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'Pure Diagnosis' and 'Pure Treatment': A case considering whether the Bolam principle is applicable across the spectrum of Clinical Negligence cases - Penny Fitzpatrick & Marianne Walker, Slater and Gordon

22/05/17. In the recent case of Desmond Muller v Kings College Hospital NHS Foundation Trust the key question to be answered was whether the test in Bolam should be applied to a case where the sole issue of breach of duty was a misdiagnosis.

The Facts

Mr Muller was on holiday when he first noted a painful lesion on the sole of his foot, the cause of which was unknown. He was referred to a dermatologist at Orpington Hospital who took a punch biopsy which was reported by the Defendant histopathologist to contain ‘features of an ulcer consistent with trauma’. The lesion failed to heal. An excision of the affected area was carried out in July 2012, and reported to show acral lentiginous malignant melanoma (‘ALMM’). Following diagnosis, the original punch biopsy was reviewed and found to contain histopathological features of malignant melanoma.

The Expert Evidence

The Claimant adduced expert evidence in support of his position on breach of duty that the...

Image ©iStockphoto.com/J-Elgaard

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