Logical approach behind the ‘Bolam’ principle: analysis of subsequent cases Careful dissection of the ‘ Bolam ’ case does enable us to appreciate the logical approach in reaching a judicial decision that is justifiable, fair and reasonable rather than a very loose standard of medical care. [78] Those findings are sufficient to determine this case in favour of the defendants. The qualification added by the Bolitho case is the practice accepted by a responsible body of medical men must be logical. EP - 235. Richard Bolitho. The Bolam test was later supplemented by the Bolitho addendum in the case of Bolitho v City & Hackney Health Authority [ Bolitho ]. JO - Journal of Professional Negligence He began to suffer right foot pain due to … When applying the Bolam test, the court must be satisfied that the expert body of professional opinion the defendant is relying on has a logical and defensible basis for approving of the defendant’s practice. This is the limited extent to which the courts will examine medical procedures. To operate on an ERD does not address the cause of the generation of fluid and carries substantial risks. 1. Then, in light of a close analysis of post- Bolitho case law, Section III elucidates and categorises the factors that have indicated, expressly or impliedly, that the requisite logical basis fora defendantdoctor’sexpertmedical opinionwas absent.The results of that … TY - JOUR. 10 The addendum requires the expert medical opinion to pass a threshold test of logic; it is met if the medical experts who gave testimony have compared the risks and benefits and come to a defensible conclusion that fulfils a threshold of logic and consistency. Bolitho merely necessitates that the judge consider medical evidence in a similar manner to other forms of expert evidence in cases concerning medical negligence. The Facts The Appellant (Claimant at first instance) had a number of health problems including Type 2 Diabetes. Her two-year-old son had been admitted to hospital with … In his opinion delivered in the Bolitho case, Lord Browne-Wilkinson indicated that experts should direct their minds to the question of comparative risks In teaching the rudiments of the 1957 Bolam test as ‘reined’ in by the Bolitho principle, it is invariable for at least one student to ask “is it not obvious that explanations must make logical sense to the Court?” Which invariably raises the point in my mind, “The question should be: The Bolitho principle demands that Bolam oriented statements makes logical sense to whom? The Claimant suffered from osteoarthritic changes in the both hips This case was brought by the mother of Patrick Bolitho, a young boy who died following a cardiac arrest in hospital that resulted in severe brain damage. Case Logic 17" Checkpoint Friendly Rolling Laptop Case Case Logic 18" Laptop Briefcase Case Logic 15" Laptop and Tablet Case Case Logic 17" Laptop and Tablet Case Case Logic 15.6” Top Loading Laptop Case CAMERA BAGS. 63 Other interesting post-Bolitho reviews have concentrated on different aspects, e.g. T1 - The Logic of Bolitho. profession, would perhaps be unlikely to withstand logical scrutiny if that practice is contrary to a clear consensus emerging from the evidence base. 205. This case is of interest for some readers in the use by the court of the Bolitho test to assess the logical and reasonableness of the defenders expert opinion on the question of negligence and the findings of the judge on his interpretation of the decision of the Supreme Court in Montgomery v Lanarkshire Health Board. [77] I also consider that the practice survives Bolitho scrutiny as being “responsible” or “logical”. Bolitho was born in 1756 in Falmouth, Cornwall, in Great Britain, the second son of a prestigious naval family.He joined the navy in 1768. The case Bolam v Friern Hospital Management Committee (1957) 1 WLR 583 established that if a doctor acts in accordance with a responsible body of medical opinion, he or she will not be negligent. Y1 - 2006. Cases such as this one demonstrate the reluctance of the courts to reject the principles established by Bolam. SP - 225. There was a conflict of evidence between Sister Sallabank and Dr. Horn as to what was said to Dr. Horn in the course of the two telephone calls at about 12.40 and 2 p.m. The case came on for trial before Hutchinson J. In 1998 Lord Browne-Wilkinson challenged the authority of Bolam in the case of Bolitho v City and Hackney Health Authority [3]. The logic of Bolitho; Medical ethics of informed consent: a survey of medical professionals in Singapore; Proving causation – beyond the ‘but for’ test; Book Reviews; Index to Volume 22; Close section Vol.22 No.3. The Bolitho Test helped to clarify what was meant by “a responsible body,” defining it as one whose opinion had a “logical basis.” Combined together, the Bolam Test and the Bolitho Test make up the twin pillars of all assessments of medical negligence. AU - Heywood, R. PY - 2006. The court determined that it had to try the issue of the prescription of Nifedipine as a tocolytic drug by the standards of the time, and not by subsequent developments. He served in the wars against France and the United States. In this case, Lord Browne-Wilkinson set out an