Family of man who died after suffering head injury in camping community successful in claim against ambulance service

About this case:

• Citation:
  [2025] CSOH 17
• Judgment:
  External link
• Court:
  Court of Session Outer House
• Judge:
  Lord Young

Lynda O’Neill, the widow of Brian O’Neill, and other family of the deceased raised an action against the Scottish Ambulance Service alleging that there was a failure to transport him to hospital after a 999 call was made on his behalf. The defender disputed the action on the basis of causation and the reliability of their main witness, a doctor who treated Mr O’Neill on site.

The case was heard by Lord Young, with L Sutherland KC and H Masters, advocate, appearing for the pursuers and A Bergin and J McGowan, advocates, for the defender.

2-3 hour wait

Mr O’Neill was a member of the Carbeth Hutters Community, a collection of huts on land to the north of Milngavie that developed out of a post-World War 1 camping initiative. The huts remained “off-grid” to the extent of not being connected to the usual service utilities. On the evening of 27 June 2020 while visiting his hut, Mr O’Neill suffered a fall while drunk which caused a laceration to his head. He was attended by a number of fellow “hutters”, including Dr Leanne Rae, but on the following morning he was found unconscious and subsequently pronounced dead.

At 11:24pm on the night of Mr O’Neill’s fall, a 999 call was made by one of the men in the group attending him. The call was categorised as “green category” which would be the subject of further triage and remote consultation. A trainee advanced paramedic practitioner, Ms Noden, called back at 11:41pm and spoke with Dr Rae, who told her that the bleeding from the wound had stopped. Ms Noden advised that there would be a 2-3 hour wait for an ambulance and asked whether Mr O’Neill could attend hospital by taxi. No ambulance was sent to transport Mr O’Neill to hospital.

Ms Noden allocated a stop code, “CSDSELF”, at the end of the second 999 call. Her evidence, which was disputed by Dr Rae, was that she had been told that Dr Rae would deal with Mr O’Neill’s condition herself and he would not be going to hospital. In her own evidence, Dr Rae said that Mr O’Neill had been happy to wait for an ambulance until the point that the delay of 2-3 hours was mentioned, and that Ms Noden had heard him say this while the phone was on speaker mode.

For the pursuers it was submitted that Dr Rae was a credible and reliable witness, and on the basis of the evidence Mr O’Neill required transfer to hospital. Both expert witnesses, including consulting paramedic Mr Jackson, had been critical of Ms Noden’s assessment. The Significant Adverse Effect Review carried out by the defender accepted that the 2-3 hour delay was wrong, and Mr O’Neill would have gone to hospital if Ms Noden has not provided erroneous information.

Counsel for the defender submitted that the court should not be satisfied that causation had been proved. The evidence indicated that Mr O’Neill had set his mind against attending hospital that evening. The court should find that he would not have accepted assistance via an ambulance and he would not have attended hospital.

Would have followed advice

In his decision, Lord Young said of the differences between the two main witnesses: “I am satisfied that Dr Rae’s recollection of the call is significantly more complete and accurate than Ms Noden’s. There are a number of reasons for that conclusion. In the first place, Dr Rae was recollecting traumatic events which she witnessed first hand. She knew early on the 28th June 2020 that Mr O’Neill had died and she gave a police statement that morning. The significance of what was discussed in the second 999 call would have been clear to her less than 10 hours later.”

He continued: “By way of contrast, Ms Noden was trying to recollect the detail from one 999 call from a busy shift during the early stages of the Covid pandemic. She was not advised of Mr O’Neill’s death until August/September 2020. I accept that she has some recollection of the call insofar as it would have been unusual to be speaking to a psychiatrist during a 999 call, but it is inherently less likely that she can recall the specific detail of the call where a number of months elapsed before she was asked to reflect on that night.”

Turning to the issue of causation, Lord Young said: “I accept Dr Rae’s evidence that Mr O’Neill was a co-operative patient who was happy for a 999 call to be placed. He could hear that Dr Rae was asking for an ambulance to be sent as she considered he needed a medical assessment beyond that which she could carry out. It was only when the erroneous 2-3 hour delay was first mentioned that his attitude shifted. But I consider that it is also highly likely that his change in attitude was also influenced by hearing Ms Noden who gave the impression that she was satisfied that he could remain where he was.”

He concluded: “If faced with the same advice from both women, I think it very likely he would have followed that advice and would have agreed to be transported to hospital either by ambulance or taxi. The evidence was that an ambulance, if actioned, could have been at Carbeth within a relatively short period of time. If Mr O’Neill had been assessed at hospital, basic wound repairs would have resulted in the head laceration being sutured or stitched and he would not have suffered the loss of blood which led to his death.”

Finally, Lord Young said in postscript: “In my opinion, Dr Rae should be commended for everything she sought to do that evening and the next morning for Brian O’Neill. She did not hesitate to go to his aid when she heard that he had been injured. Her judgment that he ought to be assessed at a hospital has, sadly, proved to be only too correct. I hope it is clear from this opinion that I do not accept as accurate any suggestion made by the defenders that Dr Rae gave an undertaking or failed to follow through on any undertaking made that evening.”

Accordingly, the pleas-in-law for the defender were repelled, and decrees were granted to the eight pursuers. Mrs O’Neill, the second pursuer, obtained decree for £277,876.33, with the others each receiving between £11,656 and £52,452.