Health and Welfare) Regulations 1948.
Lord Diplock stated: "The Plaintiff establishes a prima facie cause of action against his employer by proving the fact of non-compliance with the requirement of the Regulation and that he suffered injury as a result. He need prove no more ... if the employer can prove that the only act or default of anyone which caused or contributed to the non-compliance was the act or default of the Plaintiff himself, he establishes a good defence ... To say 'You are liable to me for my own wrongdoing' is neither good morals nor good law."
It was held that the employer had not forbidden the Claimant from using the ladder before it was secured and therefore the defence did not apply.
Peter Brumder v (1) Motornet Service & Repairs Ltd & (2) Aviva Insurance Ltd [2013] EWCA Civ 195
The Claimant was the owner and sole director of the First Defendant which specialised in servicing vehicles. He lost his finger on 8th November 2008 while trying to climb down a raised hydraulic ramp when the compressor in the ramp mechanism failed. The ramp had previously failed in 2006. The Claimant brought a personal injury claim against the First Defendant and its insurer (the Second Defendant). The trial judge found that the First Defendant had breached its duty to ensure that work equipment was maintained in an efficient state under regulation 5 of the Provision and Use of Work Equipment Regulations 1998. However he also found that the Claimant had failed to have any regard to health and safety matters when running his business and therefore he was 100% contributorily negligent. The Claimant appealed to the Court of Appeal.
The Court of Appeal held that a finding of 100% contributory negligence was wrong in principle because s.1(1) of the Law Reform (Contributory Negligence) Act 1945 requires fault from both parties (see Pitts v Hunt [1991] 1 QB 24). The case fell within the defence set out above of in Ginty v Belmont Building Supplies Ltd [1959] 1 All ER 414 and Boyle v Kodak [1969] 1 WLR 661. A person could not derive advantage from his own wrongdoing. Here the Claimant was the owner and sole director of the First Defendant and was responsible for the First Defendant's breach of the Regulations. The First Defendant could only act through the actions of the Claimant. The Ginty and Boyledefence applied even though both the Claimant and Defendant had breached the Regulations in those cases, whereas in the instant case there had been no breach by the Claimant.
Richard Boyle
Temple Garden Chambers
Image ©iStockphoto.com/EmiliaU
A Busy Day in Gwent - Ian Clarke, 1 Chancery Lane

15/10/13. Yesterday’s Guardian reported that Cwmbran magistrates’ court was closed for all normal business due to the court having to deal with 86 people, mainly from just two valleys in south Wales, being accused of taking part in one of the UKs largest “cash for crash” frauds. The charges ranged from single counts of conspiracy to defraud insurance companies to conspiracy to steal, receiving stolen goods and money laundering.
The defendants were bailed to appear at Newport Crown Court next month, although in more manageable batches. Should any of the defendants be found guilty it seems unlikely that they will be able to expect much judicial sympathy if the views expressed by the Court of Appeal in R v Nikki McKenzie [2013] EWCA Crim 1544 are anything to go by.
Mr McKenzie was convicted of fraud following his part in a wide reaching “cash for crash” scam. McKenzie played a relatively minor part, claiming to have been a passenger in a vehicle that collided with another car and that he had (inevitably) suffered whiplash as a result of the accident. It was found that the collision never happened and consequently Mr McKenzie was sentenced to 15 months’ imprisonment.
Rather shocked at the length of the sentence Mr McKenzie appealed pointing out that he was “relatively lightly convicted” and had never before been to prison. Moreover, he had been employed by the same electronics firm for 12 years and was regarded as an exemplary, hardworking and honest employee. He was described by one of the directors of his employer as “very much a family man, devoted to his wife and three sons”; his wife had been diagnosed as bipolar and the trial judge acknowledged the devastating impact that a prison term would have on her.
Despite all the mitigating factors the Court of Appeal did not consider the sentence too long noting the trial judge’s view that “deterrent sentences were called for in view of the prevalence of this type of offending and the need to show that it will not be tolerated”. So, the unfortunate Mr McKenzie had his sentence confirmed. In addition the Court of Appeal also confirmed that the costs order of £3,242 towards the cost of the prosecution was appropriate.
