• In the case of St George v Home Office [2008] E.W.C.A. Civ 1068, it was held that a claimant’s previous life-choice decisions regarding drug and alcohol abuse did not amount to contributory negligence when the alleged damage resulted from a head wound that resulted from the defendant’s negligence.

Facts of the Case

  • C had been an abuser of alcohol and drugs since the age of 16.
  • On 29th October 1997, C, aged 29, entered prison to serve a 4-month service for theft. Prison staff were aware he had previously suffered withdrawal seizures.
  • C declined the opportunity to see a doctor and was allocated to ‘an ordinary location’ within the prison.
    A health screen interview confirmed C had epileptic fits that were being investigated and C was currently using alcohol, valium and intravenous heroin.
  • C was assigned to a ward in the hospital wing. This was an open dormitory with both single and bunk beds.
  • The controlling officers mandated who slept in which bed, with C assigned to a top bunk.
  • On 3rd November 1997, C had a withdrawal seizure and fell 7-8 feet to the floor, suffering a head wound.
  • C was attended by nurses and taken by ambulance to hospital. C suffered progressive severe brain damage, leaving him very severely and permanently disabled.

Issues

  • Was D negligent in assigning C a top bunk while knowing C’s history of seizures?
  • Did C’s history of drug and alcohol abuse constitute contributory negligence towards his mental condition?

Held by the Court of Appeal (Civil Division)

  • Finding for C, that his past fault that led to his addictions was too remote in place, time and circumstance, and was not sufficiently connected with the negligence of D. It was not just, fair or equitable to reduce C’s damages.

Lord Dyson

  • When there is a difference between experts on a fundamental point, the court must justify its preference for one over the other through analysis of the underlying material and their reasoning. It is not sufficient, if there is no such material/reasoning, to accept the opinion of one expert on the grounds that he has given his evidence confidently.
  • There may be cases where the court cannot decide which opinion is more persuasive. Occasionally, where there are alternative explanations for an injury, but the court is unable to say on the balance of probabilities which is to be preferred, C must fail on the grounds that he had failed to discharge the burden of proof.
  • The judge at first instance did not base his conclusion solely on his preference for C’s evidence because of his confidence. The doctor’s own clinical experience (one case) was a slender basis for accepting theory. However, the judge was entitled to be impressed by the fact that C had had three previous withdrawal seizures and none of them had resulted in the injuries C suffered in the present case.
  • The judge was entitled to hold that C was at fault in becoming addicted. He was entitled to infer that C must have known at that time that abuse on the scale necessary to cause addiction was dangerous to his health. He was also entitled to conclude, without benefit of medical evidence, that D had discharged the burden of proving fault. However, that is not the cause of subsequent negligent medical treatment.
  • “The position of C was analogous to that of a patient who is admitted to a rehabilitation clinic for the express purpose of being weaned off his addiction to drugs. If such a patient were placed in a top bunk and suffered a withdrawal seizure and injury as a result of a fall to the floor, D accepts that his claim for damages would not be reduced for contributory negligence. He seeks to distinguish such a case on the grounds that C was not admitted to prison for the purpose of being treated for his drug addiction. That is true, but the prison and the rehabilitation clinic share the common objective of weaning those in their care off drug and alcohol dependency. The methods by which they seek to achieve this may differ, but their objectives are the same. It is foreseeable to both the clinic and the prison staff that the person in their care may suffer a withdrawal seizure in the process” [61].

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