Ratcliffe v Plymouth and Torbay HA [1998] EWCA Civ 206

Nurses developed Repetitive Strain Injury (RSI) while working in a neonatal unit and sued their employer for negligence. The Court of Appeal held the employer was not liable, finding the specific risk of this injury was not reasonably foreseeable at the time.

Facts

The claimants were five nurses who worked in the Neonatal Intensive and Special Care Baby Unit at Derriford Hospital, Plymouth. They claimed to have developed work-related upper limb disorders (WRULDs), commonly known as Repetitive Strain Injury (RSI), as a result of their duties. These duties included cradling the heads of premature babies for prolonged periods while carrying out procedures. The nurses sued their employer, the Plymouth and Torbay Health Authority, in negligence. At first instance, the trial judge found in favour of the nurses. The Health Authority appealed that decision.

Issues

The principal legal issue on appeal was whether the Health Authority had breached its common law duty of care to its employees. This turned on the central question of foreseeability: was the risk of nurses developing this type of upper limb disorder from their specific work in the neonatal unit reasonably foreseeable by a prudent employer during the relevant period (the late 1980s)?

Judgment

The Court of Appeal unanimously allowed the appeal, overturning the trial judge’s decision and finding that the employer was not negligent.

Lord Justice Stuart-Smith

Giving the leading judgment, Lord Justice Stuart-Smith conducted a detailed analysis of the evidence concerning the state of knowledge at the time. He stressed that foreseeability must be judged without the benefit of hindsight. He found that while WRULDs were known in certain industrial settings (e.g., poultry processing), there was no evidence that a similar risk was known to exist in the context of neonatal nursing. He highlighted a complete lack of medical literature, industry guidance, or previous complaints that would have alerted a reasonable employer to this specific danger. He stated:

No-one in the nursing or medical profession in this country or indeed in the world had identified the work in the NNU as giving rise to a risk of WRULD until the Plaintiffs began to complain in 1989 and 1990.

Consequently, he concluded that the risk was not foreseeable:

In my judgment it cannot be said that the risk of this type of injury developing in the NNU from this type of work was one which was so plain that a reasonably prudent employer should have appreciated it.

Lord Justice Pill

Lord Justice Pill agreed, pointing out what he saw as the fundamental error in the trial judge’s reasoning. He argued that the judge had wrongly inferred foreseeability by analysing the components of the tasks and comparing them abstractly to tasks in other industries, rather than assessing the actual knowledge available within the nursing profession.

He appears to have assumed that because the tasks when analysed could be described in a way which brought them within the description of tasks which in other contexts had caused WRULD, the risk was foreseeable. That in my judgment involves an unacceptable use of hindsight.

Implications

The case is a significant authority on the test for foreseeability within the tort of negligence, specifically in employers’ liability claims. It firmly establishes that the foreseeability of a risk must be assessed based on the actual and available knowledge within that specific industry or profession at the time of the alleged breach. The court rejected reasoning based on hindsight or abstract analysis of tasks. The decision raised the evidential threshold for claimants bringing actions for novel or emerging types of industrial injury, requiring them to prove that the specific risk was, or should have been, known to the prudent employer in their particular field.

Verdict: The appeal was allowed. The judgment in favour of the claimants was set aside, meaning the defendant Health Authority was found not to be liable for the nurses’ injuries.

Source: Ratcliffe v Plymouth and Torbay HA [1998] EWCA Civ 206