Tort of Negligence: Causation and Remoteness Flashcards
(166 cards)
Preliminary points
• The last two steps C will have to take in establishing negligence is that there is causation of his damage and his damage is not too remote
• Causation is different from remoteness
• Stapleton: factual causation concerns the ‘but-for’ test. Legal causation concerns novus actus, and issues of remoteness. The latter is a normative enquiry drawing the line between recoverable and irrecoverable damage
• ZCT: the steps for C are therefore as follows
(a) Establish factual causation using the ‘but-for’ test
(b) Establish legal causation (no novus actus etc)
(c) Show that the damage is not too remote
Establishing factual causation
The orthodox ‘but-for’ test
• The test is whether, on the balance of probabilities, C would have suffered the damage but for D’s breach of DOC. C has to demonstrate that there is more than a 50% likelihood of the cause being the breach of duty by D.Loss of chance is generally irrecoverable in personal injury cases, but recoverable in consequential economic loss cases.
Establishing factual causation
The orthodox ‘but-for’ test
Barnett v Chelsea & Kensington Hospital Management Committee [1969]
ϖ H (night-watchman) went to D’s hospital after drinking tea and becoming ill. The nurses on duty told the doctor, and the casualty office told C to go home and go to the GP if he was still sick the next morning. Several hours later H died from arsenic poisoning. It transpired that the tea was contaminated with arsenic and it ultimately caused death to H the other morning. Is D liable? D argued that H must have died in any event. C sued on behalf of H as his wife. Held: Neild J: the onus of proof rests on C. It was said that the only way ti deal with the arsenic poisoning is to use the specific BAL antidote, but there was no reasonable prospect of C given it before the time at which he died. According to the facts, as there was no chance of BAL being administered before the death of C, C has failed to establish on the grounds of probability that D’s death caused the death of H!
Establishing factual causation
The orthodox ‘but-for’ test
Hotson v East Berkshire AHA [1987]
loss of chance; balance of probabilities) C (13) injured his hip after falling from the tree as was hospitalised by D. His injury was undiagnosed. C suffers severe pain and is taken to the hospital again 5 days later. C was suffering from avascular necrosis which resulted in a deformity to his hip. C sued D for delaying the treatment. C argued the doctors acted negligently and he suffered gross injury. D argued that the delay did not affect C’s ultimate condition. FI Held: C had a 25% chance of avoiding avascular necrosis if he had been diagnosed right away. The trial judge awarded 25% of the damage. HL Held: the trial judge is wrong! The burden of proof is the balance of probabilities. There was 75% chance that he would have suffered the deformity in any case. Hence, the deformity was not caused by the breach of duty. C had to show that it was more likely that he suffered deformity because of the breach of duty
Establishing factual causation
The orthodox ‘but-for’ test
Hotson v East Berkshire AHA [1987]
Lord Bridge
Lord Mackay
Lord Ackner
Lord Bridge: there are formidable difficulties in the way of accepting the analogy between the contract cases of loss of chance (Chaplin v Hicks) and tort. There is no principle to entitle D to discount from the full measure of damage to reflect the chance that Cs necrosis might well still have developed.
Lord Mackay: following Mallett v McMonagle, in determining what did happen in the past the court decides on the balance of probabilities. Anything that is more probable than no it treats as certain. Loss of chance would not be recoverable for the present cause.
Lord Ackner: the debate on the loss of chance cannot arise when there has been a positive finding that, before the DOC arose, the damage complained of had already been sustained or become inevitable! C was unable to prove on the balance of probabilities that his deformed him was caused by D’s breach in delaying over a period of 5 days the proper diagnosis and treatment!
Establishing factual causation
The orthodox ‘but-for’ test
Hotson v East Berkshire AHA [1987]
(loss of chance) D misdiagnosed a lump under C’s left arm as harmless, thus leading to delay in treatment of 9 months during which the disease had spread. There was a malignant tumour. During those 9 months, C’s chances of recovery (within the next 10 years) wasreduced to 25% (up to the date of trial). However, even if C had been correctly diagnosed or referred to the specialist by the GP without the delay, C’s chance of recovery would still have been 45% only. C argued that 1) the delay caused the tumour to grow, meaning that he suffered a physical injury, and 2) that the court should revisit Hotson, arguing that Fairchild(mesothelioma case) has changed the law with regard of policy reasons, making loss of chance of recovery compensable per se. HL Held: Loss of chance is NOT recoverable.Hotson is followed. There are pragmatic problems to recognise that loss of chance is recoverable:
Gregg v Scott [2005]
Baroness Hale
1) Hotson: C’s claim is for the reduced chance of achieving recovery. In Hotson, D had not even caused the loss of the chance because by the time C got to the hospital there was already no chance. Hence, this Gregg case is a new case not covered by previous authority.Hotson was distinguishable!
