The High Court has given judgment in a clinical negligence claim by a private patient over whether Diclofenac was prescribed and given before an ERCP procedure at London Bridge Hospital in July 2019.
Key facts
- Who: A private patient, a private hospital operator and a consultant gastroenterologist, the parties to the claim.
- From: Judgment given 29 May 2026
- Source: Andrew Alexander v HCA International Limited & Anor [2026] EWHC 1284 (KB)
On 29 May 2026 HHJ Richard Roberts, sitting as a Deputy High Court Judge in the King's Bench Division, handed down judgment in Alexander v HCA International Limited and another [2026] EWHC 1284 (KB). The trial took place on 16, 17, 18 and 20 March 2026.
Background
The claimant was a private patient at London Bridge Hospital, which is owned and operated by the first defendant, HCA International Limited. On 16 July 2019 the second defendant, a consultant gastroenterologist, performed an endoscopic retrograde cholangiopancreatography (ERCP) on him. The claim is for damages for clinical negligence arising from that procedure.
The claimant developed post-ERCP pancreatitis. The judgment describes a long course of later treatment, including repeated surgery, a fistula, home intravenous feeding and diabetes requiring insulin. On 11 July 2021 he had an operation to close the fistula and reconnect the small bowel to the sigmoid colon, and afterwards returned to full-time work. A medical expert, Mr Poston, reported lasting effects on his bowel function and a permanent pancreatic condition.
Points settled before the decision
The first defendant had pleaded that the claim was statute barred. At the start of the trial its counsel said it was not pursuing that defence. Quantum had been agreed, subject to liability, at £550,000.
The questions for the court
The case concerned whether 100mg of Diclofenac, given rectally, should have been administered around the procedure. The court identified five issues:
- whether the consultant gave the hospital a written prescription for Diclofenac;
- whether he gave the nurses an oral instruction to administer it;
- whether it was in fact administered;
- whether, on the balance of probabilities, the pancreatitis was caused by the failure to give it; and
- alternatively, whether that failure made a material contribution to the pancreatitis.
Further questions followed, including whether the claimant should have been told, and was told, at his consultation on 14 June 2019 and on the day of the procedure that the drug would be given rectally. The court also considered whether a written prescription must be given before a prescription drug is administered in hospital.
The court heard evidence from the claimant, the second defendant, the first defendant's endoscopy manager and a nurse, together with expert evidence.
What this means for those involved in clinical negligence claims
The judgment records how the court approached a claim brought against both a private hospital operator and the consultant who performed the procedure, including questions about prescriptions, nursing records and causation. Anyone with a claim of their own should note that each case turns on its own facts and evidence.
Sources
- Andrew Alexander v HCA International Limited & Anor [2026] EWHC 1284 (KB), High Court (King's Bench Division), 29 May 2026: https://caselaw.nationalarchives.gov.uk/ewhc/kb/2026/1284