exception to the Bolam test – the courts may set aside a body of expert medical opinion when it … “ logical analysis ... situation, 101 and cases are determined on case to case basis. If there is no logical basis for the practice, then the practice will not be defensible in court. Properly considered clinical guidelines will similarly weigh the risks and benefits. Abstract Over the last quarter of a century, English medical law has taken an increasingly firm stand against medical paternalism. This was recognised in the classic direction of McNair J. to a jury in Bolam vs Friern Hospital Management Committee. In applying the Bolam test where evidence is given that other practitioners would have adopted the method employed by the defendant, it must be demonstrated that the method was based on logic and was defensible. The claim relates to treatment received by Patrick Nigel Bolitho at St. Bartholomew's Hospital on 16 and 17 January 1984 when he was two years old. However, whether it is viewed as a single Bolam/Bolitho test, a single but two-stage Bolam and then Bolitho test or two totally separate Bolam and Bolitho tests is really rather academic: the key take-home message is that, to be held non-negligent, a particular medical or surgical practice must be a logical one. Law Intl. The judgment given by the House of Lords in the recent case of Bolitho imposes a requirement that the standard proclaimed must be justified on a logical basis and must have considered the risks and benefits of competing options. Back to lecture outline on breach of duty in the law of negligence However, in case that approach was wrong, the judge justified his rejection of the defendant’s experts by applying the Bolam test in the light of the Bolitho qualification. Professional negligence: duty of care methodology in the twenty first century; The future of immunity for expert witnesses : R. Heywood, “The Logic of Bolitho” (2006) 22 Professional Negligence 225; Maclean, A., “ Beyond Bolam and Bolitho ” (2002) 5 Med. M3 - Article. Patrick suffered catastrophic brain damage as a result of cardiac arrest induced by respiratory failure. The evidence of the defendant’s experts was not sufficient to exonerate the screeners because it did not stand up to logical … The law defines this as a duty to provide care that conforms to the standard reasonably expected of a competent doctor. The expert’s evidence therefore fell within the Bolitho exception (from the case of Bolitho v City and Hackney Health Authority [1996] 4 All ER 771). VL - 22. Bolitho narrowed the scope of the test, stating that the court must be satisfied that the body of opinion relied upon has a logical basis. The Bolitho case was the start of the erosion of medical protectionism enshrined in Bolam as it gave the judiciary far greater discretion when determining liability in … Bolitho has called attention to this issue and will therefore take effect not only in determining the logical basis of the course of action offered by the defendant, but also by engaging more forcefully in assessing risk analysis . The judge accepted Sister Sallabank's version (which is the one I … A doctor is not guilty of negligence if he or she has acted in accordance with a practice accepted as proper and responsible by a responsible body of medical practitioners skilled in t… Doctors owe a duty of care to their patient. Richard Bolitho is a fictional Royal Navy officer who is the main character in a series of novels written by Douglas Reeman (using the pseudonym Alexander Kent). In Bolitho v City and Hackney Health Authority, the House of Lords followed and applied the ‘ Bolam principle’. Whilst a layman may conclude that the doctors acted negligently, a Court is unable to ignore evidence from a professional that is capable of standing up to rational analysis. Bolitho v City and Hackney Health Authority The case. In this case Lord Browne-Wilkinson reminded the court that they are Bolitho v City of Hackney Health Authority 4 All ER 771 is a Tort Law case focusing on breach of duty, causation and the Bolam Test. In this post, 12KBW pupil Samuel Cuthbert considers the ramifications of the case of Bradfield-Kay v Cope [2020] EWHC 1352 (QB) for the tests set out in Bolam v Friern Hospital Management Committee [1957] 1 WLR 583 and Bolitho v City and Hackney HA [1998] AC 232.. Background to the case. The Bolam case very clearly distinguished between the negligence by an ordinary man and negligence by a professional in the following words: “But where you get a situation which involves the use of some special skill or competence, then the test as to whether there has been negligence or not is not the test of the man on the top of a Clapham omnibus, because he has not got this special skill. Bolitho case law, Section III elucidates and categorises the factors that have indicated, expressly or impliedly, that the requisite logical basis for a defendant doctor's expert medical opinion was absent. In this post Thea Wilson of 12 KBW considers the recent case of Williams v CWM Taf Local Health Board, in which the Court of Appeal gave further guidance regarding the heavy burden on claimants of satisfying the Bolitho test.. 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