Khan v Meadows [2021] UKSC 21 – UKSC Weblog

On this put up Rebecca Khan, a Authorized Help Assistant at Matrix Chambers, feedback on the case of Khan v Meadows [2021] UKSC 21 – handed down on the 18th of June 2021. This enchantment raised essential questions concerning the software of the scope of responsibility precept in scientific negligence instances. The judgment is handed down along with the court docket’s judgment in Manchester Constructing Society v Grant Thornton UK LLP [2021] UKSC 20.

The Information

The appellant, Ms Meadows, is the mom of a kid with haemophilia and autism. Previous to her being pregnant, the appellant consulted her GP observe in 2006 to determine whether or not she carried the haemophilia gene. The appellant ought to have been referred to a haematologist for genetic testing. As a substitute, following blood assessments, Ms. Meadows was negligently led to imagine by the respondent Dr Khan, a basic practitioner in the identical observe, that she was not a provider of the gene. On account of this recommendation, and earlier consultations, Ms. Meadows was wrongly led to imagine that any baby she had wouldn’t have haemophilia.

Ms. Meadows turned pregnant along with her son Adejuwon in 2010, who was recognized with extreme haemophilia shortly after his start. Had Ms Meadows identified that she carried the haemophilia gene, she would have undergone fetal testing for haemophilia whereas pregnant. This might have revealed the fetus was affected, and the appellant would then have chosen to terminate her being pregnant.

In 2015 Adejuwon was additionally recognized with autism, an unrelated situation. Nevertheless Adejuwon’s autism made the administration of his haemophilia extra difficult. He’s more likely to be unable to handle his personal remedy or administer his personal remedy. In itself, Adejuwon’s autism is more likely to stop him from being in paid employment.

There is no such thing as a dispute that Dr Khan is liable in negligence for the prices of mentioning Adejuwon attributable to his haemophilia. The difficulty on this case arises from the query of whether or not Dr Khan is accountable for all prices associated to Adejuwon’s disabilities arising from the being pregnant or solely these related along with his haemophilia.

The judgments beneath

The Excessive Court docket held that Dr Khan was accountable for prices related to each Adejuwon’s haemophilia and autism.

The Court docket of Enchantment allowed Dr Khan’s enchantment, discovering her accountable for prices related to Adejuwon’s haemophilia solely. It’s thought-about the scope of a defendant’s responsibility of care laid down in South Australia Asset Administration Corpn v York Montague Ltd [1997] AC 191 (“SAAMCO”) as determinative of the problem. In concluding that Dr Khan needs to be accountable for a sort of loss which didn’t fall throughout the scope of their responsibility to guard the Ms. Meadows in opposition to, the Excessive Court docket decide had utilized the “however for” causation check.

The Court docket of Enchantment took the view that it was inadequate for the court docket to seek out that there’s a hyperlink between the breach and the stage within the chain of causation, on this case the being pregnant itself, and thereafter to conclude that the appellant is accountable for all of the fairly foreseeable penalties of that being pregnant. The Excessive court docket had referred to 1 hyperlink within the chain of causation depriving the Ms. Meadows of the chance to terminate the being pregnant. The SAAMCO check requires the hyperlink to be between the scope of the responsibility and the injury sustained.

Supreme Court docket

Unanimously dismissing the enchantmentthe Supreme Court docket addressed the next points:

  1. The authorized subject of whether or not in a scientific negligence case the court docket ought to observe the strategy of ascertaining the scope of a defendant’s responsibility of care laid down by the Home of Lords within the SAAMCO check, and, if it ought to, how that strategy is to be utilized.

The Supreme Court docket utilized a six stage mannequin to investigate the place of the scope of responsibility precept within the tort of negligence [28]. The mannequin served to exhibit that the questions of factual causation and foreeability can not circumvent the questions which should be addressed in figuring out the scope of the defendant’s responsibility [30].

The appellant submitted that the scope of responsibility precept in SAAMCO doesn’t apply in scientific negligence claims, and is just relevant in instances of pure financial loss [61]. The court docket couldn’t settle for this submission, as there isn’t any principled foundation for excluding scientific negligence from the ambition of the precept. Holding that the scope of responsibility in query should contemplate the “nature of the service which the medical practitioner is offering” so as to decide what dangers “the legislation imposes an obligation on the medical practitioner to train affordable care to keep away from” [63].

  1. Is the medical practitioner liable in negligence for the prices of mentioning the disabled baby who has each circumstances or just for these prices that are related to the hereditary illness?

Making use of the ideas above, the court docket concluded that the losses regarding Adejuwon’s autism had been exterior the scope of Dr Khan’s responsibility of care [77]. Lord Leggatt thought-about the scope of responsibility precept’s software on this case to be easy. The one objective of the appellants session was to study if she carried the haemophilia gene. There was no discovering that Dr Khan ought to or must have been conscious of any reality which gave rise to an obligation to advise on some other matter [84].

Because the Home of Lords made clear in SAAMCO, an expert whose responsibility is proscribed to advising on a selected subject material isn’t answerable for all foreseeable hostile penalties to the claimant of giving negligent recommendation. They’re solely accountable for losses that are “throughout the scope” of the adviser’s responsibility of care. On this case, the subject material of the respondent’s recommendation was restricted as to if the appellant carried the haemophilia gene and due to this fact solely losses causally linked to that subject material are throughout the scope of their responsibility to the appellant [98].


This case highlights an essential distinction in instances of wrongful start between medical companies meant to forestall the start of any baby, and companies advising on a specified danger linked to the start.

The judgment serves as a reminder that the straightforward ‘but-for’ check isn’t at all times a enough situation for the imposition of legal responsibility, and solely kinds a precondition for authorized causation. The significance of the scope of responsibility can’t be ignored, and has the potential to play a big function in limiting the defendant’s publicity to legal responsibility.

Rebecca Khan is a Authorized Help Assistant at Matrix Chambers.

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