Paul v The Royal Wolverhampton NHS Trust

Factual and Procedural Background

This case concerns an application by the Defendant to strike out the claims of the Second and Third Claimants on the basis that their statements of case disclose no reasonable grounds for bringing the claims or, alternatively, that the claims have no real prospects of success. The Second and Third Claimants seek damages as secondary victims for psychiatric injury allegedly caused by witnessing the death of their father, the primary victim, who suffered from multiple health issues including Type II diabetes and chronic kidney disease. The father was admitted to hospital on several occasions, with alleged failures in cardiac care in November 2012. He ultimately died suddenly in January 2014 after collapsing in the street while accompanied by his two daughters, the Second and Third Claimants. The claimants allege negligence in the hospital's failure to perform inpatient coronary angiography and subsequent treatment, which would have likely prevented the fatal event. The daughters witnessed their father's collapse and death, which forms the basis of their secondary victim claims for psychiatric injury.

Legal Issues Presented

1. Whether the claims of the Second and Third Claimants as secondary victims disclose reasonable grounds or have real prospects of success.
2. Whether the Second and Third Claimants satisfy the control mechanisms required to establish a duty of care for psychiatric injury as secondary victims, particularly the requirement of proximity in time and space to the relevant event or its immediate aftermath.
3. Whether the fatal collapse of the primary victim constitutes a relevant event for the purposes of establishing proximity under the principles governing secondary victim claims.
4. How established case law, including the application of the Alcock criteria and subsequent authorities, applies to clinical negligence cases involving negligent omissions and delayed manifestation of injury.

Arguments of the Parties

Defendant's Arguments

• The Second and Third Claimants cannot be classified as secondary victims because there is no relevant event and no sufficient proximity between the claimants and the alleged negligence.
• Reliance on the classic formulation of secondary victim claims from Alcock v Chief Constable of South Yorkshire Police, emphasizing the necessity of a duty owed directly to the claimant, reasonable foreseeability, and close proximity in time, space, and relationship.
• The fatal collapse witnessed by the claimants occurred approximately 14 months after the alleged negligent hospital care and cannot be considered the relevant event for proximity purposes.
• Reference to Taylor v Somerset Health Authority, where a claim based on witnessing a delayed death resulting from negligent omission was rejected due to lack of an immediate traumatic event.
• Distinction between legal proximity (duty of care) and physical proximity (closeness in time and space to the event), submitting that the claimants fail on both counts.
• Submission that the claims are bound to fail given the established authority and control mechanisms limiting secondary victim claims.

Claimants' Arguments

• The law on secondary victim claims is complex and evolving, and the court should not strike out the claims at this stage as they are not bound to fail.
• Clinical negligence cases involving negligent omissions and delayed injury manifestation require careful consideration distinct from conventional personal injury cases.
• The control mechanisms derived from Alcock apply, but their interpretation and application should consider whether the claimants were close in time and space to the incident and whether the collapse was sufficiently shocking.
• Distinction from Taylor v Somerset Health Authority on the facts, as in the present case the claimants witnessed the collapse itself, not merely the aftermath.
• Reference to Sion v Hampstead Health Authority recognizing that nervous shock can arise from negligent incidents without violence or suddenness, if the claimant experiences a sudden and unexpected shock.
• Reliance on W v Essex County Council to argue that categories of secondary victims are not closed and flexibility is needed in assessing temporal and spatial limitations.
• Use of North Glamorgan NHS Trust v Walters to support the proposition that negligent omission cases with delayed manifestation can constitute a single horrifying event with sufficient proximity.
• Argument that the defendant's interpretation of authority would preclude recovery in negligent omission cases, which is incorrect.
• Submission that the matter should proceed to trial due to the complexity and lack of clarity in the application of secondary victim criteria in clinical negligence cases.

