FBD (A Protected Party by his Mother and Litigation Friend, KMF) v The Hillingdon Hospitals NHS Foundation Trust.

Author: Charlotte Buck, Second Six Pupil

Isaac Hogarth, of 12 King’s Bench Walk, instructed by Victoria Williams of Stewarts acted for the Claimant (‘C’) in his claim against The Hillingdon Hospitals NHS Foundation Trust (‘D’). C lacks capacity due to pre-existing learning difficulties meaning that his mother was appointed as litigation friend. The settlement reached was approved by John Halford sitting as a Deputy Judge of the King’s Bench Division in the High Court on 2  March 2026. This case summary is written by Charlotte Buck, pupil barrister at 12 King’s Bench Walk.

The facts

C is a vulnerable individual with a complex history including lifelong learning disabilities, epilepsy, and tuberous sclerosis complex (TSC). His pre‑existing conditions impact upon his ability to communicate, and throughout his life he has relied heavily on his mother.

On the 8th August 2018, C aged 52 suffered an unwitnessed fall in his garden. He was found by his mother lying awkwardly across the raised edge of a flowerbed. At the time, C was taking blood thinning medication and was at heightened risk of internal bleeding.

C attended Hillingdon Hospital by ambulance where he continued to suffer symptoms including an inability to mobilise and continuous severe back pain. He required assistance with urination, and bowel incontinence was later noted.

Despite C’s symptoms, there was considerable delay in considering spinal injury. C was not properly assessed until the 10th August, when a consultant finally identified pronounced weakness in both legs and arranged an urgent MRI. The scan revealed an epidural collection, thought to be a haematoma, compressing the spinal cord.

C was transferred to St Mary’s Hospital where he underwent emergency surgery in the form of a C7–T4 laminectomy and spinal fixation. However, the delay in identifying the haematoma and performing the surgery resulted in C being left with C7 ASIA D incomplete tetraplegia. Following the negligence, he was less mobile, wheelchair dependent for walking long distances, and left with bladder and bowel dysfunction. Most importantly, he lost a great deal of independence in his daily activities.

Liability

D initially denied liability, but later in their Defence made several admissions which resulted in the Court entering judgment for C at a CCMC on 22 October 2024. Crucially, D admitted that if C had undergone timely surgery, he would have recovered to a strong ASIA D level, remained independently mobile, avoided bladder and bowel care, retained independence in daily activities, and would have avoided needing a wheelchair. His recovery and hospital stay would have also been much shorter.

Quantum arguments

In terms of quantum, there were very few heads of loss that the parties were able to agree on. However, the pertinent issues of dispute were life expectancy, care, and accommodation.

On life expectancy, the experts’ opinions differed by ten years. The complicating factor being C’s previous medical conditions, particularly his TSC and uncontrolled epilepsy.

Both sides accepted the need for 24/7 agency care, but there remained a dispute regarding the appropriate cost of this with the expert valuations differing by nearly £70,000 per year. There was also a dispute as to whether double-handed care was required, and if so, when this would commence. D again sought to rely on C’s pre‑existing conditions to try to limit causation, suggesting that the need for such a care regime was merely accelerated because of the negligence by a period of 6-12 months. C, on the other hand, maintained that the need for this level of care was caused by the negligence due to a qualitative and quantitative shift in need.

Accommodation was another significant area of dispute, particularly given C’s reduced life expectancy. The parties disagreed not only on the size and cost of a suitable property, but also the correct approach to valuing accommodation loss in a short life expectancy case, including whether a Swift v Carpenter calculation was appropriate in the circumstances.

Settlement

On 13 January 2026, a quantum JSM took place. No settlement was reached, however, following the JSM, a Part 36 offer of £4.1 million was made and later accepted.

The trial was listed for 8 days, with a window commencing on 2 March 2026.

The agreed settlement was subsequently approved by John Halford sitting as a Deputy High Court Judge, the day the trial window was scheduled to start.

Overall, this sad case serves as a stark reminder of the vital importance of clinicians tailoring their assessments when caring for patients who struggle to communicate.