Touche, R (on the application of) v HM Coroner For Inner London North [2001] EWCA Civ 383 (21 March 2001)

On 6 February 1999 Laura Touche gave birth to twins, delivered by caesarean section. On 15 February 1999, tragically, she died. She was only 31. She died from a cerebral haemorrhage, the result of severe hypertension, possibly secondary to eclampsia. The medical evidence suggests that had her blood pressure been monitored in the immediate post-operative phase her death would probably have been avoided. (paragraph 1)

The critical issue… is whether such a death is natural or unnatural – whether, in particular, an inquest must be held into it pursuant to s.8(1) of the Coroner’s Act 1988 which requires such an inquest “where … there is reasonable cause to suspect that the deceased … has died … an unnatural death”. (paragraph 2)

…the wider point which lies at the heart of this appeal: were the Divisional Court right to hold as they did that, whenever a death takes place in hospital and a failure to provide “routine” treatment is a cause (even a secondary cause) of death, the death is unnatural? It is this holding which so concerns the coroner and…. other coroners too.. It would result… in a very significant increase in the number of inquests to be held. (paragraph 38)

…When deciding, therefore, whether or not for s.8(1)(a) purposes a death is unnatural, one should be considering why Parliament has included this category of deaths amongst those into which an inquest must be held. What is it about unnatural deaths that calls for an inquest? Is there not a powerful case for saying that an inquest should be held whenever a wholly unexpected death, albeit from natural causes, results from some culpable human failure? (Or, more strictly, whenever the coroner has reasonable grounds to suspect that such is the case.) Such deaths prompt understandable public concern and surely no small part of the coroner’s function is to carry out an appropriate investigation to allay such concern. (paragraph 43)

…cases involving a wholly unexpected death from natural causes which would not have occurred but for some culpable human failure… It is the combination of their unexpectedness and the culpable human failing that allowed them to happen which to my mind makes such deaths unnatural. Deaths by natural causes though undoubtedly they are, they should plainly never have happened and in that sense are unnatural. (paragraph 46)

An inquest will, of course, be held only if the coroner has reasonable cause to suspect such a combination of circumstances. That does not mean that he will have to make detailed investigations into every hospital death… Nor would I expect such a view of the law to involve any substantial increase in the number of inquests now requiring to be held. (paragraph 47)

Appeal dismissed.