Table of Precedents Cited

Precedent	Rule or Principle Cited For	Application by the Court
Alcock v Chief Constable of South Yorkshire Police [1992] 1 AC 310	Established control mechanisms for secondary victim claims including proximity, relationship, foreseeability, and sudden shock.	Used as the foundational framework to assess whether the claimants meet criteria for secondary victim claims.
Farah v British Airways [1999]	Equivalence of tests under CPR r 3 and CPR r 24 for striking out claims.	Applied to determine the test for whether claims disclose reasonable grounds or have real prospects of success.
Page v Smith [1996] AC 155	Foreseeability of psychiatric injury and requirement of recognized psychiatric illness.	Referenced in establishing foreseeability and injury requirements for psychiatric harm claims.
McLoughlin v O'Brian [1983] AC 410	Extension of secondary victim claims to immediate aftermath and direct perception of the event.	Used to emphasize requirement that psychiatric injury must result from direct witnessing or immediate aftermath.
Taylor v Somerset Health Authority [1993] 4 Med LR 34	Rejected secondary victim claim where death was delayed consequence of negligent omission and claimant did not witness collapse.	Key authority supporting the Defendant's submission that the claimants' case is bound to fail for lack of relevant event and proximity.
Taylor v A Novo (UK) Ltd. [2014] QB 150	Clarified distinction between legal and physical proximity and confirmed limits on secondary victim claims.	Applied to reinforce that the relevant event must be proximate in time and space and not a later consequence.
Sion v Hampstead Health Authority [1994] 5 Med LR 170	Discussed application of Alcock principles to negligent omission cases and recognized nervous shock from sudden awareness.	Supported the Claimants' argument that negligent omission cases can give rise to secondary victim claims if sudden shock is established.
W v Essex County Council [2001] 2 AC 592	Confirmed that categories of secondary victims are not closed and flexibility is required in assessing claims.	Used to argue for a flexible approach to temporal and spatial limitations in secondary victim claims.
North Glamorgan NHS Trust v Walters [2002] EWCA Civ 1792	Recognized a negligent omission case with delayed manifestation as a single horrifying event over time.	Relied upon by Claimants to support that negligent omission cases can satisfy proximity requirements if viewed as a continuous event.
Galli-Atkinson v Seghal [2003] EWCA Civ 697	Clarified that the event or its immediate aftermath may encompass multiple components retaining sufficient proximity.	Supported Claimants' submission on the interpretation of event and aftermath in secondary victim claims.
Frost (House of Lords, cited in Taylor v A Novo)	Recognized the arbitrary and unsatisfactory nature of secondary victim law and the need for strict control mechanisms.	Quoted by the court to emphasize policy reasons for confining secondary victim claims.
Caparo v Dickman [1990] 2 AC 605	Defined legal proximity as a necessary ingredient for duty of care in negligence.	Applied to distinguish legal proximity from physical proximity in the context of secondary victim claims.
Liverpool Women's Hospital NHS Foundation Trust v Ronayne [2015] PIQR P20	Clarified that shock must be horrifying, sudden, and exceptional in secondary victim claims.	Used to underline requirements for psychiatric injury causation in this case.

Court's Reasoning and Analysis

The court began by acknowledging the factual allegations as presented by the claimants and accepted for the purpose of this application. It recognized the tragic circumstances in which the Second and Third Claimants witnessed their father's collapse and death. However, the court emphasized that sympathy cannot override established legal principles. The court reiterated the strict control mechanisms governing secondary victim claims, particularly the requirement of proximity in time and space to the relevant event or its immediate aftermath.

The court accepted the parties' agreement that the tests under CPR r 3 and CPR r 24 are effectively the same, requiring that the claims be bound to fail to justify striking out.

The court reviewed the Defendant’s reliance on Taylor v Somerset Health Authority and related authorities, which establish that a delayed death resulting from negligent omission does not constitute a relevant event for proximity purposes if the claimant did not witness the collapse or immediate event. The court found the facts of the present case indistinguishable from Taylor, noting that the claimants witnessed the fatal collapse but not the earlier negligent hospital events alleged to have caused it.

The court considered the Claimants’ submissions regarding the evolving nature of secondary victim law and the applicability of cases such as Sion, Walters, and Galli-Atkinson, which allow for a broader interpretation of events and immediate aftermath in negligent omission cases. Despite these arguments, the court concluded that the established control mechanisms apply uniformly and that clinical negligence cases do not invoke different principles.

The court rejected the Claimants’ argument that the collapse constituted a seamless event connected to the hospital negligence, emphasizing that the fatal collapse occurred 14 months after the alleged negligence and in a different context, lacking the required proximity.

In light of the binding precedents and policy considerations articulated in authorities such as Frost, the court held that extending liability beyond the established limits is a matter for Parliament, not the judiciary.

Consequently, the court found that the claims of the Second and Third Claimants as secondary victims are bound to fail due to the absence of the requisite proximity, and that the fatal collapse cannot be treated as the relevant event for establishing a duty of care.

Holding and Implications

The court GRANTED the Defendant's application to strike out the secondary victim claims of the Second and Third Claimants on the grounds that the claims disclose no reasonable grounds and have no real prospects of success.

The direct effect of this decision is that the psychiatric injury claims of the Second and Third Claimants arising from witnessing their father's death are dismissed. However, the claimants retain their claims for loss of dependency under the Fatal Accidents Act 1976. The court clarified that no new legal precedent was created, reaffirming the existing strict control mechanisms governing secondary victim claims and emphasizing that any extension of liability must come from legislative reform rather than judicial development.