Coincidence Vs Causation

Today’s case is about a 35-year-old gentleman who was working on pavements for a local council when he dropped a paving stone on his foot, sustaining a fracture to his metatarsal.

He went to hospital, and it was decided that an operation was necessary. His blood pressure was taken for the operation and found to be slightly raised. Post-operatively, he was advised to attend his doctor, and it was found that his blood pressure remained slightly raised.

He attended his solicitor for a medico-legal claim in relation to injuring his foot at work and was seen by a Consultant Orthopaedic Surgeon, who put in his report that the plaintiff now had high blood pressure “probably on the basis of the injury”.

Undoubtedly, this gentleman is very young to develop hypertension; however, upon going into his history, it turned out he had a family history of hypertension and was using steroids to build up his muscle bulk during exercise.

Acutely after any injury, particularly in older people, the blood pressure may go up for a couple of days while the stress is there, but it does not last long term. If it does persist, it usually means there is some underlying problem, either with the kidneys, or, not infrequently (as in this case), due to taking steroids. A sustained, chronic rise in blood pressure is not due to peripheral trauma.

It could be argued that he is lucky that the increased blood pressure has now been found at a young age and can be brought under control. Otherwise, he has a high risk of coronary artery disease or a stroke in his 40s or 50s. It cannot, however, be related to the trauma.

The finding, therefore, would be regarded as a coincidence and not a consequence of the injury.

MDU figures for 2021 show that fewer than one in six actions in medical negligence actually succeed, with the vast majority failing on the grounds of causation. It must be remembed that subsequence is not the same as consequence.

Initial screening is therefore essential to manage client expectations at an early stage. This avoids unnecessary effort and costs for all concerned. Too many cases are taken to Court with no chance of success. This is stressful for both the client and their legal adviser, and indeed for the medical personnel involved.

For fast and effective screening of all potential medical negligence cases, contact Peyton Medico Legal Services now on +44 (0)28 8772 4177 or email rpeyton@rpeyton.com

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