Meadows v Khan

Factual and Procedural Background

This is a claim brought by the Plaintiff for additional costs incurred in raising her son, who suffers from both haemophilia and autism. It is admitted that but for the Defendant's negligence, the child would not have been born because the Plaintiff would have terminated the pregnancy upon discovering the haemophilia diagnosis during pregnancy. The parties agree that the Plaintiff can recover costs related to haemophilia, but dispute whether costs related to the unrelated autism condition are recoverable. The Defendant contends liability is limited to haemophilia-related costs, as the medical service was only concerned with that risk. The Plaintiff argues damages should cover all additional disability-related costs arising from the pregnancy continuation, based on established wrongful birth principles.

The central legal issue concerns whether a mother who sought medical advice to avoid the birth of a child with a particular disability can recover damages for costs associated with an unrelated disability.

All other issues were resolved by agreement, enabling the court to consider legal submissions on an agreed factual background without oral evidence. Judgment had been entered for damages to be assessed, with quantum agreed subject to the court’s determination of the key legal issue. The agreed damages would be £9,000,000 if both conditions’ costs are recoverable, or £1,400,000 if only haemophilia-related costs are recoverable.

The relevant facts include the following: The Plaintiff, aged 40, is mother to the child born in 2011. She sought to avoid having a child with haemophilia after a family member was diagnosed. In 2006, she consulted a general practitioner (GP) to determine if she was a carrier of the haemophilia gene. Blood tests were arranged but did not detect carrier status, which required specialist genetic testing. The Plaintiff was told the results were normal and was led to believe any child would not have haemophilia. In 2010 she became pregnant; the child was born with severe haemophilia and later diagnosed with autism, which was unrelated to haemophilia. The haemophilia has caused significant medical complications, and the autism complicates treatment and prognosis. The autism is congenital and was a natural, foreseeable consequence of the pregnancy, though unrelated causally to haemophilia.

Legal Issues Presented

1. Whether a mother who consulted a doctor to avoid the birth of a child with a particular disability can recover damages for additional costs associated with an unrelated disability.

Arguments of the Parties

Plaintiff's Arguments

• The Defendant is liable for all consequences of the pregnancy continuation caused by negligence, except those excluded by law such as costs of raising a healthy child.
• Based on precedents, costs related to disabilities arising from normal pregnancy incidents are recoverable, including congenital conditions like autism.
• No rational distinction exists between a mother wanting to avoid any pregnancy and one wanting to avoid a pregnancy with a particular disability; liability should cover all disability-related costs.

Defendant's Arguments

• There is a material distinction between avoiding any pregnancy and avoiding a specific disability; the Defendant’s duty was limited to haemophilia-related risks only.
• The additional losses from autism fall outside the scope of the duty owed and the assumption of responsibility.
• Applying the SAAMCO principle, liability should be limited to the consequences of the inaccurate information provided, i.e., haemophilia, not unrelated risks.
• It would not be fair, just, or reasonable to transfer risks from the parent to the doctor for unrelated disabilities.
• The case differs from previous wrongful birth claims because it involves an unrelated disability arising despite the consultation being limited to one condition.

Table of Precedents Cited

Court's Reasoning and Analysis

The court began by accepting the established principle that but for the Defendant’s negligence, the pregnancy would have been terminated, and the child with combined haemophilia and autism would not have been born. The autism was congenital and a foreseeable natural consequence of the pregnancy, though unrelated causally to haemophilia. The court rejected the Defendant’s argument that liability should be limited to haemophilia-related costs under the SAAMCO principle, which limits liability to losses within the scope of the duty.

The court found the analogy with the mountaineer’s knee in SAAMCO inapt because, unlike the mountaineer’s injury which was unrelated to the negligent advice, the autism arose from the same pregnancy that continued due to the negligence. The continuation of the pregnancy was the critical causal link.

The court considered the purpose of the Defendant’s duty was to provide information enabling the Plaintiff to decide whether to terminate a pregnancy afflicted by haemophilia. The birth and all its consequences, including the autism, flowed from the continuation of that pregnancy. It was therefore fair, just, and reasonable to hold the Defendant liable for all consequences of that pregnancy continuing.

The court noted that previous cases (Parkinson and Groom) allowed recovery for costs associated with disabilities unrelated directly to the negligence but arising from the pregnancy continued due to negligence. It saw no principled basis to distinguish this case from those precedents.

The court also rejected the Defendant’s suggestion that imposing liability here would lead to unfair burdens on doctors or open floodgates to claims, observing that the coexistence of two disabilities is rare and the case-specific circumstances limit broader implications.

Regarding the Defendant’s initial acceptance that pregnancy-related costs were recoverable, the court found this consistent with its reasoning and rejected the Defendant’s later attempt to limit recoverability.

Finally, the court acknowledged the difficulty in drawing precise lines in causation and loss but emphasized the importance of consistent application of established wrongful birth principles without arbitrary distinctions based on the underlying reason for pregnancy termination.

Holding and Implications

The court HELD that the Plaintiff is entitled to recover damages for the additional costs associated with both haemophilia and autism. The scope of the Defendant’s duty extended to all consequences of the pregnancy continued due to negligent advice, including unrelated congenital disabilities arising naturally from that pregnancy.

The damages will be assessed in the agreed sum of £9,000,000.

The decision affirms and applies established wrongful birth principles as set out in Parkinson and Groom, rejecting attempts to limit liability by distinguishing types of disabilities or reasons for seeking medical advice. The ruling does not establish new precedent but confirms that liability for wrongful birth damages includes all disability-related consequences of the pregnancy continued due to negligence, even if some disabilities were unrelated to the original risk about which advice was sought.