The sentence may well be cause for some sleepless nights in the valleys among those who may have played relatively minor parts in such scams. Whether such sentences will have a deterrent effect remains to be seen; criminals tend not to think that they will be caught, and as Keith J pointed out in McKenzie such fraudulent claims are “easy to assert and difficult to disprove”. What is clear though is when a case of fraud is made out the courts are increasingly keen to hand out significant sentences, which should be welcomed.
Ian Clarke
1 Chancery Lane
Image ©iStockphoto.com/payphoto
Vicarious Liability: The Times, They Are a-Changing - Thea Wilson, 12 King's Bench Walk

15/10/13. “[Vicarious liability] is not a static concept and has adjusted over the centuries to provide just solutions to the challenges of changing times. And times are still a-changing … We need to adapt to the current demands.”
E v English Province of Our Lady of Charity and another1 per Ward LJ
Introduction
Vicarious liability is a long-established doctrine of English law; dating back at least as far as the seventeenth century2. The doctrine was “founded in policy rather than conceptualistic reasoning”3 and essentially creates strict liability of employers for their employees’ acts because for policy reasons it is considered right to impose liability. As with many areas of the common law, the doctrine has always been in a state of evolution, but this has particularly been the case over recent years.
There are essentially two tests to be considered in a case involving vicarious liability. First, whether the relationship between the defendant and the tortfeasor is sufficiently close to be regarded as a master/servant or employer/employee relationship. Second, whether the act complained of was within the course or “scope” of the employment relationship. Both tests have changed considerably over the last half century.
As the nature of working relationships evolved in the late 20th and early 21st century, so too has the test for what is an employment relationship. Where previously the Courts looked to the ‘control test’ alone, now numerous tests are considered in order to make that determination (as exemplified in E v English Province of Our Lady of Charity and another).
This article concentrates, however, on the evolution of the second half of the vicarious liability test; what acts are within the scope/course of employment. Here there have been the biggest changes. Here also, the changes have had the greatest implications for practitioners on both sides of the claimant/defendant divide.
Origins of the doctrine
Over a hundred years ago, Salmond set out the principles of vicarious liability as developed by the common law over the preceding three hundred years:
“A master is not responsible for a wrongful act done by his servant unless it is done in the course of his employment. It is deemed to be so done if it is either (1) a wrongful act authorised by the master, or (2) a wrongful and unauthorised mode of doing some act authorised by the master.”4
From the start of the last century until well into its closing decades, in most cases there was a narrow interpretation of what was within the scope of employment.
The case of Kirby v National Coal Board5is an example of this. There, the claimant sued for personal injuries caused by an explosion at the defendant’s mine. An investigation had established that the cause of the explosion was an unknown employee of the defendant striking a match in an area of the mine known as “the waste”. The defendant had strict rules prohibiting employees from entering the mine with either cigarettes or matches. “The waste” was an area of the mine behind a conveyor belt in which employees had no reason to be. Although the Court held that simply entering the mine with prohibited items did not cause the employee to be acting outside the scope of his employment, it held that “the lighting of the match for the purpose of smoking in such circumstances is not misconduct in doing the servant’s work for the master, but it is an independent act unauthorised by the employer”6
Since Kirby, the law has moved on. Although this process has been interrupted in places, there has been a steady relaxation of the definition of “scope of employment”.It appears that the doctrine, having evolved from policy considerations has expanded for policy reasons; the judiciary having the object of identifying solvent defendants with a connection close enough to the actual doer of wrong, whether that wrong be negligent, criminal or both, so as to enable the injured victim to recover compensation.
Development of the law
An early sign of change in the arena of vicarious liability came in Morris v CW Martin & Sons7. Perhaps it is unsurprising that this early evolution came in a judgment of a Court including Lord Denning MR. At first instance, the judge had held that an employee’s act of stealing the plaintiff’s expensive mink coat was outside the scope of his employment with the defendant. The employee had been employed to clean coats and had special access to the room in which the coat was stored. Lord Denning, commenting on the extensive evolution of the law over the previous hundred years, cited a 1912 decision8 to support the fact that an employer could be liable for the criminal act of an employee. The Court held that the ultimate analysis was it was right to impose liability because the employer owed a duty to take care of the goods.
