Introduction

In the given case of Cassidy v. state of health, the concepts of negligence in medical
environment and vicarious liability are involved.
The concept of res ipsa loquitor was first introduced in the case of Byrne V. Boadle (the
Barrel case). However, it only gained popularity in the case of Scott V. London & St.
Katherine Docks Company. It means that the facts are enough to prove the negligence of the
defendant and the onus to prove that there was no negligence is on the defendant.
Another concept of vicarious liability is involved wherein the minister of health is being held
liable for the negligent acts of the doctor employed by him in the govt. hospital. It can be
ascertained that however negligent the act may be and whom so ever may be delegated the
act performed whether it be a servant or a contract of service or to an independent contractor.
The Coram constituted of Somervell LJ., Denning LJ. and Singleton LJ.
The date of:
1. Coming to court-1948
2. Filing case-1948
3. Judgement-1951
The court in which the case was filed was the court of appeal (England and Whales). The
Court of Appeal is the highest court within the Senior Courts of England and Wales, and
second in the legal system of England and Wales only to the Supreme Court of the United
Kingdom.
 Table of cases

S.NO. Name of the case

1. Evans v. Liverpool Corporation
2. Hillyer v. St. Bartholomew's Hospital
3. Strangways-Lesmere v. Clayton
4. Lindsey C. C. v. Marshall
5. Gold v. Essex County Council
6. Lavelle v. Glasgow Infirmary
7. Reidford v. Aberdeen Magistrates
8. Collins v. Hertfordshire County Council

Table of statutes
S.NO. Name
1. Public Health Act 1936
Statement of facts

1. In the present case of Cassidy V. Minister of Health, he plaintiff is Mr. Cassidy, a

labourer and the defendant is the Minister of Health.
2. In the present case, Mr. Cassidy, is a labourer whose two fingers, the third and fourth
finger in his left hand were contracted.
3. The plaintiff then consulted with his panel doctor, Dr. Flanagan who diagnosed the
plaintiff’s current condition as Dupuytren’s disease and further sent the plaintiff to the
Walton Hospital.
4. Upon visiting the Walton Hospital at Liverpool, he was advised by Dr. Fahrni who
was a whole time assistant medical officer of the said hospital. The diagnosis made by
the Dr. Flanagan was confirmed by Dr. Fahrni and recommended the plaintiff an
operation which was to be performed on April 8, 1948.
5. The operation was also personally performed by Dr. Fahrni.
6. According to standard post operation care, the patient was made to keep his hand and
lower arm rigid in a splint for eight to fourteen days. While undergoing this treatment,
the plaintiff was under the care of Dr. Fahrni, Dr. Ronaldson (the house surgeon of the
hospital), and the nursing staff of the hospital.
7. After the fourteen days of keeping the hand rigid in a splint, the hand was released
from the splint. It was found that the hand was now for all intents and purposes
useless. Not only were both the fingers which had been operated were now bent and
stiff but also affected the two good fingers.
8. After this, two manipulative operations were performed to correct the current
condition but both of them were in vain. Now all attempts to remedy this condition
were abandoned.
9. The plaintiff then filed a case against the minister of health holding him/her
vicariously liable for the negligent wrongs committed by the doctors of the Walton
hospital. The case was filed in the Court of Appeal (England and Wales).
Issues raised

1. Whether the ministry of health can be vicariously held liable for the acts of the
doctor?
2. Whether there is sufficient proof as to the cause of the plaintiff’s resulting disability?
Judgement
The judgement given by-
L.J. Somervell-
1. The judge having found for the defendants did not consider the issue to be between
these two parties. There was considerable checking of Dr. Fahrni’s medical
background but nothing worth suspicion was found.
2. Also the ministry of health has been correctly held vicariously liable under Section 6
of the National Health services act 1946.
3. The judge also holds the hospital responsible for all those in whose care the plaintiff
was kept which includes, Dr. Fahrni, Dr. Ronaldson, and the nursing staff.
4. The possible allegations for negligence can be summarized as follows-
a. That the splinter was tied too tightly after the operation of the plaintiff.
b. That sufficient heed was not paid to the complaints of excruciating pain made by
the plaintiff.
c. That the splint should have been loosened after some time or the hand inspected in
between which might have led to the permanent damage that was caused to the
left hand due to improper or inadequate flow of blood to the fingers.
5. The learned judge also stated the fact that even though there could be three probable
negligent acts which could have led to the damage to the hand of the plaintiff however
it is difficult to ascertain which particular act led to it. Also the judge feels that the
defendants failed to rebut this inference of not questioning the very fact that it is
difficult to find a particular act of negligence when there is no surety if whether the
operation itself was performed in a negligent manner. Also no outside expert was
consulted.
6. He thus allows appeal for the case.

Denning L.J.-
1. The hospital treating a patient is under duty to take reasonable care and reasonable
care of him and also exercise reasonable skill. The hospital authorities or the doctor is
not to be put under liability by the fact that whether the patient is paying any charges
or not but by the fact that they are treating that patient.
2. This must be done through the doctors and the hospital staff. The doctor howsoever
skilled he may be cannot lead to the hospital authorities not being liable because the
hospital has the responsibility to take care and that too reasonably of the patient. This
was most probably a rule to relieve charitable hospitals of their liability towards the
patient which was stated i9n the case of hillier delivered by Kennedy L.J. also the
hospital can only be relieved of its liability if the patient himself chooses the doctor.
3. However it does not matter if it is a contract for service or of service. The hospital has
also failed to explain that this can happen without negligence as well.
He thus allows appeal of the case.
Singleton L.J.-
1. It lies upon the defendants to show that the damage occurred without negligence on
their part - "Where the thing is shown to be under the management of the defendant or
his servants, and the accident is such as in the ordinary course of things does not
happen if those who have the management use proper care.
2. The plaintiff need not prove that whether the negligence was caused by A, B, C OR D
or any two of them. He must show that the defendant is liable for the acts of any one
of them.
3. Also the fact that the plaintiff was under the care of the defendant he need not prove
who in particular was liable but just prove the case of negligence on the basis of prima
facie evidence.
4. "But in each case the first task is to discover the extent of the obligation assumed by
the person whom it is sought to make liable. Once this is discovered it follows of
necessity that the person accused of a breach of the obligation cannot escape liability
because he has employed another person, whether a servant or agent, to discharge it
on his behalf, and this is equally true whether or not the obligation involves the use of
skill. It is also true that, if the obligation is undertaken by a corporation, or a body of
trustees or governors, they cannot escape liability for its breach, any more than can an
individual, and it is no answer to say that the obligation is one which on the face of it
they could never perform themselves.
5. Also the judge does not find any difference between the Dr. Ronaldson or Dr. Fahrni
or the nursing staff as all of them are skilled professionals employed by the hospital
and need to perform their duty with reasonable care and skill and hence negligence by
any one of them will lead to the defendant being liable.
Ratio Decidendi

The Court of Appeal held that the defendant was vicariously liable.

The fact that the worker engages in specialised and technical work for which he is specially
qualified does not mean that he is necessarily not a servant. The Court held that a person is a
servant of the defendant if he was chosen for the job by the defendant and is fully integrated
into the defendant’s organisation.

In this case, the doctors were appointed to the hospital by the defendant and not chosen by the
patient, and were fully integrated into the hospital. They were therefore the defendant’s
servants.