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Understanding the Legal Landscape for Secondary Victims in Clinical Negligence Claims: A Closer Look at Paul v Wolverhampton NHS Trust

In the realm of clinical negligence claims, the legal tests for successfully claiming compensation as a secondary victim are complex and often challenging to navigate. The English case of Paul & Another v Royal Wolverhampton NHS Trust [2024] UKSC 1 sheds light on the intricacies involved, offering valuable insights for those contemplating such legal action.

The Basics of Secondary Victim Claims

Secondary victims, in the context of clinical negligence, are individuals who suffer psychological harm as a result of witnessing the injury or death of a loved one due to medical negligence. Unlike primary victims who directly experience the harm, secondary victims face additional legal hurdles in proving their case.

The Significance of Paul v Wolverhampton NHS Trust

The Paul case is a landmark judgment that established important precedents for secondary victim claims. It emphasizes the need for clear and specific criteria to be met when pursuing compensation in such cases and that clinicians do not have a specific duty to protect families of patients from witnessing their death or injury from treatment.

Key Elements to Prove

  1. Proximity to the Incident
    A crucial factor in a secondary victim claim is the proximity of the individual to the incident. The closer the relationship with the primary victim and the incident itself, the stronger the case. In Paul v Royal Wolverhampton NHS Trust, the court considered the close family member’s proximity to the traumatic effects of earlier medical negligence.
  2. Witnessing the Event or Immediate Aftermath
    To succeed in a secondary victim claim, it is essential for the individual to have directly witnessed the incident or its immediate aftermath as if they had witnessed an ‘accident’. The court in Paul placed emphasis on the visual and contemporaneous perception of the shocking event, linking the psychological harm to the observed negligence. If there is any delay between the initial event and the death or injury, then the case will fail.
  3. Recognizable Psychiatric Injury
    Claimants must provide evidence of a recognizable psychiatric injury resulting from the witnessed incident. This often involves obtaining expert medical testimony to establish a clear connection between the event and the psychological harm suffered.
  4. Foreseeability of Harm
    A successful secondary victim claim must demonstrate that the harm suffered was foreseeable. In Paul, the court analysed whether a reasonable person could have anticipated the psychological consequences for the mother witnessing the negligent medical procedures.

The Emotional Impact on Secondary Victims

The emotional toll on secondary victims can be immense, and the legal system recognizes the need for accountability in cases of clinical negligence. However, the stringent criteria aim to ensure that claims are well-founded, avoiding frivolous litigation while offering justice to those genuinely affected.

Seeking Legal Advice

Navigating the legal intricacies of secondary victim claims in clinical negligence requires expert guidance. It’s crucial to consult with a qualified attorney who can assess the specific details of your case, provide tailored advice, and guide you through the legal process.


The Paul v Royal Wolverhampton NHS Trust case provides valuable insights into the extreme challenges faced by secondary victims in clinical negligence claims. While the legal landscape is intricate, understanding the key elements to prove, such as proximity, witnessing the event, recognizable psychiatric injury, and foreseeability of harm, is crucial. Seeking legal advice is paramount to building a strong case and pursuing just compensation for the psychological harm endured as a secondary victim.

If you or your child have suffered psychological harm as a result of witnessing the injury or death of a loved one due to medical negligence you may be entitled to a compensation. For a free initial consultation with one of our medical negligence experts please call 0330 822 3451 or request a call back online.

Note: This is a general guide and may not cover all aspects of the law or be applicable to every situation. It’s essential to seek legal advice from a qualified professional for personalized assistance.

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