Case of note: Michael Darnley v. Croydon Health Services NHS Trust

Date published:

The claimant suffered a head injury in an assault and was taken by his friend to A&E, where he arrived at 20.26 on 17 May 2010. He told the receptionist he was in considerable pain but the department was very busy and he was advised that he would have to wait four or five hours to be seen. In fact, he would have been reviewed by the triage nurse within 30 minutes although there would have been a further wait after that to see a doctor. Mr Darnley therefore decided to leave hospital and went home at 20.45, 19 minutes after his arrival. Unfortunately his condition deteriorated and his family called an ambulance which returned him to hospital. A computed tomography (CT) scan revealed the presence of an extradural haematoma. He was transferred for neuro-surgery to St.George’s Hospital but it was too late to prevent serious permanent brain injury.

It was accepted on behalf of the trust that if Mr. Darnley had waited to be triaged, his treatment would have been prioritised such that he would have made a full recovery. A claim was commenced on the basis that the receptionist had been negligent in failing to give Mr Darnley details of the triage system.  Had this information been offered, the patient maintained would have waited.  The claim was rejected by the High Court in 2015.

This ruling was upheld by the Court of Appeal in March 2017. The court decided that there was no general duty upon receptionists to keep patients informed about likely waiting times. Their function was to record new arrivals, tell them where to wait and pass on relevant details to the triage nurse. It was not their function to give any wider advice to patients and it was not fair, just or reasonable to extend their responsibility in this way. Litigation about what was said in A&E departments could proliferate and healthcare providers might react by telling receptionists to do nothing other than ask patients for details. That would be undesirable.

The court also observed that any duty owed by receptionists could not extend to liability for the consequences of a patient walking out without notice.

This was a sad case because the claimant suffered significant lasting injury. However, the claim was a novel one which we considered important to resist in the interests of the NHS. Roughly 100,000 patients visit A&E departments in England every week, so opening up receptionists to negligence claims of this kind would have had very serious consequences for the NHS.