The High Court has allowed an appeal after finding that hepatitis C was a significant contributory factor in a woman’s death, and remitted her compensation application to the Hepatitis C Compensation Tribunal to assess compensation and make an award.
The appeal concerned the Tribunal’s September 2017 dismissal of an application brought by E.D. on her own behalf and for her mother’s statutory dependants. The Tribunal had not been satisfied that hepatitis C played an active, non-minimal role in the death. The appeal was heard afresh by Mr Justice Bernard J. Barton, who delivered judgment on 26 November 2019.
The court found that the woman did not die as a result of contracting hepatitis C. It identified neutropenic sepsis as the immediate cause of death, with immunosuppression and multiple myeloma as underlying conditions. The woman had contracted hepatitis C in 1977 after receiving contaminated Anti-D and had lived with the infection for about 30 years before her death in 2008.
Medical experts disagreed about whether the infection impaired her liver function and reduced her ability to withstand chemotherapy, sepsis and renal failure. The court accepted evidence from the appellant’s experts that hepatitis C impaired her ability to fight sepsis. It found that the infection contributed to neutropenic sepsis and the consequences of immunosuppression, although its precise effect on her chances of survival could not be quantified.
The judgment treated the death certificate as prima facie evidence of its recorded causes, not as conclusive proof. The certificate listed hepatitis C as an “other significant condition” contributing to death. The court considered that entry alongside the medical evidence and the death notification form.
Under the statutory test, the court said a contributory factor must be meaningful to the causes of death. It found that hepatitis C impaired the woman’s ability to fight the sepsis, the predominant direct cause of death, and therefore met that test. The ruling addressed eligibility under the statutory provision; the court did not assess or set the amount of compensation. It sent the application back to the Tribunal for that assessment and an award.