on 24 January 2014 C suddenly lost consciousness and fell to the ground… and caused him a serious spinal cord injury.
He was 43. His faint was caused by an undiagnosed heart condition. It was eventually diagnosed as ‘intermittent atrioventricular (AV) block’… The condition is treatable with a pacemaker, and he later had one fitted. If CM had had a pacemaker at the time, he would not have fainted and sustained his injury. 
C had been to his local GP practice in the previous June and September, with symptoms which the doctors did not connect with a possible heart condition. He went again on 18 October 2013, complaining of unusual breathlessness after exertion and what felt to him like an unusual heartbeat (palpitations), amongst other things. D sent him for an electrocardiogram (ECG) test… He took the ECG test at the surgery on 21 October 2013, three days after his GP appointment. When the results came back to D, they showed some electrical abnormalities. The doctor now accepts that he should have referred C to a hospital cardiology department for further investigation, as soon as the ECG result came back. But he did not. 
This is C’s claim for damages for personal injury, on the basis that the spinal cord injury was caused by D’s negligence in failing to refer him for investigation of the abnormal ECG. That negligence is admitted. The issue before me is causation. 
Causation is a matter of fact and evidence… 
..my conclusion is that the negligence of D, in failing to refer an abnormal ECG result to a hospital cardiology department, caused C to collapse on 24th January 2014 because of undiagnosed and untreated intermittent AV block, and to sustain serious injury as a direct result.