Medical negligence and proximity

United Kingdom

A claim by daughters who witnessed their father, Mr. Paul’s, death as a result of a heart attack seeking damages for psychiatric injury, has been struck out. It was held that there was a lack of proximity between the Royal Wolverhampton NHS Trust’s negligence in the care and treatment given to Mr. Paul in November 2012 and his eventual death in January 2014. On this basis, it was found that the claimants’ claim was bound to fail.


Mr. Paul suffered from a number of illnesses and received various treatments for them. In particular, he was treated at New Cross Hospital for cardiac symptoms in November 2012. It later transpired that an inpatient coronary angiography ought to have been arranged during that emergency admission, which would have revealed significant coronary artery disease, requiring coronary revascularization and would have likely avoided his death in January 2014.

As a result of witnessing the onset of Mr. Paul’s heart attack which led to his death, his young daughters (aged 12 and 9) showed symptoms of PTSD and proceeded to claim damages in respect of Royal Wolverhampton NHS Trust’s alleged failure to provide care to Mr. Paul.


At trial, it was accepted by the claimants and defendant that the daughters, as secondary victims, would succeed in establishing that they fell within each of the control mechanisms except for “proximity”.

Master Cook rejected that the death of Mr. Paul and the initial negligence in November 2012 amounted to sufficient proximity in space and time and this initial negligence could not be said to be the “relevant event” for deciding the proximity required to establish liability.


This case highlights the requirement for proximity between the initial negligence and the “relevant event” in order to establish liability under established control mechanisms. The event ought to be an immediate aftermath flowing from the negligence and should be close in proximity in terms of both time and space.

Further reading: Paul v The Royal Wolverhampton NHS Trust [2019] EWHC 2893 (QB).