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Secondary Victims in Medical Negligence Claims

The conventional view in English law is that a duty of care exists between a healthcare professional

and their patient and a breach of that duty may result in a claim for medical or clinical negligence. In

making a claim, the law draws a distinction between primary victims, who suffered the negligence,

and secondary victims. Recently, the Supreme Court considered three conjoined cases that involved

allegations that the defendants had failed to diagnose life-threatening conditions which led to

traumatic deaths along with subsequent psychiatric injuries to the primary victims’ close relatives.

man looking stressed in therapy session

What is a ‘secondary victim’ of medical negligence?

Secondary victims are those persons who are not directly subjected to medical negligence but

witness the suffering of close relatives resulting in psychiatric injury to themselves as a consequence.

Decision in Paul v Wolverhampton NHS Trust (2024)

The primary issue in this and the two conjoined cases was to determine whether an individual can,

as a consequence of earlier clinical negligence, make a claim for psychiatric injury caused by

witnessing the death or some horrifying event suffered by a close relative.

The Supreme Court determined that witnessing an ‘accident’ is a necessary condition for a

secondary victim claim and that witnessing a medical crisis (the suffering or death of a relative from

illness) or its aftermath is not sufficient. An accident is defined as ‘an unexpected and unintended

event which caused injury by violent external means to one or more primary victims’.

The decision was not unanimous. Lord Burrows, dissenting, considered that the Supreme Court had

‘taken an unwarranted backward step’ in ‘departing from the reasoning in almost all of the reported

medical negligence cases in this area’. For Lord Burrows the relevant event is the death. In

considering the distinction between a death caused by an accident and a heart attack, the first

instance potentially permits a secondary victim to recover damages but not the second, a distinction

that might be considered arbitrary.

Practical Implications of Paul v Wolverhampton NHS Trust to medical negligence claims

In practice, the need for a secondary victim to witness an ‘accident’ means that such claims in

medical negligence cases have become more problematic. On a more positive note, secondary

victims in ‘accident’ cases no longer have to prove their injury was caused by a ‘sudden shock to the

nervous system’ and was a sufficiently ‘horrifying event’. These terms lacked precision and the

clarification will assist those advising on the merits of a claim.

If you believe that you or a loved one has been a victim of medical negligence please call for a free, informal chat to see if Graystons Solicitors can help you fight for the justice and compensation you deserve. Call 0151 645 0055 or email


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