Causation and remoteness — SQE1 Tort question
A worked single-best-answer question on causation and remoteness, with why each wrong option is wrong — the way SQE1 traps candidates.
Aled attended a hospital emergency department complaining of severe vomiting after drinking tea at work. The duty doctor negligently refused to examine him and sent him home. Aled died later that night from arsenic poisoning. Expert evidence establishes, on the balance of probabilities, that even with prompt examination and treatment he would have died, because the poison could not have been identified and treated in time. Aled's widow sues the hospital trust.
Which of the following best describes the trust's liability?
- AIt is liable, because the doctor's refusal to examine Aled was a breach of duty.
- BIt is liable, because the breach materially increased the risk of Aled's death.
- CIt is liable for a proportion of the damages reflecting Aled's lost chance of survival.
- DIt is liable, because the doctor's breach was more than a minimal contributing cause of death.
- EIt is not liable, because Aled would have died even without the breach, so the breach did not cause his death.
Show answer and reasoning
Rule: A defendant is liable only if, on the balance of probabilities, the damage would not have occurred but for the breach.
- A Breach alone is not enough; the claimant must also prove causation. (answers a different question)
- B The material increase in risk approach is confined to mesothelioma-type cases and does not apply here. (right rule, wrong facts)
- C Loss of a chance of a better medical outcome is not recoverable in English law where survival was below 50% (Gregg v Scott). (wrong rule)
- D The evidence shows the breach made no difference to the outcome, so it was not a contributing cause at all. (right rule, wrong facts)
Source: Barnett v Chelsea and Kensington Hospital Management Committee [1969] 1 QB 428; Gregg v Scott [2005] UKHL 2