Bolitho v City and Hackney Health Authority

January 24, 2024
Micheal James

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Introduction to Bolitho v City and Hackney Health Authority:

In 1994, Patrick Bolitho, a young boy, arrived at the hospital suffering from respiratory distress. Crucially, due to a low battery in a doctor’s pager, critical medical attention was delayed. This delay had devastating consequences – Patrick suffered cardiac arrest and sustained severe brain damage, ultimately succumbing to his injuries.

Seeking Justice:

Patrick’s mother, Kathleen Bolitho, refused to let her son’s death be in vain. She initiated legal proceedings against the City and Hackney Health Authority, claiming negligence on the part of the medical staff. The central argument was twofold:

  • Breach of Duty: The failure to attend to Patrick promptly was a clear violation of the doctor’s duty of care.
  • Causation: The delay in treatment directly caused Patrick’s death.

Navigating Legal Currents:

The defense hinged on the complexities of medical negligence law, specifically:

  • The Bolam test: This test established that a doctor’s actions cannot be considered negligent if they conform to the practices accepted as proper by a responsible body of medical professionals.
  • Causation: The defense argued that even if the doctor had seen Patrick immediately, the outcome might not have been different.

The Verdict and its Ripples:

The court, in a nuanced and controversial decision, found the hospital not liable. While acknowledging the doctor’s breach of duty, they concluded that even with prompt treatment, Patrick’s condition was likely too severe for recovery. This conclusion, based on expert medical testimony, sparked debate and challenged traditional notions of causation in medical negligence cases.

A Legacy of Complexities:

Bolitho v City and Hackney Health Authority left a lasting mark on legal and medical landscapes:

  • Clarification of the Bolam test: The case clarified that the accepted medical practice should be based on logical and defensible grounds, not simply routine practice.
  • Causation in medical negligence: It highlighted the challenges of establishing causation in complex medical situations, where multiple factors can contribute to an outcome.
  • Ethical and legal dilemmas: The case raised questions about the balance between individual accountability and the limitations of medical knowledge and intervention.


Bolitho v City and Hackney Health Authority remains a poignant reminder of the human cost of medical errors and the complexities of pursuing justice in such situations. It is a case that not only shaped legal precedent but also sparked critical conversations about medical ethics, accountability, and the limitations of our knowledge in the face of life-or-death scenarios. The echoes of this case continue to resonate in courtrooms and medical facilities alike, reminding us of the ongoing quest to balance justice with the uncertainties inherent in the world of healthcare.

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