R v Adomako explained

R v Adomako
Court:House of Lords
Full Name:Regina (Respondent) v. Adomako (Appellant)
Date Decided:30 June 1994
Citations:
  • 98 Cr App R 282
  • [1994] 3 All ER 79
  • [1994] 3 WLR 288
  • (1994) 98 Cr App R 282
  • [1994] UKHL 6
  • [1995] AC 171
  • [1995] 1 AC 171
Transcripts:transcript at BAILII
Judges:
Number Of Judges:5

R v Adomako. 1994. UKHL. 6., was a landmark United Kingdom criminal law case where the required elements to satisfy the legal test for gross negligence manslaughter at common law were endorsed and refined.[1] It was held that in cases of manslaughter by criminal negligence involving a breach of duty the gross negligence test relied on by the Court of Appeal was sufficient and that it was not necessary to direct a jury to consider whether the recklessness definition should be applied. The test, as set out in R v Bateman 19 Cr. App. R.8 and Andrews v DPP [1937] AC 576, confirmed that there needed to be in existence a breach of duty of care where the serious and obvious risk of death was reasonably foreseeable and that the breach or omission in question caused actual death and that the conduct of the defendant, when all the circumstances were considered, was so bad as to amount to a criminal act or omission.[2] [3] The requirement to show that the defendant's breach of duty was "gross" helped develop the definition of gross negligence.[4]

Facts

On 4 January 1987, Alan Loveland, a thirty-three-year-old man, underwent an eye operation for detached retina.[5] [6] At 9:45 am, anaesthesia was induced by the intravenous administration of paralytic drugs and an endotracheal tube was inserted to enable the patient to breathe with the aid of a mechanical ventilator.

At 45 minutes into the operation there was a change of anaesthetist from the registrar, Dr. Said and his assistant, to Dr John Adomako, a locum peripatetic. Around 35 minutes later, the supply of oxygen to the patient was interrupted by the endotracheal tube becoming disconnected. The disconnected ventilator went unnoticed and unremedied by the appellant, Dr Adomako. It was not until an alarm sounded on a blood pressure monitoring machine that the anaesthetist was alerted to a problem of some kind at which point Dr Adomako checked various pieces of equipment but failed to notice the disconnected oxygen tube which by now had not been supplying oxygen for at least four and a half minutes. A period of hypoxia led to cardiac arrest at 11:14 am, some 11 minutes after the tube became disconnected.[7] It was the eye surgeon who noticed that the ventilator was disconnected and this was after resuscitation had commenced. Although Alan Loveland was successfully resuscitated, the prolonged period of oxygen deprivation caused cerebral hypoxia leading to severe brain damage. Alan Loveland never regained consciousness and died 6 months later.

On 26 January 1990 a jury convicted John Adomako of gross negligence manslaughter by a majority of 11 to 1.[8] [9] Mr Adomako appealed his conviction challenging the basis that a breach of duty should not have amounted to involuntary manslaughter, however, his conviction was upheld by the House of Lords.[10]

Judgment

Mr Adomako's appeal was dismissed. The House of Lords held that the ordinary common law principles of negligence had to be applied and that it needed to be established whether the appellant's negligent conduct was so bad in all the circumstances as to amount to a criminal act or omission.[11] Adomako was under a duty to act as a reasonable anaesthetist.[12]

The House of Lords in R v Adomako clarified the requisite elements for gross negligence manslaughter at common law with a four-part test which became known as the Adomako test:[13]

Lord Mackay of Clashfern expanded on how the test for involuntary manslaughter was formulated:

Circularity of the Adomako test

The application of the test for gross negligence manslaughter in Adomako has been identified as involving an element of circularity.[14] Lord Mackay conceded that the formulation of the test involved a circularity element but that this was not fatal to this test being the right one in order to identify how far the defendant's "conduct must depart from accepted standards to be characterised as criminal".[15] The circularity problem is that the jury must be directed to convict the defendant if they, the jury, believe the conduct of the defendant was "criminal". This, however, leaves the burden of a question of law to be decided by the jury where they would not usually be expected to supply reasons for their verdicts which, in turn, leads to the problem of not being able to readily identify which criteria the jury applied for their determination in a certain case.[16]

Grossness element

The determination of the element of "grossness" in negligence can be variable and inexact.[17] In a criminal court, it must be established that there is mens rea, where the extent of the defendant's liability depends on the amount of damage done and the degree of negligence.[18] [19] It is for the jury to examine the defendant's conduct in order to determine whether the element of "grossness" is sufficiently serious that it amounts to a criminal offence and would therefore warrant criminal liability for manslaughter.[20] In the case of Adomako, the breach of duty was so serious that the appellant's conduct amounted to "a gross dereliction of care".[21]