The move towards a more expansive definition of “scope” has not been entirely consistent. Well after the move started, some areas were found outside the realm of vicarious liability. In Heasmans v Charity Cleaning Co Ltd9, the Court held that the claim failed because the employment relationship afforded merely the opportunity to commit the wrong (in this case, making long distance telephone calls on phones belonging to the plaintiff which the employee was employed to clean); there was no greater nexus between the wrong and the employment. Such cases can be seen as blips in the general expansion however. In Brink’s Global Services v Igrox10, the Court confirmed that in light of the decision in Lister v Hesley Hall11, Heasmans should be seen as overruled.
There appear to be two factors which have influenced the general expansion. One was the influence of decisions in other areas. Caparo Industries plc v. Dickman12 pushed the Courts to look at proximity and whether it would be fair, just and reasonable to impose liability. Fairchild v. Glenhaven Funeral Services Ltd13 broadened the doctrine of causation to ensure ‘justice’. The cases have appeared to make a difference to the attitude of the Court; shifting the focus towards looking to ensure justice for a wronged Claimant and to ensure the availability of a remedy. The other factor has been the influence of cases involving serious sexual offenses.
Sexual Offenses cases
The first attempt to deal with this difficult and distressing area of vicarious liability came in the decision of the Court of Appeal in T v North Yorkshire CC14. There, a Council-operated school for mentally handicapped children organised a school trip to Spain. During the course of the trip, the claimant shared a bedroom with the deputy headmaster and was sexually assaulted. There was no suggestion that the Council itself had been negligent in organising the trip or in assigning the claimant to share a room with the deputy headmaster; the issue was simply whether they were vicariously liable for his acts. The Court held that the sexual tort was not an unauthorised mode of performing an authorised act; it was an independent act “far removed from an unauthorised mode of carrying out a teacher’s duties on behalf of his employer”15
In the three years between this decision, and the House of Lords’ decision in Lister, a sea-change in policy occurred. Several of their Lordships in Lister were influenced by the explicitly policy-based approach of the Canadian Supreme Court in the combined cases of Bazley v Curry and Jacobi v Griffiths16. Although not binding on the English Courts, these decisions had a profound impact on English Judges.
Bazley and Jacobi involved the grooming and sexual abuse of a young and vulnerable young boy by an employee of the defendant non-profit organisation at their residential care home. The parties agreed that vicarious liability was governed by the Salmond test, but diverged on its meaning. McLauchlin J, considered that the Court should first look to whether there was clear precedent on the issue. Where, as in these cases, there was no helpful authority, the policy rationales behind finding a defendant strictly liable should be explored. McLachlin J held that Courts should openly confront the issue rather than hide behind semantic discussions of “scope of employment”. The fundamental question was whether the wrongful act was sufficiently related to the authorised conduct to justify vicarious liability; whether there was sufficient connection between the creation/enhancement of risk and the wrong that accrued from that risk. In deciding that, subsidiary factors including the opportunity for wrong afforded by the enterprise; the extent to which the wrongful act furthered the employer’s aims; the extent to which the wrongful act was related to friction, confrontation or intimacy inherent in the enterprise; the extent of power conferred on the employee relative to the victim; and the vulnerability of potential victims to wrongful exercise of power, could be considered.
The expansion of approach to sexual offenses cases in the English Courts started in Lister v Hesley Hall. The facts of this case are well-known. The warden of a boarding annex employed by the defendant school for children with emotional and behavioural difficulties sexually abused a number of boys in his care. The Court of Appeal, bound by T v North Yorkshire CC, found there to be no vicarious liability in the circumstances of the case. The Court of Appeal’s finding and the finding in T v North Yorkshire CC were unanimously overruled, albeit for different reasons, by the House of Lords.
Lord Steyn (with whom Lord Hutton agreed) and Lord Clyde both considered with weight the Canadian decisions. Lord Steyn held that the question was whether the warden’s torts were so closely connected with his employment for vicarious liability to exist. He held that they were “inextricably interwoven”. Lord Clyde placed weight on the fact that the defendant had delegated to the warden the duty of care that they owed to the boys. Lord Hobhouse also laid weight on the assumption of duty of care by the warden’s employer as a crucial factor. Lord Millet looked to whether the employer has created a risk inherent to the nature of the business.
