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Duty of Care at A & E

Darnley v Croydon Health Services NHS Trust (2018)

This case examines the duty of care owed to patients by non-medically qualified staff at an A & E Department.

The Claimant, a 26 year old man, had been assaulted and attended at the A & E Department at the Mayday Hospital in Croydon.  He told the receptionist that he had suffered a head injury and was feeling unwell.  He was told he would have to wait up to 4 to 5 hours before someone examined him.  He told the receptionist that he could not wait that long as he was close to collapse.  He was told that if he did collapse he would be treated as an emergency.  He left the department.

He was not told by the receptionist that he would be seen by a triage nurse within 30 minutes. 

Following a deterioration in his condition he was taken by ambulance back to the hospital and a CT scan identified a large extradural haematoma.  Although he underwent surgery, he suffered permanent brain damage in the form of a severe left hemiplegia.  It was later found that if he had suffered a collapse whilst at the Mayday Hospital, he would have been treated immediately and made a very near full recovery. 

The Claimant brought proceedings against the Defendant hospital.  However, the trial Judge decided as a matter of law it would not be fair, just and reasonable to impose liability upon the Defendant for harm arising as a result of failure by the reception staff to inform the Claimant of the likely waiting time to be seen by a triage nurse.  The Claimant’s appeal was dismissed and the case came before the Supreme Court. 

The duty of care owed by the hospital for non-medically qualified staff was examined.  It was found that the Defendant had charged its non-medically qualified staff with the role of being the first point of contact with persons seeking medical assistance and, as a result, with responsibility for providing accurate information as to its availability.  A receptionist in an A & E Department could not of course be expected to give medical advice or information but he or she could be expected to take reasonable care not to provide misleading advice as to the availability of medical assistance.  The receptionists on duty were both aware of the standard procedure and that anyone complaining of a head injury would be seen by a triage nurse.  They also accepted that the usual practice was such that  a patient would be told that they would be seen by a triage nurse within 30 minutes of arrival or as soon as possible.  Accordingly, the hospital was found liable. 

This case is important as this extends the liability of a Hospital Trust to the actions of unqualified staff when advising patients in certain circumstances.

For further information about clinical negligence or personal injury claims, please contact Jon Wilson.