Clinical Negligence & Healthcare
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Sarah Simcock acted for the London Ambulance Service in the 8 inquests into the deaths as a result of the London Bridge and Borough Market terror attacks
experience & expertise
Sarah undertakes clinical negligence claims, acting for both claimants and defendants. She regularly appears in cases in the High Court and county courts, drafts statements of case and advises in claims involving doctors, dentists and professionals from other related fields. Sarah’s recent experience involves a number of cases involving issues of consent as well as surgical negligence in particular in general abdominal and gynaecological cases. Sarah also often deals with cases involving a primary care setting and allegations of failures or delays in diagnosis of serious conditions.
Sarah also has extensive experience of clinical negligence claims for the MOD and in a prison healthcare context including in relation to fatalities. These cases have involved not only allegations in relation to the actions of individuals but also in relation to the workings of the system and the application of guidance, policies and training.
Sarah also has experience acting for the emergency medical services such as ambulance services in negligence claims. Often in these claims the nature, quality and speed of the emergency response are in issue and policy and resources are highly relevant, as well as involving allegations against individuals. Often issues of causation are important in this context.
Sarah has an extensive Court of Protection practice and her experience in medical treatment cases includes urgent applications for life saving medical treatment and non-urgent medical treatment such as for HIV, dental surgery and chronic physical conditions. She also has experience of “end of life” withdrawal of medical treatment and issues arising in relation to the validity and interpretation of advanced directives. Sarah regularly deals with cases involving a deprivation of liberty and use of force to provide medical treatment. Many of Sarah’s cases have involved the interaction between the Mental Health Act 1983 and the Mental Capacity Act 2005 as well as issues of public law.
Sarah frequently acts in welfare cases in the Court of protection in applications relating to best interests in relation to residence and social, nursing or medical care. These cases have involved the removal of elderly clients into institutional care or their return home from residential care, DNR decisions and residence and contact disputes as well as issues surrounding forced marriage. Sarah has also advised in cases involving allegations of serious sexual assault against adults lacking capacity by family members. Challenges to standard authorisations of a deprivation of liberty regularly arise in Sarah’s cases involving whether residential placements involve a lawful deprivation of liberty or are too restrictive in their nature and whether alternative residential or care options should be explored.
Sarah undertakes disclosure applications in the High Court and crown courts in cases which have a medical aspect and often deals with issues of public interest immunity, confidentiality and data protection. She also acts in applications for injunctions including cases involving the Protection from Harassment Act 1997.
Sarah acted for the London Ambulance Service in the 8 inquests in relation to the victims who were killed in the terror attack that took place on London Bridge and in Borough Market on 3 June 2017. The London Ambulance Service, provided care and treatment at the scene to some of the deceased as well as the other victims of the attacks. The Coroner conducted a wide-ranging inquiry into how the deceased came by their deaths as well as the overall response of the emergency services, including the LAS, to the attack. The Chief Coroner, HHJ Lucraft QC, recorded determinations of unlawful killings in relation to each deceased along with narrative conclusions that reflected that the injuries of those who died were unsurvivable. The Chief Coroner will consider whether to make a report to prevent future deaths in relation to potential improvements which could be made to systems and procedures to ensure the emergency response to such complex incidents is as effective as possible in the future.
Sarah also acted for the London Ambulance Service in the 7th July 2005 London Bombings Inquest. This inquest comprised a wide-ranging inquiry into individual deaths, in particular the issue of survivability, whether those who were injured by the bomb blasts, but did not die immediately, could have been saved, perhaps by different or more timely action by the emergency services. Hallett LJ, sitting as coroner, came to conclusions that in all those cases where the person had succumbed to their injuries nothing could have been done to save them. Hallett LJ also made an in depth inquiry into the quality and nature of the emergency response generally with a view to making recommendations to prevent future deaths.
