Kennedy v Frankel [2019] EWHC 106 (QB) (25 January 2019)

C is married to Dr Philip Kennedy, who was a consultant neurologist until his retirement in 2006. In 2006, when aged 44, C developed a tremor in her left upper limb. Her husband was concerned that this was a sign of Parkinson’s disease and arranged for her to see his former colleague D a specialist in movement disorders. D saw C privately, but without charge. He diagnosed Parkinson’s disease and advised on her treatment. Dopamine agonist medication, which C took on his advice, caused her psychiatric side effects, including an impulse control disorder (ICD) and eventually psychosis. [1]

C’s case that D failed to advise her of the risk of impulse control disorder associated with dopamine agonist medication and that he failed to respond in a timely or appropriate way when she developed the condition. She accepts that an appropriate warning would not have deterred her from taking the medication initially but contends that, properly advised, she would have ceased taking it far earlier and would have avoided the serious effects that developed. She therefore brings a claim for clinical negligence. It is an irony that it has since been discovered that she did not have Parkinson’s disease at all. However, it is not alleged that this amounted to a negligent misdiagnosis. [2]

Her claim relates to losses flowing from the ICD and psychosis. In addition to the more usual claims for treatment and care during her illness, she also brings claims relating to increased spending due to the ICD and for costs associated with separating from her husband as a consequence of her psychosis. Happily, C has now made a good recovery following cessation of the medication and her relationship with her husband has been restored. [3]
D denies liability. He maintains that his treatment of C was reasonable at all times, based upon the information available to him at the time. Even if the Court finds that there should have been more detailed discussions about ICD and alternative medication, D denies that C’s treatment would have been changed earlier than it in fact was. [4]

…this judgment is limited to the issues of breach of duty and causation (excluding the ‘scope of duty’ argument). [9]

C had an unpleasant time coming off the drug but went on to make a good recovery. Her ICD and psychosis resolved completely, and she and Dr Kennedy were able to save their marriage. Upon withdrawing from ropinirole, she did not develop the motor symptoms that would have been expected, leading to the suspicion that she did not in fact have Parkinson’s disease. Dr Gibb, the neurologist from whom she sought a second opinion, confirmed in April 2013 that she did not have Parkinson’s disease. [109]

…D should have warned the C of the risk of developing ICD on ropinirole from April 2010. Further, when symptoms of ICD emerged, he should have clearly explained that taking levodopa instead was likely to abolish symptoms of ICD while still providing good control of the symptoms of Parkinson’s disease. However, any breach prior to October 2011 did not cause any loss, since I conclude that, properly advised, C would have continued to take ropinirole until that time. [111]