In March 2025 the High Court reaffirmed that a medical practitioner should not be held to have been negligent simply because something went wrong during a surgical procedure. To do so impermissibly reasons backwards from cause to effect.
In this case, the Plaintiff claimed damages from the defendant, a gynaecologist and obstetrician, following a laparoscopic surgical procedure during which cystic masses around her ovaries were removed together with her right ovary. It was agreed that as a consequence of the surgical procedure, the plaintiff sustained a perforation in the dome of her bladder, which was subsequently repaired surgically.
The main issue determined by the Court was whether the plaintiff’s injury was caused by the defendant’s negligence. The plaintiff had to prove that, in the defendant’s performance of the surgical procedure and his use of the LigaSure surgical device, he failed to adhere to that level of skill and diligence of a reasonable gynaecologist and obstetrician in the circumstances.
The test applied by the Court in making its determination was whether the defendant employed reasonable skill and care and whether his conduct fell below the standard of a ‘reasonably competent’ medical practitioner in his field.
The Court decided that the plaintiff failed to prove that in the defendant’s use and application of the LigaSure surgical device during the performance of the laparoscopic surgical procedure, the defendant was negligent and such negligence resulted in her sustaining a perforation in the dome of her bladder. In the Court’s view, based on a careful evaluation of the facts and of the expert evidence led by both parties, the perforation to the bladder was an unfortunate complication, the kind of which that can occur in the best of hands.
This judgment serves as a reminder that the res ipsa loquitur principle rarely has application in medical malpractice claims. Just because a complication arose during a surgical procedure or during medical treatment, does not mean that there is automatically blameworthy conduct attributed to the medical practitioner. In each case the Court will determine whether the medical practitioner’s conduct fell below the standard of the reasonably competent practitioner in that medical field. The medical practitioner will, as in this case, have to call expert evidence to show that the event can or did occur without any negligence.