Sarah often represents families, NHS Trusts, private healthcare bodies and individual clinicians in inquests involving medical deaths both in relation to hospital care and primary care in the community. These involve a wide variety of issues including surgical deaths and deaths from infective processes such a c-diff or MRSA or as a result of drugs prescriptions or failure or delay in diagnosis of life threatening conditions.
Sarah has particular expertise in representing bodies who provide healthcare services in prisons as well as individual medical professionals such as prison GP’s. These inquests usually involve not only inquiry into the actions of individuals but also in relation to the workings of the system and the application of guidance, policies and training. Sarah is often involved in Art 2 inquests resulting from a death of a person detained in a psychiatric institution. These inquests highlight the cross-over between a custodial and a medical context and Sarah’s practice in both the police and clinical negligence and health care fields is an asset in this regard.
Sarah also regularly advises on judicial review of coroners’ decisions and on complex issues of disclosure and public interest immunity.
Sarah also acts in public inquiries and appeared in the Baha Mousa Inquiry into the death of an Iraqi detained by British troops representing a group of 15 individual soldiers who were in conflict with other witnesses in the inquiry due to allegations of assault or mistreatment of detainees amounting to torture made against them or because they themselves had made such allegations against others. The group also comprised an army medic who was alleged to have been complicit with others in mistreatment of detainees contrary to his medical duties.
cases & work of note
- Inquests arising from the deaths in the London Bridge and Borough Market terror attack 
Acting for the London Ambulance Service. The inquest concerned eight victims who were killed in the attack that took place on London Bridge and in Borough Market on 3 June 2017. The London Ambulance Service, provided care and treatment at the scene to some of the deceased as well as the other victims of the attacks. The Coroner conducted a wide-ranging inquiry into how the deceased came by their deaths as well as the overall response of the emergency services, including the LAS, to the attack. The Chief Coroner, HHJ Lucraft QC, recorded determinations of unlawful killings in relation to each deceased along with narrative conclusions that reflected that the injuries of those who died were unsurvivable. The Chief Coroner will consider whether to make a report to prevent future deaths in relation to potential improvements which could be made to systems and procedures to ensure the emergency response to such complex incidents is as effective as possible in the future.
- Inquest into the death of Michael Uriely 
Representing a Consultant Paediatrician in the inquest into the death of a nine year old boy who from asthma and pneumothorax. He had seen Michael privately on three occasions in the seven months prior to his death. Michael had a history of asthma which was poorly controlled and prone to periods of acute exacerbation. Despite being treated by an NHS and private GP, Consultant Paediatrician and having had a hospital admission shortly before his death he died following an acute deterioration in his condition. The inquest examined the actions of all the health professionals involved as to whether there was any contribution to the death as well as systemic aspects of the treatment of asthma in this case in the NHS and private sphere. The Coroner found that medication changes advised by the private Paediatrician in the months prior to the death were reasonable. A narrative conclusion recording that Michael was inadequately treated in his last hospital admission was recorded. The Coroner has written a “Prevention of Future Deaths” report to NICE.
Clicke here, here and here for press coverage
- Inquest into the death of Michael Bence-Lyons 
Acting for the NHS Hospital Trust in the inquest into the death of a 60 year old man from pulmonary embolism and deep vein thrombosis following surgery to repair a tendon in his knee. Mr Bence-Lyons had been discharged home without any compression stockings and with no continuing prescription for anti-coagulant medication. Whilst the Coroner found that he should have had compression stockings, there had been no indication for continuing medication as he was partially weight bearing on leaving the hospital. The Coroner therefore found that there was no basis for a finding of neglect against the hospital.
- Inquest into the death of Frankie White 
Representing the family of a premature baby who died at four days old from group B streptococcus (GBS) septicaemia. There had been a failure to appreciate risk factors for GBS which were present and as a result a failure to do a full sepsis screen and immediately administer intravenous antibiotics to Frankie at the appropriate time. The Coroner found that the delay in administering antibiotics led to the Frankie’s death and had they been given when they should have on the balance of probabilities he would have survived. The NHS Trust issued a formal apology to the family in respect of this failure in their care of Frankie.