The current position
Whilst Lister expanded the law significantly, a Claimant is far from guaranteed to succeed in every case involving a criminal sexual act. In N v CC Merseyside Police17, Nelson J held that the police constable was not vicariously liable for the actions of an off-duty probationary police constable. The PC had picked the claimant up outside a club when she was severely intoxicated. He had gained the confidence of the club’s first aider and the claimant by wearing his uniform and showing his warrant card. He offered to take the claimant to a police station and the claimant got into his car. He took her to his home and raped and sexually assaulted her whilst she was unconscious; filming the assaults. Nelson J’s decision rested heavily on the absence of any duty of care owed by the employer to the claimant (it is of course established law that the police do not owe the general public a duty of care in advance of a crime being committed). He also considered that the employer did nothing to introduce the risk of the employee committing the act. Here, the employer had merely, through providing a uniform and warrant card, given their employee the opportunity to commit a tort.
On the other hand, it does appear almost impossible for the Catholic Church to escape vicarious liability in such cases. In Maga v Archbishop of Birmingham18, the claimant was sexually abused by a Roman Catholic priest. The claimant was not Catholic and had met the priest because he had been admiring the priest’s car. The priest had never attempted to get the claimant involved in church services and the claimant had only once attended the Church. Lord Neuberger considered vicarious liability attached on the grounds that (1) the priest was normally dressed in clerical garb and it was his employment that gave him authority; (2) the priest’s employment required him to evangelise; (3) the priest had responsibility for youth activity in the church and developed his relationship with the claimant at a church-organised function; (4) the claimant occasionally helped out (cleaning/ironing/etc) on church premises and several acts of abuse (including the first) occurred on church premises; and the role as a priest gave him the status and opportunity to draw the claimant into his sexually abusive orbit. Longmore LJ disagreed that the duty to evangelise was an important element, but agreed with Lord Neuberger’s finding. He held that the grooming of the claimant was only possible because of the position as a priest and laid importance on the fact that the archdiocese had a special concern for the vulnerable and oppressed.
On the face of it, it is difficult to distinguish the circumstances of N and Maga. Ultimately the difference appears to comes down to the fact that in Maga the Church was found to have materially increased the risk of the tort, whereas there was no such finding in N. However the factors that influenced the Courts to make such findings were almost identical; both the priest and the PC used their uniforms and positions of authority to gain advantage of and access to the vulnerable claimant. Whilst acts of abuse took place on the employer’s premises in Maga, the Church was also liable for those acts which took place at the priest’s home and in his car and this alone seems insufficient to justify the difference in finding. Although the police clearly did not owe the claimant a common law duty of care, it is difficult to see why the Catholic Church should have been found to owe a greater duty of care than the police; the police arguably do have a special concern for the vulnerable and oppressed (just as the Church was found to have) and the priest’s duty to evangelise was not acted upon and was not a unanimous part of the Court’s reasoning.
Various Claimants v Catholic Child Welfare Society19 has recently considered the issue again. Although both cases were cited in argument, only Maga was considered in the Court’s decision and there was no reference to the inconsistency between the cases. The case involved the serial sexual abuse of boys at a school/community home for vulnerable boys between 1958 and 1992. Lord Phillips gave the leading decision of the Supreme Court. Having found, despite the absence of an employment contract between the defendant and the abusers that there was a quasi-employment relationship between them, he went on to consider whether the abuse was within the scope of this relationship. He held:
“The precise criteria for imposing vicarious liability for sexual abuse are still in the course of refinement by judicial decision. … A common theme can be traced; it is imposed where D, whose relationship with the abuser put it in a position to use the abuser to carry on its business or to further its own interests, has done so in a manner which has created or significantly enhanced the risk that the victim or victims would suffer the relevant abuse.”
Creation of risk was a key test although, alone, it was not enough to impose vicarious liability.
