I have to say of Dr. Dinwiddie also, that he displayed what seemed to me to be a profound knowledge of paediatric respiratory medicine, coupled with impartiality, and there is no doubt, in my view, of the genuineness of his opinion that intubation was not indicated." I have no doubt that, in the generality of cases, the proposition of law is correct but equally have no doubt that the judge in the circumstances of the present case was not guilty of any self-misdirection. Bolitho v City and Hackney Health Authority  4 All ER 771: A two-year old boy suffered brain damage as a result of the bronchial air passages becoming blocked leading to cardiac arrest. City and Hackney Health Authority continued (back to preceding text) Where, as in the present case, a breach of a duty of care is proved or admitted, the burden still lies on the plaintiff to prove that such breach caused the injury suffered: Bonnington Castings Ltd. v. Wardlaw  A.C. 613; Wilsher v. 634, 639: ". He treats the judge as having only asked himself one question, namely, the second question. As to the first of those issues, Dr. Horn's evidence was that, had she come to see Patrick at 2 p.m., she would not have arranged for him to be intubated. To the extent that the Lord Justice noticed the first question--would Dr. Horn have intubated?--he said that the judge was wrong to accept Dr. Horn's evidence that she would not have intubated. It was agreed that the only course of action to prevent the damage was to have the boy intubated. He had not slept well and had been restless; further he seemed to be having increasing difficulty in breathing and was wheezier. He has subsequently died and these proceedings have been continued by his mother as administratrix of his estate. Later, at p. 588, he referred to "a standard of practice recognised as proper by a competent reasonable body of opinion." Buchanan, Alec. AVMA Medical & Legal Journal 1999 5: 1, 17-20 Download Citation. Although he retained his colour he became a little agitated and began to cry. Dr. Rodger did not attend Patrick after the second episode. The judge identified the questions he had to answer as follows: "[Mr. Owen, for the defendants] submitted therefore that (if once it was held that Dr. Horn was negligent in failing to attend at either 12.40 p.m. or 2 p.m) the sole issue was whether Patrick would on one or other of these occasions have been intubated. . He was very white in colour. In a case of non-attendance by a doctor, there may be cases in which there is a doubt as to which doctor would have attended if the duty had been fulfilled. Sister Sallabank also heard the buzzer and sent out a call for the cardiac arrest team. Bolitho v City and Hackney Health Authority House of Lords Citations :  AC 232;  3 WLR 1151;  4 All ER 771;  PIQR P10;  Lloydâs Rep Med 26; (1998) 39 BMLR 1. what would have happened? LORD BROWNE-WILKINSON. Bolam sets out that a doctor is not negligent if they have acted in accordance with a responsible body of â¦ (Emphasis added.) * Enter a valid Journal (must Although the judge does not in turn say so, it was implicit in his judgment that he accepted that Dr. Dinwiddie's view was a reasonable view for a doctor to hold. Creating a unique profile web page containing interviews, posts, articles, as well as the cases you have appeared in, greatly enhances your digital presence on search engines such Google and Bing, resulting in increased client interest. In the Bolam case itself, McNair J. stated  1 W.L.R. He was seen on the morning round by the consultant who carried out an examination (albeit not a full one) but he was not concerned about his condition. (APPELLANT) v. CITY AND HACKNEY HEALTH AUTHORITY (RESPONDENTS) ON 13 NOVEMBER 1997. I adopt the analysis of Hobhouse L.J. . Before confirming, please ensure that you have thoroughly read and verified the judgment. For example, in Hucks v. Cole (a case from 1968 reported in  4 Med. The judge accepted this evidence. The Bolam test--should the judge have accepted Dr. Dinwiddie's evidence? BOLITHO (ADMINISTRATRIX OF THE ESTATE OF PATRICK NIGEL BOLITHO) (DECEASED) (A.P.) This argument, which was raised for the first time by amendment to the notice of appeal in the Court of Appeal, commended itself to Simon Brown L.J. Nurse Newbold immediately returned to Patrick. If this was the real reason for the judge's finding, he erred in law even though elsewhere in his judgment he stated the law correctly. As to the second of the judge's questions (i.e. He said: ". There can be no doubt that, as the majority of the Court of Appeal held, the judge directed himself correctly in accordance with that approach. On the following morning, 17 January, the medical notes indicated that he was much better but that there was still reduced air entry on the left side. Common law authority in respect of not implementing a particular medical intervention is to be found in the House of Lords judgment in Bolitho v City and Hackney Health Authority 5. MENU. Bolitho test: A legal test that modified the 1957 Bolam test, which the English courts had been using to determine medical negligence by a doctor or nurse. Bolitho v City and Hackney Health Authority: HL 24 Jul 1997 References: Gazette 10-Dec-1997, Times 27-Nov-1997,  UKHL 46,  AC 232,  4 All ER 771,  3 WLR 1151 Links: House of Lords , Bailii A child was brought to a hospital suffering from breathing abnormalities. Given the recent and the more remote history of Patrick's illness, culminating in these two episodes, surely it was unreasonable and illogical not to anticipate the recurrence of a life- threatening event and take the step which it was acknowledged would probably have saved Patrick from harm? 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