- JS v NHS Trust 
Advising and representing hospital in case of alleged surgical negligence in perforation of small bowel and further failure to identify the injury intra-operatively. Issues of consent to treatment also arise.
- AH v NHS Foundation Trust 
Advising and drafting pleadings for the Claimant in case of alleged surgical negligence in spinal surgery in failing to adequately decompress nerve resulting in the necessity for further surgeries and permanent damage
- SD v GP 
Advising Claimant and drafting letter of claim in case involving the delayed diagnosis of an ectopic pregnancy
- EF v Surgeon 
Advising Defendant in claim involving surgical negligence causing vessel damage and hysterectomy
- SW 
Representing a young woman with a learning disability in Court of Protection proceedings concerning her capacity to consent to sexual relations and marriage, as well as contact with men including her fiancé. Complicated evidential issues arose in relation to the capacity evidence in this case, the expert psychiatrist having given her opinion that SW retained capacity in relation to decisions about sexual relations but not contact or marriage. As a result the proceedings also concerned best interests decisions in relation to these issues.
- CT 
Acting for elderly man with dementia by the Official Solicitor in welfare application in the Court of Protection to determine where it was in his best interests to reside and what care package was appropriate. The Local Authority were initially of the view that he should remain in residential care, but following extensive consideration between the parties of the options, the court approved the agreement of a trial return home in accordance with his wishes.
- AB and CD 
Representing elderly couple by the Official Solicitor in a welfare application in the Court of Protection who were resident in a care home in the presence of a dispute amongst family members in relation to where they should live and the nature of their care.
- JB 
Representing care home resident with dementia by the Official Solicitor in application by her to challenge the standard authorisation of her deprivation of liberty at the care home. She had been taken into residential care temporarily due to her home becoming uninhabitable but there had thereafter been no proper efforts to return her home in accordance with her wishes. The Court of Protection approved a care package allowing her to return home.
- HS 
Representing Polish man in welfare application in the Court of Protection in relation to residence and care best interests issues. HS was resident in a neurological rehabilitation unit and deprived of his liberty there. He remained there despite the fact that there was no further medical progress to be gained and agreement by the parties he should be discharged to residential care. However he wished to return home to Poland and there were questions as to whether this was possible and what interim measures in the UK were suitable.
- LB 
Representing young woman living in supported accommodation by the Official Solicitor in Court of Protection proceedings relating to a dispute between the family and local authority surrounding the care package provided in particular concerning whether it was the least restrictive option in various respects. Following a round table meeting the issues were narrowed by the parties such that the court was then able to make an order approving the final care plan.
- AL 
Representing an elderly woman with a learning disability and dementia by the Official Solicitor in Court of Protection proceedings in relation to a dispute over best interests as to residence between the family and clinical commissioning group. AL had lived with her sister for her whole life but had recently been taken into residential care due to concerns for her well-being and safety. The CCG were of the view she should remain there whilst her sister wished to continue to care for her at home.
- GA 
Representing NHS and Social Care Trust in Court of Protection proceedings as to the best interests of patient in relation to where he lives and what care he receives. GA had been living in the community but his physical and mental condition had deteriorated through disengagement with health and social services to such a degree that he was hospitalised. The Court was then concerned with where he should live upon his discharge from hospital and in trying to prevent any similar crisis in the future.
- OM 
Representing the clinical commissioning group responsible for commissioning accommodation and care for young man from Isle of Wight with learning disabilities and physical health problems. A crisis situation had arisen resulting in an urgent application to the Court of Protection when he had refused to leave his grandmother’s house to return to his residential care unit following a visit. A dispute arose as to his best interests in relation to where he should live pending more permanent and suitable accommodation being found for him on the Isle of Wight.
