UK Healthcare Law Blog

Major new decision on Montgomery and causation in Birth Injury Cases

CNZ v. Royal Bath Hospitals NHS FT and SoS for Health and Social Care, 11 January 2023 (here)

    1. Mr Justice Ritchie has given judgment for the claimant in a historic CP case which has significant implications both for Montgomery and material contribution causation in clinical negligence cases, particularly those involving acute profound hypoxic ischaemia. The Claimant, a second twin, was born in 1996. She has profound disabilities as a result of about 16 minutes’ acute profound hypoxia.
    2. In summary:
      • Montgomery applied in 1996;
      • Montgomery applies to both antenatal consultations and decisions made intrapartum in the delivery room/ operating theatre;
      • Elective caesarean section was a ‘reasonable alternative treatment’ for twins in 1996 even where this was ‘not standard management’;
      • acute profound hypoxic ischaemia is a ‘divisible injury’ to which material contribution applies;
      • it is not possible to divide the functional outcome which would result from a shorter insult, so a claimant is entitled to damages in respect of 100% of her injury even if she would have suffered some injury in any event;
      • in an acute profound hypoxic ischaemia case, ‘every minute counts’.

Click here to read the full blog post by John de Bono KC.


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