The High Court considered an application, made weeks before trial, to amend a clinical negligence claim against an osteopath who admitted failing to advise emergency hospital attendance for suspected Cauda Equina Syndrome.
Key facts
- Who: The claimant, a patient with Cauda Equina Syndrome, and the osteopath she is suing in a clinical negligence claim.
- From: 8 May 2026 (judgment date)
- Source: Chelsea Williams v Daniel Wilkinson [2026] EWHC 1088 (KB)
In Chelsea Williams v Daniel Wilkinson [2026] EWHC 1088 (KB), handed down on 8 May 2026, Mr Justice Cotter in the High Court (King's Bench Division) dealt with a pre-trial application in a clinical negligence claim against an osteopath. The hearing took place on 30 April 2026.
Background
The claimant saw the osteopath between 5.00pm and 6.00pm on 14 February 2020 with symptoms of Cauda Equina Syndrome (CES). He noted her symptoms, considered she had CES and advised her to call 999 if her symptoms increased or she had difficulty urinating. He accepts that he failed to recognise a medical emergency and that he should have advised her to attend A&E urgently.
She went home and called an ambulance later that evening after her symptoms deteriorated. She was operated on the next day and has significant residual symptoms. It is not disputed that she has CES with neuropathic pain and urinary and bowel symptoms.
The dispute
Breach of duty was conceded before proceedings were issued. The osteopath denies that his failure caused any injury or damage. He says there was no neurological deterioration while she waited for surgery (which the claimant does not accept), that she would not have been operated on any earlier, or that any earlier surgery would have made no material difference. He also argues that any residual injury was caused by non-negligent damage during the operation.
The claimant's schedule of loss seeks £873,395, including general damages. The osteopath's counter-schedule says the proper award is £86,571.
A seven-day trial was listed in a five-day window starting on 15 June 2026. On 16 April 2026 the claimant applied for permission to amend her particulars of claim, to rely on a further witness statement from herself and a statement from her solicitor dated 2 April 2026, and to rely on further expert evidence from her urology, pain management and spinal experts. The osteopath opposed the application in its entirety. It was not in issue that if permission to amend were granted, the trial date would be lost.
The proposed amendment
The claimant's current case is that, with reasonable management, she would have gone directly to A&E, arriving between 6.00pm and 6.30pm on 14 February 2020, and would probably have had emergency surgery that evening.
The amendment would say she would either have gone directly to A&E or gone home and called 999 or 111, and that the second was more likely because she needed to collect her son from nursery and does not drive. On that account she would probably have had surgery during the night or at about 9.00am, rather than at 4.10pm, around seven hours earlier.
The judge noted that the claimant's further statement did not say when she would have called 111 or 999, which he described as a significant omission. He also noted that the spinal surgeons' view was that a delay of six hours or less would not have made any material difference to the outcome.
What this means for people in clinical negligence claims
In this case the osteopath's breach of duty was admitted before proceedings began, but whether his failure caused injury, and what would have happened had she been advised to attend hospital as an emergency, remained in dispute. The claimant's application to change her pleaded case was opposed, and it was not in issue that granting it would mean losing the June 2026 trial date.
Sources
- Chelsea Williams v Daniel Wilkinson [2026] EWHC 1088 (KB), High Court (King's Bench Division), 8 May 2026: https://caselaw.nationalarchives.gov.uk/ewhc/kb/2026/1088