Khan v Meadows [2021] UKSC 21 – UKSC Weblog

On this submit Rebecca Khan, a Authorized Assist Assistant at Matrix Chambers, feedback on the case of Khan v Meadows [2021] UKSC 21 – handed down on the 18th of June 2021. This attraction raised essential questions in regards to the software of the scope of obligation precept in scientific negligence instances. The judgment is handed down along with the courtroom’s judgment in Manchester Constructing Society v Grant Thornton UK LLP [2021] UKSC 20.

The Info

The appellant, Ms Meadows, is the mom of a kid with haemophilia and autism. Previous to her being pregnant, the appellant consulted her GP observe in 2006 to determine whether or not she carried the haemophilia gene. The appellant ought to have been referred to a haematologist for genetic testing. As a substitute, following blood exams, Ms. Meadows was negligently led to imagine by the respondent Dr Khan, a common practitioner in the identical observe, that she was not a service of the gene. On account of this recommendation, and earlier consultations, Ms. Meadows was wrongly led to imagine that any little one she had wouldn’t have haemophilia.

Ms. Meadows turned pregnant together with her son Adejuwon in 2010, who was recognized with extreme haemophilia shortly after his delivery. Had Ms Meadows recognized that she carried the haemophilia gene, she would have undergone fetal testing for haemophilia whereas pregnant. This might have revealed the fetus was affected, and the appellant would then have chosen to terminate her being pregnant.

In 2015 Adejuwon was additionally recognized with autism, an unrelated situation. Nonetheless Adejuwon’s autism made the administration of his haemophilia extra sophisticated. He’s more likely to be unable to handle his personal therapy or administer his personal treatment. In itself, Adejuwon’s autism is more likely to forestall him from being in paid employment.

There isn’t a dispute that Dr Khan is liable in negligence for the prices of mentioning Adejuwon attributable to his haemophilia. The problem on this case arises from the query of whether or not Dr Khan is chargeable for all prices associated to Adejuwon’s disabilities arising from the being pregnant or solely these related together with his haemophilia.

The judgments under

The Excessive Courtroom held that Dr Khan was chargeable for prices related to each Adejuwon’s haemophilia and autism.

The Courtroom of Enchantment allowed Dr Khan’s attraction, discovering her chargeable for prices related to Adejuwon’s haemophilia solely. It’s thought-about the scope of a defendant’s obligation of care laid down in South Australia Asset Administration Corpn v York Montague Ltd [1997] AC 191 (“SAAMCO”) as determinative of the difficulty. In concluding that Dr Khan ought to be chargeable for a sort of loss which didn’t fall throughout the scope of their obligation to guard the Ms. Meadows in opposition to, the Excessive Courtroom decide had utilized the “however for” causation check.

The Courtroom of Enchantment took the view that it was inadequate for the courtroom to search out that there’s a hyperlink between the breach and the stage within the chain of causation, on this case the being pregnant itself, and thereafter to conclude that the appellant is chargeable for all of the fairly foreseeable penalties of that being pregnant. The Excessive courtroom had referred to 1 hyperlink within the chain of causation depriving the Ms. Meadows of the chance to terminate the being pregnant. The SAAMCO check requires the hyperlink to be between the scope of the obligation and the harm sustained.

Supreme Courtroom

Unanimously dismissing the attractionthe Supreme Courtroom addressed the next points:

  1. The authorized subject of whether or not in a scientific negligence case the courtroom ought to comply with the strategy of ascertaining the scope of a defendant’s obligation of care laid down by the Home of Lords within the SAAMCO check, and, if it ought to, how that strategy is to be utilized.

The Supreme Courtroom utilized a six stage mannequin to investigate the place of the scope of obligation precept within the tort of negligence [28]. The mannequin served to reveal that the questions of factual causation and foreeability can’t circumvent the questions which have to be addressed in figuring out the scope of the defendant’s obligation [30].

The appellant submitted that the scope of obligation precept in SAAMCO doesn’t apply in scientific negligence claims, and is simply relevant in instances of pure financial loss [61]. The courtroom couldn’t settle for this submission, as there is no such thing as a principled foundation for excluding scientific negligence from the ambition of the precept. Holding that the scope of obligation in query should think about the “nature of the service which the medical practitioner is offering” with a purpose to decide what dangers “the legislation imposes an obligation on the medical practitioner to train affordable care to keep away from” [63].

  1. Is the medical practitioner liable in negligence for the prices of mentioning the disabled little one who has each circumstances or just for these prices that are related to the hereditary illness?

Making use of the rules above, the courtroom concluded that the losses referring to Adejuwon’s autism had been outdoors the scope of Dr Khan’s obligation of care [77]. Lord Leggatt thought-about the scope of obligation precept’s software on this case to be easy. The one goal of the appellants session was to study if she carried the haemophilia gene. There was no discovering that Dr Khan ought to or must have been conscious of any reality which gave rise to an obligation to advise on some other matter [84].

Because the Home of Lords made clear in SAAMCO, knowledgeable whose obligation is restricted to advising on a specific material just isn’t chargeable for all foreseeable opposed penalties to the claimant of giving negligent recommendation. They’re solely chargeable for losses that are “throughout the scope” of the adviser’s obligation of care. On this case, the subject material of the respondent’s recommendation was restricted as to whether the appellant carried the haemophilia gene and subsequently solely losses causally related to that material are throughout the scope of their obligation to the appellant [98].


This case highlights an essential distinction in instances of wrongful delivery between medical providers meant to forestall the delivery of any little one, and providers advising on a specified danger related to the delivery.

The judgment serves as a reminder that the straightforward ‘but-for’ check just isn’t at all times a ample situation for the imposition of legal responsibility, and solely types a precondition for authorized causation. The significance of the scope of obligation can’t be ignored, and has the potential to play a big position in limiting the defendant’s publicity to legal responsibility.

Rebecca Khan is a Authorized Assist Assistant at Matrix Chambers.