Psychiatric Injury Emergency Transfer Claims: Expert Challenges in Employer Liability

The Background – From Clinical Negligence to Employee Injury

A recent High Court judgment, Michelle Prudence & Anor v Gloucestershire Hospitals NHS Foundation Trust, has spotlighted the growing medico-legal issue of psychiatric injury claims by healthcare workers following emergency transfers. In this case, two midwives alleged psychiatric harm after accompanying a newborn, later deceased, in an emergency ambulance transfer. The original negligence was admitted by the Trust regarding the baby's delivery, but the court had to consider whether this extended to a duty of care owed to the midwives as employees.

The Legal Claim – Primary Victims or Professional Collateral?

The claimants argued they were primary victims due to being placed “in the zone of foreseeable physical injury” during the traumatic transfer. Drawing on precedents like Cullin and Donachie, they claimed that because their exposure resulted from admitted negligence, liability should follow. But the judge was not persuaded that admitted failings in patient care automatically meant a duty of care was owed to the staff who responded.

The judgment clearly stated:“…negligence in the delivery of Baby Margot… [is] not contiguous with duties of care owed to the Claimants as employees…”

The Medico-Legal Complexity of Psychiatric Injury Emergency Transfer Claims

The judgment turned heavily on the adequacy of the pleadings. The claimants’ applications to strike out ten paragraphs of the defendant’s defence and seek summary judgment were largely dismissed. The court observed a "lack of clarity" in how duties of care to the claimants had been pleaded.

As the judgment noted: “The Claimants… continue to clarify and develop their claims in each pleading… not the most encouraging start to Applications…”

Without clear identification of breaches owed to the claimants, the defendant's more cautious approach to admitting or denying specific facts was upheld.

The Role of Expert Evidence – Essential, Not Optional

One of the most important findings was the Court’s firm stance on the necessity of expert input. In declining to resolve causation issues prematurely, Master Thornett stated:

“These latter issues are questions for expert evidence. The broad manner and scope of the Claimants’ Applications are quite insufficient as a substitute.”

Crucial questions such as whether an earlier transfer would have prevented the emergency, or whether the midwives would have been involved anyway, could not be answered without detailed expert evaluation of clinical timelines and professional duties.

Key Takeaways for the Medico-Legal Sector

• Admissions of negligence in patient care do not automatically imply liability to healthcare staff involved in later events.

• “Primary victim” status for psychiatric injury requires precise pleading of foreseeability and direct duty of care.

• Attempting to bypass expert evidence with overbroad summary judgment risks being struck down by the Court.

• The HSIB report, though heavily relied upon, does not equate to proof of negligence to third parties like employee witnesses.

  
  

Final Observation – What This Means for Expert Witnesses

This judgment reinforces the importance of precise medico-legal framing and robust expert input when clinicians themselves become claimants. Whether acting for claimants or defendants, expert witnesses must be prepared to tackle not just clinical breach, but also complex causation and occupational foreseeability questions.

As the Court highlighted:“…there might still be reasonable grounds for believing that a fuller investigation into the facts… would affect the outcome of the case.”

The implications are clear: psychiatric injury emergency transfer claims sit at the intersection of duty, trauma, and professional accountability—and they demand expert interpretation at every step.

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