2) Reformulation ‘abuse’ argument: Compare the loss of a chance approach: my negligence probably caused a reduction in the chance of your keeping that leg: I pay you the value of the loss of your leg, discounted by the chance that it would have happened anyway. If the chance of saving the leg was very good, say 90%, the claimant still gets only 90% of his damages, say £90,000. But if the chance of saving the leg was comparatively poor, say 20%, the claimant still gets £20,000. So the claimant ends up with less than full compensation even though his chances of a more favourable outcome were good. And the defendant ends up paying substantial sums even though the outcome is one for which by definition he cannot be shown to be responsible. The result of this is that almost any claim for loss of an outcome could be reformulated as a claim for loss of a chance of that outcome!!That is, the claimant still has the prospect of 100% recovery if he can show that it is more likely than not that the doctor’s negligence caused the adverse outcome. But if he cannot show that, he also has the prospect of lesser recovery for loss of a chance. If (for the reasons given earlier) it would in practice always be tempting to conclude that the doctor’s negligence had affected his chances to some extent, the claimant would almost always get something. It would be a “heads you lose everything, tails I win something” situation. D will almost always be liable for something! This would surely be a case of two steps forward, three steps back for the great majority of straightforward personal injury cases! Mitchell: so what she is saying is that the 50% threshold must be maintained for C to sue.
3) Implications of loss of chance recovery: Negotiations and trials would be a great deal more difficult, as C will always pursue the loss of chance argument till the end. Recovery would be much less predictable both for claimants and for defendants’ liability insurers. Introducing itwould cause far more problems in the general run of personal injury claims than the policy benefits are worth.
4) Uncertainty argument: The approach to causation should be the same for both past and future events. What, if anything, has the doctor’s negligence caused in this case? We certainly do not know whether it has caused this outcome, because happily Mr Gregg has survived each of the significant milestones along the way. Can we even say that it reduced the chances of a successful outcome, given that Mr Gregg has turned out to be one of the successful minority at each milestone? ZCT: so the argument is, if you say that I’ve caused you loss of chance of recovery, but at the very end you recovered, what is the value of the loss? If my chance of recovery is 100%, and you lowered it to 99%, it seems unreasonable that you have to compensate me for it because I’ll most likely recover anyways!
Gregg v Scott [2005]
Lord Hoffmann
Lord Hoffmann:
1) Hotson: The issue is whether Chaplin v Hicks can apply to clinical negligence. Hotson is indistinguishable.
2) Precedent issue: allowing loss of chance recovery would involve abandoning a good deal of authority! Therefore this suggestion was rejected in Hotson, Wilsher v Essex AHAand Fairchild v Glenhaven Funeral Services. There are no new arguments to justify the departure from precedent
3) Control mechanisms: C argues that his injury can be a ‘hook’ on which to hang a claim for damages which it did not actually cause. This is an artificial limitation lacking in principle! It resembles the control mechanisms which disfigure the law on PI. There will also be definition problems about ‘injury’ – e.g. Wilsher’s excessively oxygenated blood.
Gregg v Scott [2005]
Lord Philips
1) Hotson: Hotson was distinguishable, as the claim there was for the adverse outcome rather than for the loss of chance of avoiding that outcome. Oliphant: but this does not say when C can choose the first rather than the latter
2) Procedural history argument: Before the trial, however, it was discovered that Mr Gregg had a rare type of cancer with a less favourable prognosis. This led Mr Gregg to advance an alternative claim for damages for the reduction of the chance of a favourable outcome. Mitchell: It is not sensible to ignore what has happened between the moment when the breach occurred and the date of trial. Here, C is still alive after the treatment and when he’s suing. Allowing the recovery of loss of chance will be admitting the arbitrary factor of how long it takes for the case to get to court! Randomness is the antithesis of justice. This is because C’s chance of recovery has gone back to 25% (from 17%) by the time he sues! ZCT: the concept is that, if it takes C 1 more month before he gets to court and continues to receive medical treatment, C’s chance of recovery usually rises (during remission).
