Classic case studies

No.1 - Bolam v Friern Hospital Management Committee

Ten cases every consulting engineer should know

Bolam v Friern Hospital Management Committee [1957] 2 All ER 118 

In summary:

Bolam laid down the test for the standard of care applicable to all professionals. 

Facts: 

Bolam sustained injuries during treatment provided to him as a voluntary patient at FHMC’s mental hospital. He claimed damages alleging FHMC had been negligent in (1) failing to administer a relaxant drug prior to the treatment; (2) failing to provide at least some form of manual restraint or control beyond what had in fact been provided; and (3) failing to warn of the risks involved with the treatment. 

Expert witnesses all agreed there was a firm body of medical opinion opposing the use of relaxant drugs, and also that a number of competent practitioners considered that the risk of the patient suffering from a fracture was in fact increased by enhanced manual restraint rather than mitigated. 

FHMC also maintained it was not usual practice to warn their patients of the risk of treatment (which in this instance it believed to be small) unless the patient specifically asked about this. 

The court held that: 

A professional person is not necessarily negligent if he conforms to a practice accepted as proper by some responsible members of his profession, even if other members would have taken a different view.  FHMC was not in breach of duty because it had acted in a way regarded as proper by a responsible body of opinion. 

FHMC was not criticised by the court for having failed to warn the patient of the potential dangers involved with the treatment as it believed them to be minimal. It was held that in order to recover damages for failure to give warning of the dangers, Bolam would need to show not only that the failure had been negligent, but also that if he had been warned of the dangers, he would not have consented to the treatment. 

Bolam is a medical negligence case but the Bolam test has been consistently upheld as applicable to all professional liability cases in England and Wales. The degree of care and skill required therefore is that which is to be expected of a member of the particular profession in question with ordinary or reasonable competence and experience. 

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