Ambulance crew not negligent in choice of hospital: Stephen Lowe v Yorkshire Ambulance Service NHS Trust (Sheffield County Court, 12 February 2016 – Recorder P W Miller)

Abstract

The claimant lived in Mexborough in Yorkshire. On 19 June 2009 at approximately 07:00, hewas in his kitchen at home when his wife noted that he was neither walking nor talking normally and was showing weakness on the right side. She promptly telephoned for an ambulance. One of the trust’s ambulances arrived at 07:14. It was staffed by two paramedics who examined Mr Lowe and agreed that he had probably suffered a stroke. By 07:20, therefore, they were aware that the patient was in urgent need of emergency medical treatment and that they had, without delay, to decide upon and telephone an alert to the most appropriate accident and emergency (A&E) department. There were only two possibilities: Rotherham District Hospital and Doncaster Royal Infirmary, each of which possessed an A&E department and stroke unit. The crew were very familiar with local traffic conditions and calculated that it would have taken them between 20 and 22min to reach Doncaster, whereas Rotherham could be reached in 5min less. They were also aware that in the event the patient required onward referral to the neurological department at the Royal Hallamshire Hospital in Sheffield, the further ambulance journey would take 10 to 11min from Rotherham but 25 to 26min from Doncaster. An important distinction between the stroke units at the two hospitals was that at certain times of the day Doncaster, but not Rotherham, offered thrombolysis. In 2009, this was a relatively new treatment involving the use of drugs to break down blood clots. However, the service was only available from 08:00 h until 20:00 h at Doncaster, and the ambulance staff knew that prior to 08:00 h, it was not possible to contact the relevant department by telephone. Furthermore, the Ambulance Service’s guidance in respect of the period 20:00 to 08:00 h was to ‘‘Manage the patient as their condition dictates, with a pre-alert to emergency department as per local protocol’’. In view of all the above considerations, the crew took Mr Lowe to Rotherham District Hospital.