A&E receptionist's actions considered breach of duty

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Casualty receptionist case overturned in favour of Appellant Darnley (Appellant) v Croydon Health Services NHS Trust (Respondent) [2018] UKSC 50 on appeal from [2017] EWCA Civ 151.

The claim concerns a Mr Michael Darnley, who was struck on the head on 17 May 2010. Mr Darnley’s friend drove him to the Accident and Emergency department at Mayday Hospital, Croydon, managed by the Croydon Health Services NHS Trust.

Both Mr Darnley and his friend informed the A&E receptionist that he had a head injury and was feeling very unwell, therefore requiring urgent attention. The receptionist told Mr Darnley that he would have to wait up to five hours before he could be seen by a clinician. Mr Darnley said he could not wait that long as he felt he was about to collapse, he was informed by the receptionist that if he collapsed he would then be treated as an emergency.

The identity of the A&E receptionist is unknown, although it must have been one of the two receptionists on duty at that time, neither of which had any recollection of the conversation. Each receptionist described her usual practice when a person with a head injury asked about waiting times. One said that they could expect to be seen by a triage nurse within 30 minutes of arrival, the other that the triage nurse would be informed and that they would be seen as soon as possible.

Mr Darnley left A&E after 19 minutes because he felt too unwell to remain. Mr Darnley became distressed about an hour after leaving A&E and an ambulance was called which took him back to Mayday Hospital. He underwent a CT scan which identified a large extradural haematoma with a marked midline shift. He was transferred to St George’s Hospital and underwent an operation at 01:00. Unfortunately, Mr Darnley suffered permanent brain damage in the form of a severe and very disabling left hemiplegia – complete paralysis of the left side of his body.

Mr Darnley brought proceedings against the Trust alleging a breach of duty by the reception staff concerning the information he was given about the time he would have to wait and the failure to assess him for priority triage. The High Court dismissed the claim. Mr Darnley appealed to the Court of Appeal, the appeal was dismissed by a majority. Mr Darnley appealed to the Supreme Court who have unanimously allowed the appeal with the Queen’s Bench Division to provide an assessment of damages in due course.

Impact of the Supreme Court’s decision

The Supreme Court considered that the actions of the receptionist are a breach of duty and a breach of the standard of reasonable care that one should expect from a department and staff, medically trained or non-medically trained, providing services of emergency medical care. The receptionist was aware of standard procedure with regards to waiting times, however, Mr Darnley was given misleading information in this regard from the receptionist, which caused him to leave A&E and ultimately caused his injuries.

Further Information and Legal Support

If you or a family member have been affected by medical negligence you may be entitled to compensation. For more information please do not hesitate to contact a member of our Medical Negligence team.



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