The future of vicarious liability
In the last twelve months, historic sexual abuse cases have never been far from the headlines. There currently is potential for numerous cases involving employers in many different industries, notably the BBC, to be sued for their vicarious responsibility for these assaults and criminal acts. In the absence of any fault on the part of the employers themselves, there is potential for questions to be raised over vicarious liability which may well lead to consideration of the issue by the Government (particularly in light of their views on strict liability of employers in the context of health and safety20). In contrast to attitudes to health and safety, however, public opinion does not appear to be against such strict liability. Since Lister, now over 10 years old, there has been no statutory attempt to reverse the law.
In the absence of intervention, we are left with a situation considerably expanded, though with some limits21. The test is still in evolution and the exact considerations will continue to be looked at. Does the Court look to the creation of risk? Is it the existence of a duty of care owed by the employer to the wronged party? Or must the case simply involve a situation where the Courts, for policy reasons, consider it “fair, just and reasonable” to impose liability on an employer whose deep pockets (or whose insurer’s deep pockets) are perfectly capable of compensating the claimant who would otherwise receive nothing from the actual tortfeasor? As Ward LJ observed, the times clearly are a-changing; it remains to be seen how much further they will change or whether our current law will pause somewhat in its continued evolution over the next few years.
1[2012] EWCA Civ 938; [2013] Q.B. 722; [2013] 2 W.L.R. 958; [2012] 4 All E.R. 1152; [2013] P.T.S.R. 565; [2012] I.R.L.R. 846; [2012] P.I.Q.R. P19; Times, August 13, 2012, at p764
2 Boson v Sandford (1690) 2 Salk 440
3 Allen & Ors v The Chief Constable of the Hampshire Constabulary [2013] EWCA Civ 967, per Gross LJ at paragraph 15
4 Salmond, Law of Torts, 1907
5 1958 SC 514
6 Per Lord Guthrie
7 [1966] 1 QB 716
8 Lloyd v Grace, Smith & Co
9 [1987] ICR 949
10 [2011] IRLR 343
11 [2002] 1 AC 215
12 [1990] 2 AC 605
13 [2003] 1 AC 32
14 [1999] IRLR 98
15 Per Butler-Sloss LJ
16 (1999) 174 DLR (4th) 45
17 [2006] EWHC 3041 (QB)
18 [2010] 1 WLR 1441
19 [2012] UKSC 56, [2012] 3 W.L.R. 1319
20 See the Enterprise and Regulatory Reform Act 2013.
21 See, for example, Allen & Ors v The Chief Constable of the Hampshire Constabulary [2013] EWCA Civ 967
Thea Wilson
12 King's Bench Walk
Image ©iStockphoto.com/liveostockimages
Does the Thing Ever Speak for Itself in Medical Claims? - Dr Jock Mackenzie, Anthony Gold Solicitors

14//10/13. Two cases in the last year have again explored the concept of res ipsa loquitur, the Latin maxim literally meaning “the thing speaks for itself”, and its applicability in medical negligence cases.
The maxim first appears to have arisen in reported cases in Byrne v Boadle (1863) 9 LT 450, a case in which a barrel of flour from a warehouse hit the plaintiff as he was walking by. Its classic exposition was 4 years later in Scott v London and St. Katherine’s Docks (1865) 3 H. & C. 896, this time when a bag of sugar fell from a hoist on to the plaintiff below, and in which Erle CJ set out his explanation of the principle as follows (at p. 601):
“where the thing is shown to be under the management of the defendant or his servants, and the accident is such as in the ordinary course of things does not happen if those who have management use proper care, it affords reasonable evidence, in the absence of explanation by the defendants, that the accident arose from want of care”.
This concept subsequently was considered in medical negligence cases, the first of which was Cassidy v Ministry of Health [1951] 2 K.B. 343, in which a patient who went into hospital to be treated for two stiff fingers and who was discharged with a hand with useless function was entitled to an explanation by the hospital of how that could have happened absent any negligence. In that case, the inference of negligence was not successfully rebutted by the defendant (as per Denning LJ). A number of subsequent first instance medical cases and three Court of Appeal ones (Bull v Devon Area Health Authority (CA 2 February 1989; (1993) 4 Med LR 117); Delaney v Southmead Health Authority (CA 6 June 1992; (1995) 6 Med LR 355); and Fallows v Randle (CA 7 May 1996; (1997) 8 Med LR 160)) led up to the seminal case of Ratcliffe v Plymouth and Torbay Health Authority[1998] Lloyd’s L.R. Med. 162.
