Wilsher vs Essex Area Health Authority
Reference : [1988] AC 1074
Jurisdiction : England
Plaintiff : Wilsher
Defendant : Essex Area Health Authority
Facts :
Plaintiff Wilsher, who was an infant, was delivered prematurely in Essex Area Health Authority hospital. During the postnatal care of the child, an inexperienced junior doctor at the defendant hospital accidentally administered the baby excess oxygen. The baby afterwards suffered blindness through retrolental fibroplasia (a condition that happens to the premature infant due to some causes). The House of the Lords then found that, according to the medical evidence, five potential factors were identified as contributing to the problem. Four factors were related to the premature birth condition of the baby, while the excessive oxygen administered by the junior doctor was the fifth possible factor that could have led to blindness.
Issue : Whether administering excess oxygen by the junior doctor actually caused the blindness of the plaintiff?
Decision :
Initially, the trial judge found the defendant, Essex Area Health Authority liable stating the “McGhee Principle”. In the case of “McGhee v National Coal Board”, the defendant was found liable for materially increasing the risk of damage. So, the Court of Appeal applied the “Material increase of risk” in this case stating, the doctor’s action contributed to the blindness suffered by the plaintiff, Wilsher, as it was one of the five causes of the blindness and the burden of proof fell on the defendant. However, the defendant, Essex AHA, later appealed the decision, and the House of Lords, upon review, overturned the lower court’s ruling.
The judgment of the House of Lords was in favor of the defendant hospital. The court found it impossible to determine whether the junior doctor’s action caused the damage. In McGhee, there was only one possible factor that led to the disease, which was the ‘dust of the bricks’. But in this case, there were four other possible factors that could potentially cause the blindness of the infant.
Lord Bridge of Harwich stated that, it could not be conclusively determined that the junior doctor’s negligence was the actual cause of the blindness. As a result, the burden of proof was on the plaintiff to establish that, the excess oxygen had led to the blindness, on a balance of probabilities. Any of other four causes could have also be the cause of the damage sustained by the plaintiff. And thus the plaintiff failed to sufficiently demonstrate a direct causal link between the alleged negligence and the infant’s eye condition.
“McGhee Principle” can only be applied if there is only one cause of the damage and that is occurred by the defendant’s action. However, in this case there were five other potential causes of the damage. The actual cause of the infant’s blindness could not be clearly identified and the defendant, Essex Area Health Authority cannot be held liable for the injury for their negligence which only led to one of. the numerous causes.
Author :
1. Nusiba Hasan Ohee
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