Causation in stroke case not demonstrated: Choudhury v South Central Ambulance Service NHS Trust and Portsmouth Hospitals NHS Trust (High Court, 13 May 2015—Cox J)

On 16th March 2010 the claimant, then aged 42, suffered an ischaemic stroke. He developed ‘‘locked-in syndrome’’ due to infarction in the brain stem and cerebellum, secondary to basilar artery thrombosis. He is now virtually totally paralysed, doubly incontinent, and is fed through a PEG (Percutaneous Endoscopic Gastrostomy) tube. His ability to communicate is extremely limited and he is dependent on 24 hour nursing care. His life expectancy is markedly reduced. On his behalf it was alleged that delays in taking him to hospital and in diagnosing his condition while there and providing the necessary treatment gave rise to the development of locked-in syndrome. In particular, it was maintained that failure promptly to start the claimant on Aspirin caused his deterioration. The trusts denied that such treatment would have resulted in a better outcome, although they admitted various breaches of duty as noted below.