Stewarts’ client Andrew, who sustained a life-changing spinal cord injury following a delay in diagnosis and treatment of a spinal epidural abscess, has secured summary judgment in a claim against an NHS trust for medical negligence. Partner Nadia Krueger-Young and senior paralegal Holly Looker acted for Andrew.

Background

Andrew, who was an injecting drug user at the time, attended William Harvey Hospital with severe back and neck pain and extensive wounds to his arms. He underwent blood tests and IV antibiotics but self-discharged. Blood cultures confirmed a bacterial infection, and he was asked to return to hospital. Andrew reattended in the early hours of the following day. He complained again of severe back pain but self-discharged again, before being readmitted later that same day by ambulance.

After waiting for several hours, he attempted to leave hospital again but struggled to walk. He was then admitted, but no formal neurological examination was undertaken. The NHS trust subsequently admitted that this failure was negligent. Limited records confirm Andrew could still move all four limbs. Two days later, Andrew had deteriorated to the point he was unable to move his legs. An MRI scan was performed to investigate his neurological loss, and an epidural abscess was identified at the top of his spine, compressing his spinal cord. By this time, Andrew had also lost the use of his arms.

Andrew was airlifted to King’s College Hospital for urgent decompression surgery. By the time he was prepared for surgery, he had complete paralysis in his hands and was unable to sign the consent forms.

Following the surgery, Andrew has been left with tetraplegia. He has severe lower limb weakness that prevents him from standing or walking, as well as weakness in his upper limbs.

The legal claim

The trust admitted that it failed to undertake a neurological examination when Andrew was admitted with a neurological deficit, which resulted in delays in carrying out an MRI scan and surgery. However, the trust defended the claim on the basis that Andrew was the author of his own misfortune, by reason of being a drug user. Stewarts successfully applied to strike out this part of the defence.

The parties then exchanged expert neurosurgical evidence on causation. Additionally, the trust served a condition and prognosis report, which contained further expert opinion on causation from their neurosurgical expert. The trust’s neurosurgical evidence confirmed that most of Andrew’s functional deficits, including the inability to walk, were because of the admitted failures. The trust’s neurosurgical expert also opined that Andrew’s injuries were due to a non-negligent vascular event that would have occurred in any event.

Stewarts sought clarification of the trust’s causation position, but the responses were inconsistent with the evidence. Stewarts then applied for summary judgment.

Summary judgment – the law

Summary judgment allows the court to determine a claim or issue without a full trial where the opposing party has no real prospect of success and there is no other compelling reason for the matter to proceed to trial.

Under the Civil Procedure Rules 24.3, the court must consider whether the claim or defence has a realistic prospect of success. A realistic case is one that carries some degree of conviction and must be more than merely arguable. In addition, if the respondent cannot show a real prospect of success, they may still defeat the application by demonstrating another compelling reason for trial, such as the need for time to investigate the claim.

Summary judgment is unusual in medical negligence claims as disputed factual and expert evidence often needs to be tested at trial. Summary judgment on contested issues of causation is rare. A review of the reported medical negligence authorities confirms that there are no reported cases where a claimant has successfully obtained summary judgment.

The court’s approach to summary judgment applications is often cautious. In Wright v Basildon and Thurrock Hospital NHS Trust, summary judgment was granted to the defendant after the claimant had been debarred from relying on expert evidence. In Hewes v West Hertfordshire Hospitals NHS Trust, summary judgment for the defendant was overturned because the court had relied on untested expert evidence and had effectively conducted a mini trial.

The court’s decision

The High Court heard the application in July 2026. Stewarts instructed Isaac Hogarth, of 12 Kings Bench Walk, to appear on behalf of the claimant. The court granted summary judgment in Andrew’s favour on breach of duty and factual causation, with the extent of damage and quantum to be determined.

The court found that Andrew did not have paraplegia by the time surgery ought to have taken place. It granted summary judgment on the basis that the severity of his motor deficits was attributable to the trust’s admitted negligence. Without such negligence, his upper-limb power would have returned to normal, and any remaining lower-limb sensory impairment would not have affected his functional capabilities.

What distinguished Andrew’s case was that the trust’s own expert evidence supported his position on the medical causation issues, and the contemporaneous clinical records were also more consistent with Andrew’s position as claimant than the trust’s position as defendant. The trust also failed to serve any witness evidence supporting an alternative position.

The decision demonstrates that even in a complex claim like Andrew’s, summary judgment may be appropriate where the evidence leaves no real prospect of a successful defence on the issue in question.

Andrew’s claim proceeds in relation to quantum and the trust’s remaining allegation of contributory negligence.