## Facts

- The case involved a patient, Barnett, who presented at Chelsea & Kensington Hospital after becoming unwell.
- Hospital staff were negligent in turning Barnett away without appropriate medical examination.
- Barnett died subsequently from arsenic poisoning.
- Medical evidence established that prompt and proper treatment would not have prevented Barnett’s death due to the severity of the poisoning.
- The hospital had breached its duty of care, but it could not be established that this breach caused the patient’s death.

## Issues

1. Whether the hospital owed a duty of care to Barnett.
2. Whether the hospital breached its duty by failing to examine and treat Barnett.
3. Whether the hospital’s breach of duty was the factual cause (“but for” cause) of Barnett’s death.
4. Whether liability can arise without a demonstrated causal link between breach and harm.

## Decision

- The court found the hospital owed a duty of care to Barnett and breached that duty by failing to properly examine him.
- Despite the breach, the court held that the hospital was not liable because the breach was not the factual cause of death; Barnett would have died regardless of the negligence.
- The “but for” test of causation was not satisfied on the facts.
- No damages could be awarded since causation was not established.

## Legal Principles

- A negligence claim requires proof of duty of care, breach, and causation.
- The “but for” test requires that the harm would not have occurred without the defendant’s breach.
- Even if a breach of duty occurs, liability is excluded if the breach did not cause the harm.
- Medical negligence is subject to the standard causation tests in tort law.
- Remoteness and foreseeability principles apply, and damages are available only for losses directly resulting from the breach.

## Conclusion

Barnett v Chelsea & Kensington Hospital established that a breach of duty in negligence does not result in liability unless it can be shown, on the balance of probabilities, that the breach caused the damage suffered. The case confirms the centrality of the “but for” test in causation analysis within negligence law.

Barnett v Chelsea & Kensington Hospital [1969] 1 QB 428