In a bizarre judgment, the English court of appeal found that a hospital receptionist does not owe a duty of care to a patient to inform him of the correct waiting times and patient-care practices in an accident and emergency unit.
The 26 year old patient, who had come in with a head injury from an assault, was told by the receptionist that it would take up to four to five hours before anyone could see him. What she did not tell him was that he would be triaged by a nurse within 30 minutes of arrival to assess the extent of his injury and determine whether he required immediate treatment.
The patient who was in pain left the hospital after 19 minutes without telling the receptionist. His condition deteriorated and he returned by ambulance some two hours later with an extradural haematoma. He was transferred to another hospital for neurosurgery to remove the haematoma but by then it was too late to prevent permanent brain injury. He sustained left hemiplegia with long term disabilities.
It was accepted that had the patient been told that a triage nurse would see him within 30 minutes, he would have waited and his treatment would have been prioritised. It was also accepted that had he received prioritised treatment, he would have made full recovery.
The court found that neither the receptionist nor the hospital (acting through the receptionist) owed any duty to advise the patient about waiting times. The damage which the patient suffered was outside the scope of any duty owed and there was no causal link between any breach of duty and the patient’s injury. In reaching its decision, the court was at pains to make the distinction between ‘civilian’ receptionists without clinical qualification and healthcare professionals. The job of a receptionist is to perform a clerical function by obtaining details of the patient and passing them on to triage nurses and healthcare professionals.
The majority of the court said that the provision of information concerning waiting times is a courtesy. It is not the performance of a legal obligation and that there is therefore no liability if the receptionist fails to provide accurate information or provides inaccurate information to the patient.
A South African court would not reach the same decision.
This is a peculiar judgment (although it is on appeal). A South African court would not reach the same decision. The duty of a hospital should be considered in its entirety. If the hospital has a duty not to misinform patients, the duty is not removed by interposing non-medical reception staff as first point of contact. The duty of care owed to patients by a hospital cannot be divided into those of receptionists and medical staff. A hospital has a duty to provide accurate information to patients including waiting times. That duty is not avoided by the misinformation having been provided by reception staff as opposed to medical staff.
There was in this judgment a not so subtle reference to the ‘floodgates’ argument that if the patient’s claim was allowed, this could become a fertile area for claimants and their attorneys about who said what in the waiting rooms of accident and emergency departments.
The case is Darnley v Croydon Health Services NHS Trust.
However, the judgment is on appeal.