12/06/2026
Since the landmark 2024 Supreme Court decision in Paul v Royal Wolverhampton NHS Trust, Polmear and another v Royal Cornwall Hospitals NHS Trust & Purchase v Ahmed (“PPP”), there have been few attempts to test and distinguish the judgment. This latest case from Newcastle is one such attempt and confirms a reluctance by the lower courts to take anything other than a rigid approach in application.
In PPP, the Supreme Court considered whether witnessing a negligently caused “medical crisis” (or its immediate aftermath) involving a primary victim could, in principle, be the basis for a claim for damages by a secondary victim. Ultimately, the Court in a majority judgment, determined that a claim could only be brought where the event triggering the secondary victim’s psychiatric symptoms was an accident in the sense of an unexpected and unintended event which caused injury (or a risk of injury) by violent external means to a primary victim. The Court confirmed that the duty of a doctor who enters into a doctor-patient relationship did not extend to protect the health of members of the patient’s family.
In this case, the primary victim of alleged negligence, BJS, was a 16-year-old and the secondary claimant, SXS, was his mother. As with all three cases in PPP and any other secondary victim claim, the facts are undoubtedly tragic and one can feel nothing but sympathy for BJS and his Mother.
In September 2020, the primary victim suffered a decline in his mental health and was detained and admitted to a paediatric ward. He made numerous attempts to escape and finally managed this, at which point, he climbed over a partition and fell several metres, sustaining serious injuries, including loss of sight in one eye and severe brain damage. This was sadly witnessed by his mother, who brought a claim for damages for psychiatric injuries as a secondary victim.
The primary victim’s compensation claim was compromised, but SXS’s claim for damages continued against the Defendants.
At trial, it was agreed by Counsel and the Judge that the Supreme Court Judgment in PPP was the only relevant authority to consider.
It was contended for the Claimant that the actual circumstances of the case were so close to what constitutes an accident, that it was analogous, such that a duty of care ought to be established.
For the Defendant, it was argued that the primary victim’s actions involved nothing external, unexpected or unintended, elements which were required for there to have been an “accident” for the claim to succeed pursuant to PPP. Whilst the primary victim was unwell, there were no external means which had caused the incident. Further, it was argued that no duty of care was owed to the secondary victim by the doctors, as the patient was her son.
In giving judgment, HHJ Freeman confirmed his interpretation of PPP, noting the “fundamental issue” was the contrast between an accident and a preventable medical crisis. He noted the Supreme Court’s definition of an accident and found that in this case, the vital element for an accident was missing. There was no event which had occurred without deliberate input from the primary victim. This required actions of a third party extrinsic to the primary victim. Although he was severely unwell, the primary victim’s injury was a result of deliberate and intentional actions of his own volition. No accident had occurred.
Here, HHJ Freeman declined to depart from the Supreme Court’s definition of an accident. He found the tragic events were a manifestation of the primary victim’s severe mental illness.
HHJ Freeman furthermore confirmed the public policy position that secondary victim claims will only succeed in exceptional circumstances. While the Supreme Court confirmed that it had not closed the door on all secondary victim claims in a medical negligence context, BJS confirms that it remains extremely difficult to contemplate a set of circumstances, which would give rise to a successful claim.
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