3) Uncertainty argument: Awarding damages for the reduction of the prospect of a cure, when the long term result of treatment is still uncertain, is not a satisfactory exercise.
Gregg v Scott
Lord Nicholls (dissenting):
where a patient is suffering from illness or injury and his prospects of recovery are attended with a significant degree of medical uncertainty, and he suffers a significant diminution of his prospects of recovery by reason of medical negligence whether of diagnosis or treatment, that diminution constitutes actionable damage. The old law is irrational and indefensible! C was clearly worse off! D’s negligence deprived C of a worthwhile chance that his medical condition would not have deteriorated. The appropriate characterisation of a patient’s loss in this type of case must surely be that it comprises the loss of the chance of a favourable outcome, rather than the loss of the outcome itself. Justice so requires, because this matches medical reality. This recognises what in practice a patient had before the doctor’s negligence occurred. It recognises what in practice the patient lost by reason of that negligence. The doctor’s negligence diminished the patient’s prospects of recovery. Of course, losing a chance of saving a leg is not the same as losing a leg; but that is not a reason for declining to value the chance for whose loss the doctor was directly responsible. The law would rightly be open to reproach were it to provide a remedy if what is lost by a professional adviser’s negligence is a financial opportunity or chance but refuse a remedy where what is lost by a doctor’s negligence is the chance of health or even life itself. This is so whether the patient’s prospects immediately before the negligence exceeded or fell short of 50%
Gregg v Scott
Lord Hope (dissenting):
the growth of the tumour was a damage in negligence. The loss of chance of avoiding the cancer was a damage consequential upon the physical injury! Oliphant: this argument was rejected in Grieves v Everard, where the development of asymptomatic pleural plaques amounted to physical damage!
Gregg v Scott
Commentary
Commentary: civil litigations are decided on the balance of probabilities. In practice, Cs can often get over 50% as medical evidence in medical negligence cases does not work to make for 100% certainty. Hence, if this is allowed, every C may sue for a mere 10% loss. Trials of medical evidence will be much less predictable and much more difficult. There will be too much litigation and risk of unfairness to D!
Oliphant:1) what Hotson and Gregg were trying to do is to ‘reframe’ the loss in question so as to satisfy the ‘but-for’ test. Instead of alleging injury, they allege that the loss as ‘loss of chance’ of avoiding the injury. The uncertainty in this case was what caused the reduced expectation of life. The delay had increased the chance of a premature death but was not enough to enable C to say that, on the balance of probabilities, it would not otherwise have happened.2) there is uncertainty as to when C might be said to have lost a chance! 3) the other difficulty in accepting loss of chance lies in assessing a value to be given to the chance.4) the problem is in the ‘balance of probability’. If C’s chance is 60%, C receives 100% if reward; if C’s chance is 40%, C receives only 40%. This seems arbitrary.
Voyiakis: ‘knowing how much risk I have caused on and how much compensation I owe you if I had caused you actual physical harm does NOT by itself suggest how much I should pay for having exposed your physical health to danger’!ZCT: what is wrong with this? There does not seem to be alternatives either.
Hoffmann: (the time argument) if C had died just before the trial, his executor would have to prove that the delay had probably hastened his death. If C was alive, it would be sufficient to prove there was a substantial possibility that the delay hastened his death. This makes no sense!
Allied Maples v Simmons & Simmons [1995]
ϖ economic loss of chance) C sued D for failing to advise on the deletion of a warranty in a sales agreement between C and X which deprived C of protection of contingent liabilities to X. D argued that its negligence did not cause C damage as it could not be shown on the balance of probability that X would have accepted the warranty Held: Stuart-Smith LJ: C had to show it would have relied on the advice if given. It is NOT necessary to show that X would have given some protection to C. It was enough that a substantial chance was lost. Compensation ordered. Rule: lost chance that the outcome would have been avoided by the action of a third party even if that chance were less than 50%.Commentary: Coote: it is acceptable to allow claims for loss of chance where the injury is economic loss because the chance itself has an economic value. No artificiality found in the case of physical harm is involved.