In this latter case, Hobhouse LJ set out a detailed analysis of the concept’s applicability and rather called into question its relevance in medical cases by observing at p. 177:
“Res ipsa loquitur is not a principle of law and it does not relate to or raise any presumption. It is merely a guide to help identify when a prima facie case is being made out. Where expert and factual evidence is being called on both sides at trial its usefulness will normally have been long since exhausted.”
More recently, the issue was again considered in Hussain v King Edward VII Hospital [2012] EWHC 3441 (QB), in which Eady J provided a helpful summary:
“11. There is no mystique about the doctrine of res ipsa loquitur. It does not represent a principle of law: nor can it be invoked as giving rise to a presumption of any kind. It is simply a conventional way of saying that the facts, as known to the claimant at the time he pleads his case, give rise in themselves to a prima facie case of negligence. This may or may not be upheld at trial, but at the pleading stage it has the effect of compelling the defendant to respond. Once the defendant has done so, the question will be whether the court has been satisfied in the light of all the evidence at trial that negligence and causation have been proved. Each case will depend upon its own facts. In the course of reaching a conclusion, the judge may or may not be prepared to draw the inference originally invited by the claimant. This was fully explained by the Court of Appeal in Ratcliffe v Plymouth & Torbay HA [1998] Lloyd’s Rep Med 162, 172-3 (Brooke LJ) and 174-7 (Hobhouse LJ).
12. Doubts have been expressed from time to time as to the utility of this doctrine in medical negligence cases, for example by Stuart-Smith LJ in Delaney v Southmead Hospital Authority [1995] 6 Med LR 355, at 359. He went on to point out that it would always be open to a defendant to put forward a possible explanation for what had occurred that was inconsistent with negligence. It would not be necessary to demonstrate such a causal explanation on the balance of probability – provided always that it was plausible. Furthermore, a defendant could seek to show that all reasonable care had been taken. This Defendant has sought to pursue both these lines of argument. One should never lose sight, however, of the simple fact that the burden of proof remains on the Claimant throughout: see e.g. Ratcliffe, cited above, at p.174. That is why a defendant is only required to show a plausible alternative explanation in order to rebut a prima facie case.”
He then helpfully went on to comment on the practical applicability of the maxim in medical cases:
“13. In practice, when it comes to medical negligence cases, a claimant is more often than not going to need to buttress his case by expert evidence to the effect that the circumstances relied upon as giving rise to a prima facie case would not ordinarily come about in the absence of negligence.”
In Hussain, Eady J held on the facts that the defendant had raised a plausible explanation such as to rebut any prima facie case of negligence; the maxim, therefore, did not apply; and the claimant failed.
In a subsequent even more recent case, this time in the Court of Appeal, Thomas v Curley [2013] EWCA Civ 117, the doctrine was again considered. In this case, during an uncomplicated laparoscopic cholecystectomy, damage to the claimant’s common bile duct had occurred. The particulars of negligence had asserted simply that the injury was sustained as a consequence of the defendant’s negligence in negligently causing injury to the claimant’s common bile duct. Additionally, in response to a Part 18 request, it was stated that: “The claimant will aver that the most likely explanation was that it was a diathermy injury; alternatively it was a traction injury. The Claimant will aver that whatever the mechanism, the injury was caused by the negligence of the first defendant. The Claimant will aver that iatrogenic bile duct injury is, in itself, evidence of negligence.”
As a matter of fact, the damage to the common bile duct had occurred away from the actual operation site of the cystic duct stump. The judge, Griffiths Williams J, concluded that the damage, which had probably been caused iatrogenically by the defendant surgeon, required a plausible explanation. However, neither the defendant’s expert nor anyone else could provide one. The defendant’s expert’s explanation would have been that the two clips on the short cystic duct stump had fallen off due to mechanical failure and had eroded through the cystic duct remnant as a result of ischaemic necrosis. However, this explanation could only be applicable if the injury had in fact been at the site of the operation, which it was not, so the likely explanation had to be one of want of care. The judge, therefore, determined that the claimant had proved her case on consideration of all of the evidence and found the surgeon negligent.
