Liverpool Women’s Hospital v Ronayne [2015] E.W.C.A. Civ 588

C’s wife was admitted to the Liverpool Women’s Hospital, administered by D, where she underwent a hysterectomy. A few days after discharge C’s wife became unwell. Ten days after the hysterectomy, she was admitted to the Royal Liverpool University Hospital through A&E. Over 24 hours C observed a rapid deterioration in his wife’s condition. Before she underwent emergency exploratory surgery, he observed her connected to various machines, including drips, monitors etcetera. The following day he observed her in her post-operative condition; unconscious, very swollen, connected to a ventilator and was being administered four types of antibiotics. The condition of C’s wife resulted from D’s admitted negligence in the performance of the hysterectomy. Although C’s wife remained in intensive care for a further nine weeks, she ultimately made a complete recovery.

Under the approach then applied to secondary victims, did the husband's experience of his wife's hospital deterioration support recovery for his psychiatric illness?

The Court of Appeal rejected the husband's claim. Applying the approach then taken to secondary victims, it concluded that his experience of his wife's deterioration and treatment did not amount to the relevant sudden shocking event and was not horrifying by the objective standard it adopted. His understandable distress at seeing a seriously ill relative receiving intensive treatment did not meet that formulation. This is a description of the 2015 reasoning, not a statement of every current requirement. In Paul v Royal Wolverhampton NHS Trust [2024] UKSC 1, the Supreme Court expressly rejected separate requirements of a sudden nervous shock and an objectively horrifying event, while explaining the limits on claims arising from medical crises.

Ronayne historically rejected a secondary-victim claim based on witnessing a relative's hospital deterioration. Its separate tests of sudden shock and objective horror must now be read subject to Paul [2024] UKSC 1, which rejected those additional requirements and clarified the relevance of an accident and the scope of medical duties.

This case requires a visible distinction between historical reasoning and current law. Repeating that hospital scenes were insufficiently horrifying without mentioning Paul would teach a test the Supreme Court has disapproved. A contemporary answer should identify the recognised psychiatric illness, the relevant duty and accident-based controls, and the relationship between the alleged negligence and what the claimant witnessed. Paul also rejects attempts to make a dramatic sequence of deterioration into a legal event simply because it forms a continuous story.