LT, RECLAIMING MOTION LT (AS GUARDIAN OF RC) AGAINST LOTHIAN NHS HEALTH BOARD [2019] ScotCS CSIH_20 (03 April 2019)

LT, RECLAIMING MOTION LT (AS GUARDIAN OF RC) AGAINST LOTHIAN NHS HEALTH BOARD [2019] ScotCS CSIH_20 (03 April 2019)

The Montgomery duty to inform and obtain consent arises only where there is evidence of a material risk associated with the proposed treatment or management plan, and where the clinician knew or ought to have known of that risk. In this case, there was no expert evidence that a suspicious CTG trace at 2230 indicated a material risk of hypoxia-ischaemia and brain damage. The registrar's interpretation of the trace as normal or no more than suspicious was within the range of non-negligent professional judgment. Therefore, no duty to inform or obtain further consent arose, and there was no breach of duty.

Citation
[2019] ScotCS CSIH_20
Parties
Pursuer and Reclaimer: LT (as guardian of RC); Defenders and Respondents: Lothian NHS Health Board
Jurisdiction
Scotland
Judgment Date
03 April 2019
Procedural Posture
Medical Negligence/reparation / Reclaiming Motion (appeal) Against Interlocutor of Absolvitor After Proof on Negligence
Outcome
Reclaiming motion refused; interlocutor of absolvitor affirmed.
Legal Topics
Informed Consent, Standard of Care, Interpretation of Medical Evidence, Montgomery Principle, Obstetric Negligence
Medical Law Tort/delict Consent to Treatment Informed Consent Standard of Care Interpretation of Medical Evidence Montgomery Principle Obstetric Negligence

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Parties

LT (as guardian of RC)

Pursuer and Reclaimer

Lothian NHS Health Board

Defenders and Respondents

Procedural Posture

Medical Negligence/reparation / Reclaiming Motion (appeal) Against Interlocutor of Absolvitor After Proof on Negligence

Legal Issues

  1. 1 Whether the registrar was under a duty to obtain the pursuer's informed consent to continue with spontaneous vaginal delivery in light of a suspicious CTG trace at 2230
  2. 2 Whether the registrar's interpretation of the CTG trace as normal or no more than suspicious was negligent
  3. 3 Whether a suspicious CTG trace, absent evidence of material risk, triggers the Montgomery duty to inform and obtain consent

Ratio Decidendi

The Montgomery duty to inform and obtain consent arises only where there is evidence of a material risk associated with the proposed treatment or management plan, and where the clinician knew or ought to have known of that risk. In this case, there was no expert evidence that a suspicious CTG trace at 2230 indicated a material risk of hypoxia-ischaemia and brain damage. The registrar's interpretation of the trace as normal or no more than suspicious was within the range of non-negligent professional judgment. Therefore, no duty to inform or obtain further consent arose, and there was no breach of duty.

Court Disposition

Reclaiming motion refused; interlocutor of absolvitor affirmed.

Orders

  • The reclaiming motion is refused.
  • The interlocutor of the Lord Ordinary dated 3 April 2018 is affirmed, assoilzing the defenders from the conclusions of the summons.