Background
On 7 October 2025, The Hon. Mr. Justice Turner handed down judgment in Conway v Yeovil District Hospital NHS Foundation Trust & Bristol and Weston NHS Foundation Trust [2025] EWHC 2488 (KB), a clinical negligence case involving catastrophic injuries sustained by an infant, Sidney Conway, following two episodes of abusive head trauma (AHT) inflicted by his mother.
The facts of this case are deeply tragic. Sidney, born in November 2014, was admitted to Yeovil Hospital in early January 2015 with symptoms including projectile vomiting, poor weight gain, irritability, and macrocephaly (abnormally large head circumference). Initially suspected to have pyloric stenosis (a condition where the passage between the stomach and small bowel becomes narrower, causing vomiting and dehydration in babies), he was transferred to Bristol Children’s Hospital where an abdominal ultrasound failed to confirm the diagnosis. Despite a concerning increase in head circumference, Sidney was discharged home on 10 January with a plan for health visitor monitoring. The following day, he was assaulted again by his mother, resulting in permanent neurodisability.
Decision
The claimant, Sidney’s father and litigation friend, alleged that the failure to promptly perform a cranial ultrasound scan (USS) constituted negligence. It was accepted that such a scan would likely have revealed signs of trauma, triggering safeguarding procedures that could have prevented the second assault.
However, the court ultimately dismissed the claim. Central to the judgment was the application of the scope of duty principle, as refined in Meadows vs Khan. Mr Justice Turner adopted the six-question 'Scope of Duty' test to assess negligence:
- Actionability – Was the harm actionable in negligence?
- Scope of Duty – What risks did the defendant owe a duty to protect against?
- Breach – Was there a breach of duty?
- Factual Causation – Did the breach cause the loss?
- Duty Nexus – Was there a sufficient link between the harm and the duty?
- Legal Responsibility – Was the harm too remote or caused by another factor?
Mr Justice Turner found that while the injuries were actionable, the Defendants’ duty did not extend to protecting Sidney from unforeseeable criminal acts by his mother. The scope of duty was limited to taking reasonable steps to address medical risks, not safeguarding against abuse that was neither known nor suspected at the time. Mr Justice Turner used the example that, if hypothetically the Claimant had been involved in a road traffic accident in the days following hospital discharge, it would not be viable to pursue a claim against the Defendant on the basis that, had an urgent cranial USS been performed, the Claimant would have remained in hospital and therefore avoid the accident.
Even if the scope of duty had been broader, the court held that there was no breach. The Defendants’ expert, Dr Rose, provided consistent and logical evidence that the decision to monitor Sidney’s head circumference post-discharge was reasonable. In contrast, the Claimant’s expert, Dr Conway, made significant concessions during cross-examination, undermining the reliability of his criticisms.
Mr Justice Turner emphasised that hindsight cannot be used to impose a higher standard of care. The absence of clinical signs of raised intracranial pressure and the resolution of other symptoms supported the decision not to pursue an urgent cranial USS.
Comment
This case highlights the boundaries of clinical responsibility. While deeply tragic, the court reaffirmed that a medical professional’s duty is to take reasonable steps to address foreseeable medical risks, not to guard against outcomes they could not reasonably anticipate. The Scope of Duty test ensures negligence claims remain properly focused, and Conway v Yeovil & Bristol Hospitals reinforces the importance of distinguishing between causation and the limits of professional accountability.
Authors:
Thsnk you to Eden Shosanya for the contribution of this article.