Stapleton: 1) Odd result: Say a manufacturer fails to warn that its non-prescription sunscreen product should not be used in salt water. A father buys the product. He applies it to himself and his infant child before they swim in the ocean. As a result both suffer skin injury. Suppose the evidence is that even if the manufacturer had given a careful warning there was only a 20 per cent chance that the father would have read and heeded it. According to
Allied Maples, it seems, the infant can recover for the 20 per cent chance that, had the manufacturer been careful, the third party (the father) would have read and heeded its careful warning. The father cannot recover at all.
Potentially contradictory to Hotson:
Suppose the negligence of D exposed E to asbestos and in E’s trade a quarter of employers are unwilling to employ persons who have been exposed to asbestos. Employment in this trade is short-term. Can E sue now on the basis that he has lost a chance of future employment? ZCT: hence, a loss of chance in health may be alternatively framed as a loss of chance in economic loss, and thus becomes recoverable!
Wright v Cambridge Medical Group [2012]
ϖ medical negligence) C (minor) was hospitalised and her disease was not diagnosed until 3 days later, during which it spread and C was discharged from the hospital. D later conceded negligence, and that if he had seen C he would or should have referred C to the hospital. C was later hospitalised and given a blood culture but by then C suffered permanent injury to the hip. C argued that had she been treated appropriately in hospital she would have made a good recovery without permanent injury. Can D argue that if he had not been guilty of the negligence complained of, he would have caused injury anyway by another type of negligence? Held: No! If D could succeed on this point, it would deprive C of the right to claim damages for the subsequent negligence! That, where a claimant had suffered permanent damage which had been caused partly by late referral by a general practitioner and partly by the inadequate treatment which she had received in hospital, it might be possible for the general practitioner to escape liability for the permanent damage by showing that that was due to the hospital’s failure to treat her competently; that there was a presumption that, had she been referred timeously, the claimant would have received competent and appropriate treatment at the hospital and, in so far as that presumption was rebuttable, the burden was on the general practitioner to rebut it. On the facts, D had failed to discharge that burden and so it could not be inferred that, had the claimant been referred to the hospital on the date when she should have been, she would have received inadequate treatment and would still have suffered the permanent injury which she had in fact sustained
Elias LJ and Neuberger LJ: Gregg’s ‘no loss of chance recovery’ ruleis applied in clinical negligence cases! Allied Maples should not be applied to personal injury cases.
Commentary: Oliphant: what if D’s negligence was failing to contact doctor X to examine patient C, and X would have done things differently? Lord Neuberger (minority) thought that there was an irrebutable presumption that the subsequent treatment will be performed WITHOUT negligence!
Material contribution to injury
- Although loss of chance remains irrecoverable, the courts have accepted that D1 and D2 may cumulatively cause the damage to C. It is not necessary to show but for causation in relation to D1, but the breach by both of them must have made the injury worse. What is not negligible is ‘material’.
- By contributing to C’s injury in more than a trifling way, C can prove causation against D, even if but-for causation is not made out. Proportional damages may be awarded if C’s injury is divisible, but probably not for RPIs.
Bonnington Castings v Wardlaw [1956]
material contribution
ϖ (full damages) C works in a workshop belonging to D. C contracts pneumoconiosis as a result of inhaling silicone dust coming from i) dust in workshop generated by a pneumatic hammer with no protection ii) swing grinders. D was not negligent for i) because there was no known protection against dust produces in this way, but was negligent for ii) as he should have installed extractor fans. Medical evidence shows that the pneumoconiosis is caused by a gradual accumulation of the silica particles (i.e. the whole of the noxious material inhaled). It cannot be wholly attributed to one source or the other. So was the swing grinders’ dust alone the cause of C’s disease? HL Held: Lord Reid:
1) C must prove D’s fault caused, or materially contributed to his injury. The same causative rules apply to breach of statutory duties. The question here is whether the dust from the swing grinder materially contributed to the disease.
2) This is a question of degree – it must not fall under the exception de minimis non curat lex (the law does not concern itself with trifles). Here the swing grinder dust was not negligible!
