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High Court, Queen’s Bench Division
9 October 2015
A GP conducting an independent medical examination for the DVLA had not on the balance of probabilities failed to advise the deceased to see his regular GP regarding his high blood pressure. Even if the defendant had failed to advise this was not causative of the deceased’s stroke nine years later.
The claimant was the widow of the deceased who died of a stroke on 7 December 2011. The defendant was a GP who had carried out a medical examination on the deceased following his disqualification from driving after failing a breath test. The claimant alleged that the defendant failed to advise him to make an appointment with his regular GP in order to have his blood pressure reviewed.The court held that neither the claimant nor her sister were able to give reliable evidence about the conversations they had with the deceased following his appointment. In particular the judge indicated that the claimant’s sister was trying too hard to assist the claimant’s case rather than give an accurate representation of what she recalled. The court was satisfied that the defendant did tell the deceased that his blood pressure was raised and may have mentioned ‘white coat hypertension’. The judge concluded there is nothing wrong with a doctor trying to reassure a patient with a benign explanation so long as this is coupled with a warning that further investigation is needed.
Although the court concluded the claimant’s case failed as breach of duty had not been established, a detailed consideration was then given to the correct causative test to be applied.
Counsel for the claimant submitted that the modified material contribution test applied to this matter as it is not possible to say that the stroke would have happened anyway and literature suggests that there is a causal/close relationship between high blood pressure and a stroke.
The judge concluded that this was not the correct test as modern interpretations of the Fairchild principles offer a narrow interpretation of the exceptions contemplated in MOD v AB  UKSC 9. The exception applies where there are two different agents causing the disease, as opposed to causing an increased risk of it occurring.
Finally the judge considered whether a deduction for contributory negligence would have been appropriate as the deceased had failed to take his GP’s advice in 2007 to have his blood pressure checked by a practice nurse. The court would have reduced the damages by 25%.Summarised by Sandra De Souza & Amy Wedgwood, Anthony Gold