- TD 
Advising NHS Trust in relation to potential Court of Protection proceedings in relation to the medical treatment of a patient detained under the Mental Health Act and lacking capacity to make decisions concerning medical treatment for both physical and mental health conditions. The patient had a diagnosis of schizoaffective disorder and was HIV positive but due to delusional beliefs periodically refused testing to monitor her physical condition and treatment for HIV. Sarah advised on whether proceedings needed to be instituted, procedures to be followed and on obtaining necessary evidence.
- EL v NHS Trust 
Advising and drafting defence in claim of obstetric negligence in failing to recognise a placental abruption in woman in labour
- Inquest into death of Leah Styles 
Representing private psychiatric hospital in Art. 2 jury inquest into death of detained psychiatric patient by hanging. In depth inquiry was undertaken into the assessment of risk and its appropriateness and the causal consequences of those assessments.
- Inquest into death of Linda McArthur 
Representing NHS Trust in inquest of patient due to a pulmonary embolus. Medical factual issues arose as to the extent of investigation and recognition of the PE and application of policies and guidance within this context.
- Inquest into death of John Hay 
Art 2 jury inquest into accidental drug related death of prisoner representing Prison GP. Complex issues arose as to standards of care in the prescription of methadone programmes on initial reception into prison and in relation to the mechanism of cause of death in this case.
- Inquest into death of Malgorzata Doniec 
Acting for NHS Trust in maternal death as a result of dural puncture during epidural injection. The coroner investigated issues of individual actions of medical professionals as well as systemic issues which resulted in a delay in CT brain scanning. The issue of neglect arose and hypothetical issues of causation were particularly significant in this case where the initial puncture of the dura was not the subject of criticism.
- Inquest into death of Samantha Samson 
Acting for NHS Trust in inquest into 2 year old’s death due to multiple complex medical problems at Great Ormond Street Hospital. Due to the complicated inter-relating nature of her medical conditions the medical and pathological evidence as to cause of death was difficult to disentangle in this case.
- Inquest into death of Thi Hien Tran 
Inquest into death of prisoner on anti-coagulants from brain haemorrhage representing prison health care services. Difficult issues arose as to the standards of care to be expected within a prison setting and there was also some complicated expert medical evidence relating to cause of death.
- Inquest into death of Adrian Johnson 
Art 2 jury inquest into death of prisoner by hanging representing health care services in prison
- Overton v Hughes 
Representing a GP in application in High Court for injunction under Protection from Harassment Act as a result of former patient harassing him, his staff and family members including leafleting the GP surgery.
- Inquest into the death of Alina Sarag 
Inquest into death of a teenager related to tuberculosis representing a GP who saw her prior to her death. The medical evidence in this case was complex as the presentation of Ms Sarag’s TB was atypical and the causation of her death was complicated.
- 52 inquests into 7/7 London bombings 
Acting for the London Ambulance Service. This inquest comprised a wide-ranging inquiry into individual deaths, in particular the issue of survivability, whether those who were injured by the bomb blasts, but did not die immediately, could have been saved, perhaps by different or more timely action by the emergency services. Hallett LJ, sitting as coroner, came to conclusions that in all those cases where the person had succumbed to their injuries nothing could have been done to save them. Hallett LJ also made an in depth inquiry into the quality and nature of the emergency response generally with a view to making recommendations to prevent future deaths. http://7julyinquests.independent.gov.uk/
- Baha Mousa Public Inquiry 
Junior counsel acting for team of soldiers in this public inquiry into the death of an Iraqi detained by British troops. The group comprised 15 individual soldiers who were in conflict with other witnesses in the inquiry due to allegations of assault or mistreatment of detainees amounting to torture made against them or because they themselves had made such allegations against others. The group also comprised an army lawyer who had been alleged to have expressly sanctioned in legal advice the use of ‘stress positions’ on detainees and also an army medic who was alleged to have been complicit with others in mistreatment of detainees contrary to his medical duties.