3) Even if more of the noxious dust came from the pneumatic hammers, here it can be sufficiently proved that the dust from the grinders made a substantial contribution (not negligible) to the concentration of noxious dust in the air C inhaled, and thus help to produce the disease
4) C was entitled to full damages
Commentary: Bailey: doubtless the accumulation of dust was sufficient to cause the injury. Miller: the decision is not dependant on the knowledge of the magnitude, or even existence, of a threshold of relationship which links dust concentration with the disease. Oliphant: what is problematic is that C was awarded full damages! Mitchell: Here, D is liable even though the ‘but-for’ causation cannot be satisfied. There is a material contribution to injury. ZCT: 1) does this reduce causation to a cause (albeit not a trivial one)?2) the ‘material’ threshold here is correct: if 1000 people hurl abuses at V and V suffered RPI because of the cumulative effect of the (say) equally abusive comments, should there be material contribution? If my 50% test is used, then there is clearly no liability. Lord Bingham’s perception of fairness will clearly not allow this to happen! But here V’s injury is indivisible – and so the 1000 people cannot be jointly and severally liable under the apportionment approach. So it seems that the ‘material’ threshold should be beyond de minimis for justice to be done.
Holtby v Brigham [2003]
(proportional liability) C developed asbestosis as a result of occupational exposure to asbestos dust after working for D for 12 years and X for 5 years. CA Held: each employer could only be liable in proportion to C’s total disability. There was divided responsibility on the ‘time-exposure’ basis. The award of full damages in Bonnington was because the question of apportionment had simply not been raised! Stuart-Smith LJ: the court only has to do the best it can using its common sense to achieve justice, not only to C but D. Commentary: Oliphant: note that proportional damages are awarded ONLY IF the injury is divisible. Holtby’s effect is to throw the risk of untreaceability of individual Ds onto C who must sue both D1, D2 and all others to recover full damages! Gullifer: but what if the tortious and innocent exposure are concurrent as in Bonnington? There will be evidential difficulties in assessing D’s contribution.
Rahman v Arearose Ltd [2001]
(Proportionate damages) C beaten up during work for which D was responsible. He received negligent hospital treatment and became blind and suffered various RPIs due to the attack and the loss of his eye. CA Held: the two events had a synergistic interaction – both D and the hospital were liable for some harm. Responsibility should be apportioned. Proportionate damages awarded to C. Commentary: Weir: there is no scientific basis for such attribution of causality: C is not half-mad because of what D1 did and half-mad because of what D2 did. ZCT: Weir is saying that RPIs cannot be divisible injuries in this case. Mitchell: this is because the injuries are divisible (e.g. back injury and arm injury)!
Hatton v Sutherland [2002]
RPI; Proportionate damages) Hale LJ: many stress-related illness are likely to have a complex aetiology with several different causes. In principle D should pay only for that proportion of harm suffered for which he by his wrongdoing is responsible! Commentary: the approach here was criticised in Dickins v O2
Simmons v British Steel [2004]
ϖ HL Held: D (suffering RPI) was held 100% responsible under the Bonnington ‘material contribution’ test.
Barker v Chorus [2006]
ϖ Lord Walker: yet damages may not always be divisible. Commentary: Keeler: Bonnington is an example, the loss was C’s incapacity to perform his usual work. Can RPI be ‘divisible’ injuries?
Ellis v Environment Agency [2008]
ϖ May LJ (CA) Held: the proportionate damage approach should be
1) Confined to industrial disease or injury cases where there has been successive exposure to harm by different agencies
2) Where the effect of the harm is divisible
3) Where it would be unjust for D to bear the whole loss
Bailey v MOD [2009]
C (suffering from pancreatitis) was negligent treated in hospital and was unable to clear vomit in her throat due to her weakened state. Her chocking caused a cardiac arrest leading to brain damage. CA Held: the injury was indivisible. The brain damage cannot be divided up and part attributed to any particular cause, but to 2 of the causes. Walker LJ: D’s negligence made a material contribution to C’s weakened condition, and her subsequent choking. There was causation! Commentary: Bailey: the ‘material contribution’ test should be confined to ‘but for’ in the normal way for the sake of coherency in the law. Stapleton: damages should not make D better off than he would have been if he had not become the victim of tort. Otherwise doctors will be more likely to be liable by some non-negligible but unassessable degree if C suffers an indivisible injury! Miller: the framing of scientific evidence is important in these cases. It is only when D’s negligence is presented as cumulative causes, NOT alternative causes of D’s injury that the Hotson test can subrogated by Bonnington.