The surgeon appealed, primarily on the ground that the judge had erred in determining breach of duty on the basis only of the principle of res ipsa loquitur, i.e. the mere fact of damage to the common bile duct being evidence of negligence, when it was apparent that the claimant’s case failed to meet the requirements of the principle.
In giving the judgment of the Court of Appeal, Lloyd Jones LJ summarised the principle as describing:
“a situation in which it is possible for the court to draw an inference of negligence where a claimant has proved a result without proving any specific act or omission on the part of the defendant which has produced the result. If it is proved on the balance of probabilities that the result could not have happened without negligence and that the situation was under the control of the defendant, then it is open to the court to conclude that it is more likely than not that the result was caused by negligence. However, it is not appropriate to draw such an inference where there is evidence as to why or how the result occurred (Scott v London and St. Katherine’s Docks(1865) 3 H. & C. 896).”
Lloyd Jones LJ then dismissed the defendant’s appeal, concluding at para 33:
“The [claimant] had established that in this case, during an uncomplicated operation, injury was caused in an area other than that where the operation took place. That called for an explanation as to how that might have occurred in the absence of negligence. None was forthcoming from the defendant’s expert or from any other quarter. That is entirely consistent with the judge’s direction to himself that he should assess the weight of the evidence and decide whether negligence on the part of the appellant had been proved. This has nothing to do with the reversal of the burden of proof and nothing to do with res ipsa loquitur”.
However, the appeal court did acknowledge that it might be considered that there had been an application of the maxim in this case because the claimant’s expert appeared to be drawing a necessary inference of negligence from the mere fact of injury to the common bile duct. The court’s reasoning, though, for concluding it was not a res ipsa case was because the inference of negligence had not arisen from the mere fact of injury to the common bile duct during a cholecystectomy operation but, rather, from both the specific facts of this case and the defendant’s expert’s inability to explain how such damage could have been caused non-negligently.
Notwithstanding that the court expressly declined to draw any inference of negligence, it would appear that Thomas was a case in which res ipsa was in fact applicable, albeit perhaps in a more precise form than originally anticipated or which the court described: the claimant had succeeded in establishing that the fact of the injury (to the common bile duct) being at a particular location (away from the site of the operation) in an otherwise uncomplicated cholecystectomy was enough evidence to infer want of care by the surgeon in the absence of any plausible alternative explanation or evidence that there was no negligence by the surgeon; and the defendant had failed to demonstrate either.
On this basis, it may seem not unreasonable to consider that a claimant in the future with a similar injury in similar circumstances, however rare such a claimant might be, would nevertheless still be able to assert the maxim to force a defendant to explain plausibly the adverse outcome or run the risk of the court inferring negligence.
The case law has consistently sought to ensure that res ipsa loquitur means little more than that the fact of a particular result, in itself, may be enough evidence to enable the court, should it so wish, to infer negligence sufficient to impose liability in the absence of the defendant rebutting any such inference. The maxim is, therefore, best considered to be a rule of evidence rather than some principle of law. In practice, it usually takes its shape in the form of a submission by the claimant that the facts establish a prima facie case of negligence against the defendant, with the onus then being on the defendant to rebut such an inference by demonstrating that there is an alternative plausible explanation and/or that reasonable care was taken, with a failure to do so potentially resulting in the court inferring negligence.
It is apparent from Hussain and Thomas that the courts will be slow to ascribe their determination of a medical case to an inference of negligence, even when there might be the opportunity to do so, and claimants would, therefore, do well to be wary of too much reliance upon it. However, notwithstanding the courts’ desire to minimise its importance, the maxim does still remain a potentially useful weapon in a claimant’s armoury worth utilising in the right circumstances.
Dr Jock Mackenzie
Anthony Gold Solicitors
Image ©iStockphoto.com/STEFANOLUNARDI
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