## Facts

- The Supreme Court consolidated three cases: Paul v Royal Wolverhampton Trust, Polmear v Royal Cornwall Trust, and Purchase v Ahmed.
- Claimants in each case were family members who alleged psychiatric injury from witnessing the death or severe injury of a loved one due to alleged medical negligence.
- In Paul, the claimants witnessed the collapse and death of their father hours after hospital discharge.
- In Polmear, the claimants did not perceive the immediate aftermath of the primary victim’s injury, as harm occurred during surgery and was not immediately apparent.
- In Purchase, the claimant, a mother, alleged psychiatric harm after her child suffered severe brain damage attributed to medical negligence.
- All claims centered around whether medical negligence leading to injury or death established sufficient proximity for secondary victim liability.

## Issues

1. Whether defendants owed a duty of care to secondary victims suffering psychiatric injury from witnessing harm to a primary victim in the context of medical negligence.
2. Whether the necessary legal requirements—proximity in time and space, close tie of love and affection, and sudden shock—were satisfied in the circumstances of each case.
3. Whether the harm suffered by secondary victims was reasonably foreseeable.

## Decision

- The Supreme Court reaffirmed the "control mechanisms" for secondary victim claims established in Alcock v Chief Constable of South Yorkshire Police [1992].
- In Paul, the Court found that witnessing the father's collapse satisfied proximity and sudden shock requirements.
- In Polmear, the claim failed as the lack of immediate perception of harm by claimants precluded sufficient proximity.
- In Purchase, although the close relationship requirement was met, the claim failed because the psychiatric injury resulted from a gradual realization of harm, not a sudden shock.
- The Court held that in medical negligence cases, delayed onset of injury or gradual appreciation often prevents secondary victim claims from meeting the necessary criteria.

## Legal Principles

- Secondary victim claims require strict satisfaction of criteria: proximity in time and space, a close tie of love and affection, and a sudden and shocking event causing psychiatric injury.
- The principles established in Alcock apply equally to medical negligence cases, but their factual circumstances often make it difficult to meet the control mechanisms.
- Foreseeability of harm to a person of ordinary fortitude is required, but is not the sole determinant of liability.
- Distinction between primary and secondary victims remains significant; stricter parameters apply to secondary victim claims to ensure manageable limits on liability.
- The Court endorsed prior case law, including Taylor v A Novo (UK) Ltd [2013], which requires a close temporal and causal connection between the negligent act and the shocking event.

## Conclusion

The Supreme Court clarified and reaffirmed the strict legal requirements for secondary victim claims in negligence, particularly within medical settings, emphasizing that liability is tightly limited by the necessity of close proximity, a sudden shocking event, and a close relationship, and that foreseeability alone is insufficient to establish a duty of care for psychiatric harm suffered by witnesses.


Paul v Royal Wolverhampton [2024] UKSC 1