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Victory for Claimant in 16-day clinical negligence trial - Coakley v Rosie
The case concerned a GP’s failure to suspect or recognise a meningococcal rash and to administer penicillin. In January 2008 the Claimant, aged 42 years old, attended the GP complaining of a rash, headache and a nine-day prodromal illness. The GP concluded she was suffering from a respiratory infection and recommended bed rest. She misdiagnosed the rash as being an allergic reaction to Lemsip Max. The Claimant returned home and fell into unconsciousness. After being found by her husband, penicillin was administered by paramedics around five and half hours after the consultation at the GP’s surgery, by which time the disease had progressed and the Claimant suffered severe neurological injury as a result of meningitis.
The Claimant was in a coma for three weeks and as a result of the infection, she suffered total loss of sight and substantial loss of hearing, requiring a cochlear implant.
The case was defended both in terms of breach of duty and causation and during the course of the trial, the court heard evidence from eleven medical experts across six scientific disciplines.
The Defendant’s case on causation was that the disease process was so rapidly progressive that the dye was cast at the time of the Claimant’s consultation at the GP’s surgery and the earlier administration of antibiotics would not have altered the outcome. Further, the Defendant argued that the damage sustained by the Claimant, specifically damage to her vision and hearing but preservation of her higher neurological function, was so unusual that it placed her outside the recognised medical literature.
The Claimant argued that, but for the Defendant’s breach of duty, the Claimant would have received penicillin at the GP’s surgery which would have halted the exponential growth of the Neisseria meningitidis bacteria and prevented the Claimant’s injuries. In the alternative, the Claimant argued that Bailey v Ministry of Defence  1 W.L.R 1052 applied as the delay in treatment had made a material contribution to the damage suffered by the Claimant. The Claimant relied on established medical literature on the effects of the early administration of antibiotics, such as the Aronin et al paper, to refute the Defendant’s assertion that the administration of penicillin around five and half hours earlier would not have altered the outcome.
The judge found for the Claimant on both breach of duty and causation, preferring the Claimant’s medical experts. He found that the Defendant had not examined the Claimant properly and failed to properly exclude a diagnosis of bacterial meningitis. In relation to causation, the judge held that the Claimant had succeeded on the “but for test” on causation. However, he also held that an argument based on Bailey also would have also succeeded.
During the trial, the parties agreed quantum which was settled on a confidential basis.
His Honour Judge Oliver-Jones QC, sitting as a judge of the High Court, handed down his judgment on 4th June 2014, which can be downloaded from here