Williams v Bermuda Hospitals Board

• Jurisdiction: Bermuda
• Judge: Evans JA,Ward JA,Bell AJA
• Judgment Date: 17 March 2014
• Neutral Citation: [2013] CA Civ Bda 2
• Docket Number: Civil Appeal 2013 No 2
• Court: Court of Appeal (Bermuda)
• Date: 17 March 2014

[2014] Bda LR 22

In The Court of Appeal for Bermuda

Before:

Evans JA; Ward JA; Bell AJA

Civil Appeal 2013 No 2

Between:

Kamal Williams

Appellant

and

Bermuda Hospitals Board

Respondent

Mr J Pachai for the Appellant

Mr A Doughty for the Respondent

The following cases were referred to in the judgment:

Stapley v Gypsum Mines LtdELR [1953] AC 663

Barker v Corus UKELR [2006] 2 AC 572

Fairchild v Glenhaven Funeral Services LtdELR [2003] AC 32

Bailey v Ministry of DefenceUNK [2008] EWCA Civ 883

Gregg v ScottELR [2005] AC 176

Bolam v Friern Hospital Management CommitteeWLR [1957] 1 WLR 582

Professional negligence — Duty of care — Delay in treatment causing ruptured appendix — Damages — Appeal — Causation — Tortious liability

JUDGMENT of Ward JA

1. On 30 May 2011 at 7:30 am the Plaintiff/Appellant was at his home and feeling unwell. Nevertheless he went to work where at 9:30 am he experienced lower abdominal pain.

2. At 10:15 am he was taken to the King Edward VII Memorial Hospital (KEMH) operated by the Bermuda Hospitals Board (BHB) with severe abdominal pain.

3. An hour later at 11:16 am he was admitted to the Emergency Department of the hospital. Dr Okereke was the doctor who admitted him. He was examined and at 11:31 am he was found to have excessive pain (10 out of 10), abnormally low blood pressure, 86/57, abnormal pulse rate, 105, and an abnormal respiratory rate of 24. He was a very sick man.

4. At 11:44 am he was again examined by Dr Okereke. The patient was screaming in considerable pain. He would not allow the doctor to touch his belly. He was diagnosed as showing symptoms consistent with appendicitis. He also informed the medical personnel that other members of his family had suffered with a similar ailment. He was given Pethidine to alleviate the pain which he was suffering.

5. At 12:15 pm Dr Okereke again examined the patient. By this time the Pethidine had begun to take effect and the patient was more comfortable. But it did not mean that the internal situation in the patient was any less dangerous.

6. At 1:10 pm Dr Okereke made a further examination and ordered a CT scan which was described as the appropriate test before surgical consultation. This test was ordered almost three hours after the patient went to the hospital at 10:15 am and almost two hours after his admission at 11:16 am.

7. There followed delay in the taking of the CT scan and in obtaining the results of the CT scan.

8. At 3:00 pm Dr Okereke called the Diagnostic Imaging Department to stress the urgency of carrying out the CT scan. He spoke to a technician who said that the department was still very busy and the scan would be taken as soon as possible.

9. The patient continued to grow worse. At 3:18 pm he had an abnormally rapid pulse rate of 118 and he was again showing signs of pain. He was given more Pethidine which had last been administered at 11:44 am. Its purpose was to mask the pain but it did not address the underlying problem.

10. At 4:00 pm there was a changing of the guard. It was the end of the work day of Dr Okereke and his final day at work at KEMH. He handed over the care of the patient to Dr DiLullo.

11. Dr DiLullo examined him at 4:17 pm and again at 4:45 pm His vital signs were stable but he was still in considerable pain with severe abdominal tenderness.

12. At 5:12 pm the patient was taken for the CT scan which was completed by 5:30 pm.

13. At 5:38 pm Dr DiLullo again examined the patient who had a slightly elevated heart rate but his blood...