Barrett v Sandwell And West Birmingham Hospitals NHS Trust [2015] EWHC 2627 (QB) (18 September 2015)  

C was born in 1978 and suffered diabetes since aged 10, complicated by retinopathy.
On 14 October 2008 he underwent left sided vitrectomy and other procedures, and right sided photocoagulation. He was discharged with a follow up appointment on 27 October 2008.

On 23 October 2008 he attended hospital as an emergency. His left side intra-ocular pressure (IOP) was raised 40. The next day it was 46. He was managed medically and operation was on 28 October 2008. His vision on the left remained poor.

There were many issues but the crucial issue was whether operation on 24 October 2008 was mandatory because of the raised IOP. The court was faced with complicated medical facts in a specialist area and heard complex and conflicting expert evidence: “In seeking to answer these questions, the court has heard factual and expert evidence from six highly qualified ophthalmic surgeons, who fundamentally disagree on some of the central issues.” (at paragraph 118)

The court considered Bolam, Bailey, and Montgomery.

The court decided the central issue for D applying the Bolam principle in in matters of treatment. See: “The principal reason for this conclusion is that whilst the elevated IOP involved risks for the patient, surgery also carried risks, and it was reasonable to regard the risks of surgery as outweighing the risks of medical treatment, albeit a responsible body of ophthalmological opinion may have taken a different view.” (at paragraph 151)