The High Court judgment of 17 March 2026 in MIM v Sheffield NHS Hospitals Teaching Trust [2026] EWHC 562 (KB) involved a claim by a secondary victim in respect of psychiatric harm that he suffered while accompanying his wife during the delivery of their son. It appears to be among the first judgments in which the Supreme Court’s 2024 decision in Paul v Royal Wolverhampton NHS Trust [2024] UKSC 1 has been applied.

In Paul, the majority of the Supreme Court (6:1, Lord Burrows dissenting) held that in situations of medical crises, the treating clinicians’ duty of care did not extend to the patient’s family. A key strand of their reasoning was that “the persons whom doctors ought reasonably to have in contemplation when directing their minds to the care of a patient do not include members of the patient’s close family who might be psychologically affected by witnessing the effects of a disease which the doctor ought to have diagnosed and treated.”

In the absence of a duty, it is self-evident that such claims must fail. Furthermore, for the majority, these claims could not be analogous to ‘conventional’ accident claims in which, for example, a motorist’s duty of care extends to loved ones who suffer psychiatric harm due to witnessing his or her negligent driving causing accidental physical injury to a close family member.

Much of the majority’s decision in Paul also examined whether witnessing a medical crisis, or subsequent harm caused by it, could amount to an “accident” for the purposes of grounding a psychiatric claim by a secondary victim. They concluded that such circumstances could not be characterised as an “accident”, which was described “a discrete event… something which happens at a particular time, at a particular place, in a particular way".

If it applied, the scope of duty point above from Paul would surely have been fatal to the claim in MIM. This point is not, however, mentioned in the decision, quite possibly because the final words quoted in the second paragraph above - witnessing the effects of a disease which the doctor ought to have diagnosed - obviously do not cover the facts. One might infer from this that there was no dispute as to whether MIM was owed a duty of care as a secondary victim.

In any event, MIM submitted that his claim should be allowed on the basis that what had happened in the labour suite to his wife and son should be treated as an ”accident”, allowing his claim to succeed.

 The judge first examined this submission from the perspective of “the ordinary person” - perhaps the 2020s reincarnation of the 19^th century’s “man on the Clapham omnibus”? - and concluded that they “would say that MIM witnessed the process of labour and the birth of his son in an injured condition such that he required resuscitation … a negligently caused medical crisis, rather than an accident.”

She also found that the MIM’s baby son was not involved in an “accident” and nor was his wife. In respect of the former, what had happened could not “amount to an unexpected and unintended event which caused injury to MIM's son by external means”.  In the case of MIM’s wife, her conclusion was that “No accident happens to the mother, and any effect the ordinary internal workings of the mother's body may have had upon the unborn baby (leaving aside whether they can properly be described as external to the baby) cannot in and of themselves be described as an accident in any normal sense either.”

MIM’s claim, for psychiatric harm caused to him as a secondary victim, would therefore be struck out on the basis that there were no reasonable grounds for bringing it.

Lord Burrows made a pithy observation in his dissenting judgment in Paul that “What one means by an accident may be regarded as drawing a somewhat arbitrary line.” Regardless of whether the “accident” test is an arbitrary line or whether the judge’s application of it to MIM’s claim as a secondary victim was very finely balanced, the takeaway from the case is that it remains extremely difficult for these claims to succeed in the context of clinical negligence. 

Although that outcome might have expected following the majority decision in Paul, a further consequence of the decision in MIM may be to make claimants more reluctant to test the limits of the ruling in Paul in other incidences of secondary victim psychiatric harm alleged to have been caused by medical negligence.