See also

Notes and References

  1. Quick . Oliver . Medicine, Mistakes and Manslaughter: A Criminal Combination? . 2010 . The Cambridge Law Journal . 69 . 1 . 186–203 . 10.1017/S0008197310000231 . 40731214 . 145789041 . 0008-1973.
  2. Web site: 14 March 2019 . Gross Negligence Manslaughter . 2023-01-06 . www.cps.gov.uk . The Crown Prosecution Service.
  3. Web site: 1 July 2019 . Gross negligence manslaughter: prison awaits Croner-i . 2023-01-06 . app.croneri.co.uk.
  4. Book: Herring, J. . 2018 . Criminal Law: Text, Cases, and Materials . Oxford University Press . 273 . 9780198811817 . It must be shown that the defendant's breach of duty was gross. Lord Mackay in Adomako explained that the jury should ask themselves whether the defendant's actions or omissions were so bad as to deserve a criminal conviction..
  5. Alghrani, A. Griffiths, D. Bennett, R. Sanders, A. Ost, S.
  6. Brahams . Diana . 1994-07-23 . MEDICINE AND THE LAW: Medical manslaughter . The Lancet . English . 344 . 8917 . 256 . 10.1016/S0140-6736(94)93018-X . 0140-6736 . 7913168 . 54397721 . During an operation for detached retina the patient showed clear signs of hypoxia....
  7. Book: Marshall, S. E. . The Structures of The Criminal Law . 2011 . OUP Oxford . 978-0-19-964431-5 . 25 . en.
  8. Brahams . D. . November 1990 . Two locum anaesthetists convicted of manslaughter . Anaesthesia . en . 45 . 11 . 981–982 . 10.1111/j.1365-2044.1990.tb14638.x . 2252199 . 34037299 . 0003-2409 . On 26 January 1990 Dr John Adomako was convicted of manslaughter at the Old Bailey after the death of a patient at the Mayday Hospital from cerebral hypoxia in July 1987.. free .
  9. Dyer . Clare . 1994-07-09 . Anaesthetist loses final appeal . BMJ . en . 309 . 6947 . 78 . 10.1136/bmj.309.6947.78 . 71495046 . 0959-8138 . The jury found him guilty of manslaughter by a majority of 11 to 1..
  10. Web site: Teacher . Law . R v Adomako - 1995 . LawTeacher.net . November 2013 . 6 January 2023 . Fujairah, UAE.
  11. R v Adomako. R v Adomako. UKHL. 1994. 6. [1995] 1 AC 171, [1994] UKHL 6, [1995] AC 171, [1994] 3 All ER 79, (1994) 98 Cr App R 282, 98 Cr App R 282, [1994] 3 WLR 288. 30 June 1994. UKHL. England and Wales.
  12. Book: Herring, J. . 2018 . Criminal Law: Text, Cases, and Materials . Oxford University Press . 270 . 9780198811817.
  13. Book: Alghrani . A. . Griffiths . D. . Bennett . R. . Sanders . A. . Ost . S. . 2013 . Bioethics, Medicine and the Criminal Law . Cambridge University Press . 149 . 9781107021532 . 2012027129 . They go on to offer an expansion of the four-part Adomako test....
  14. Book: Baird, N. . 2009 . Q&A Criminal Law 2009-2010 . 42–44 . Taylor & Francis . 9781135242855 . [A] problem with the [Adomako] test is that it is circular: the jury must be directed to convict the defendant of a crime if the think his conduct was 'criminal'. In effect, this leaves a question of law to the jury, and, because juries do not give reasons for their decisions, it is impossible to tell what criteria will be applied in an individual case..
  15. Lodge . Anne . 2017 . Gross Negligence Manslaughter on the Cusp: The Unprincipled Privileging of Harm over Culpability . The Journal of Criminal Law . en . 81 . 2 . 125–142 . 10.1177/0022018317694719 . 152012083 . 0022-0183 . Indeed, Lord Mackay acknowledged the circularity of the test in Adomako, above n. 22 at 187, but he did not perceive this circularity as ‘fatal’..
  16. Web site: 4 March 1996 . Legislating the Criminal Code Involuntary Manslaughter . 14 January 2023 . Law Commission . 3.9 . The first problem with this test is that it is circular: the jury must be directed to convict the defendant of a crime if they think his conduct was “criminal”. In effect, this leaves a question of law to the jury, and, because juries do not give reasons for their decisions, it is impossible to tell what criteria will be applied in an individual case. This must lead to uncertainty in the law. The CPS has told us that prosecutors find it difficult to judge when to bring a prosecution, defendants have difficulty in deciding how to plead, and there is a danger that juries may bring in inconsistent verdicts on broadly similar evidence..
  17. Lodge . Anne . Gross Negligence Manslaughter on the Cusp: The Unprincipled Privileging of Harm over Culpability . The Journal of Criminal Law . April 2017 . en . 9 April 2018 . 81 . 2 . 125–142 . 10.1177/0022018317694719 . 152012083 . 0022-0183 . Despite playing a significant role in defining the boundaries of manslaughter, the ‘gross negligence’ concept is notoriously indeterminate..
  18. Rex. v. Bateman . 19 . 10-11 . Cr App. R8 . 1927 . https://ipsaloquitur.com/criminal-law/cases/r-v-bateman-percy/ . 28 January 2023 . ...and the opinion of Lord Hewart C.J., where he said, at pp. 10-11: "In expounding the law to juries on the trial of indictments for manslaughter by negligence, judges have often referred to the distinction between civil and criminal liability for death by negligence. The law of criminal liability for negligence is conveniently explained in that way....
  19. Book: Cases on Criminal Law . 1923 . Bobbs-Merrill . 296 . en . ...In the civil action, if it is proved that A fell short of the standard of reasonable care required by law, it matters not how far he fell short of that standard. The extent of his liability depends not on the degree of negligence but on the amount of damage done. In a criminal court, on the contrary, the amount and degree of negligence are the determining question. There must be mens rea. . CUP Archive.
  20. Book: Child . John . Smith, Hogan, and Ormerod's Essentials of Criminal Law . Ormerod . David . 2017 . Oxford University Press . 978-0-19-878868-3 . 196 . en.
  21. Dobinson . Ian . 1 July 2009 . Medical Manslaughter . University of Queensland Law Journal . 28 . 1 . 107 . Two expert witnesses for the prosecution described the defendant’s standard of care as ‘abysmal’ and a ‘gross dereliction of care’..

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