Clinical Negligence & Healthcare
‘Tremendous analysis of the issues. Excellent preparation and always on top of the evidence. A great down to earth approach with clients, and very easy to work with. Responsive and helpful.’
Chambers & Partners
Chris successfully represented the injured claimant in the ground-breaking case of XX v Whittington which changed the law on the recoverability of surrogacy damages.
Click here to watch the Supreme Court hearing, here for press coverage from The Guardian and The Telegraph and here for our healthcare blog’s review of the decision.
experience & expertise
Chris leads the award-winning Serjeants’ Inn Clinical Negligence and Healthcare Team . He has been recognised as a leading clinical negligence practitioner for many, many years. Before the age of 30, Legal 500 included him in their “top 40 barristers under 40”. As a silk he has undertaken the most legally and technically complex cases for both top claimant and defence firms. He is a team-player, ensuring he works with his top-rank solicitors to get the best from their experts. He adopts a meticulous forensic approach. Through focussed questioning of specialists, he distils complex medical and scientific ideas into a straightforward presentation for the court. His empathetic approach ensures that clients are reassured, and understand their own cases and the legal team’s assessment of their merits.
His extensive experience has been recognised by his peers: he was appointed as co-chair of the Professional Negligence Bar Association’s Clinical Negligence weekend (2014-2018). Chris was awarded Clinical Negligence Silk of the Year at the Chambers and Partners Bar Awards 2019. He has been exposed to nearly every conceivable type of medical case, ranging from complex retinopathy of prematurity to high value cerebral palsy and brain damage cases (such as the Fieldfisher case in which a £9m award was secured for Rebecca Ling, whose heroism in the face of her profound disabilities was recognised when she carried the Olympic flame). He has extensive experience of fatal cases including recently acting for Irwin Mitchell in a £4 million settlement for the family of an investment banker who died after receiving sub-standard medical treatment.
Chris’s background in medical ethics cases and position as editor of the leading medical treatment text means he is well placed to handle the sensitive issues involved in mental health clinical negligence cases. He has acted in many high value claims involving catastrophic injuries following suicide attempts. Chris recently acted in a case involving an informal patient with a long history of mental illness, who was allowed to run away from hospital in a suicidal state, then jumped from a balcony sustaining permanent and catastrophic spinal cord injury, leaving him tetraplegic and wheelchair-bound. Click here for further details.
Chris is adept at handling cases involving novel points of law such as XX v Whittington (surrogacy), and Toombes v Mitchell (wrongful life claim from disabled woman allegedly born as a result of negligent pre-conception advice given to her mother).
He has unrivalled technical expertise in dealing with vast group actions as both junior and silk. He is exceptionally computer-savvy using his Excel skills to create impressive shortcuts for juniors and solicitors through substantial damages and disclosure exercises.
Chris spoke to APIL during lockdown on the use of technology in litigation. He has led in-house and external talks on mediation. He constantly looks to innovate and learn from other fields and professions: over the last 5 years, he has chaired a series of talks and conversations led by Nicola Hurdley, serving Detective Chief Inspector and Crisis Negotiator, on improving communication techniques by learning from internationally recognised tactics.
recommendations
“Christopher is an outstanding barrister with a significant amount of experience upon which to draw.”
Chambers and Partners
“Christopher is very well-prepared and has meticulous attention to detail. His approach to the initial stages of a catastrophic injury claim often leads to a full admission of liability.”
Chambers and Partners
“Chris is approachable and calm in all situations, yet he has a grip on every last detail of a case and his intellect is phenomenal.”
Chambers and Partners
“Tremendous analysis of the issues. Excellent preparation and always on top of the evidence. A great down to earth approach with clients, and very easy to work with. Responsive and helpful.”
The Legal 500
“He applies a great deal of intellectual rigour to the preparation of a claim so that everything is aligned to achieve the best possible outcome.”
Chambers & Partners
‘Christopher remains a go-to silk for clinical cases of utmost complexity. His forensic agendas remain the stuff of legend and ensure that all angles are covered.’
The Legal 500
“With clients he has that essential quality of being able to convey the complexities of a case without legal jargon but ensuring they are properly advised and aware of the strengths and weaknesses.”
Chambers & Partners
“Chris is as experienced as they come. He builds strong relationships with clients and experts alike, and unfazed by the more complex aspects of cases.”
Chambers & Partners
“Chris is a superb advocate with great people skills.”
Chambers & Partners
“His mastery of advocacy is phenomenal: he is captivating in court.”
Chambers & Partners
“He is very impressive and the clients see that too.”
Chambers & Partners
“Christopher is responsive, authoritative and helpful. He is very conscientious.”
Chambers & Partners
“He has meticulous forensic rigour and phenomenal attention to detail. He is supremely intelligent and tactically astute.”
Chambers & Partners
“Christopher is the go-to silk for any case involving the complex analysis of data; he has a rapier mind; he cuts straight to the heart of the matter; he is ruthless. Working with him is very much like taking a masterclass.”
The Legal 500
“A truly outstanding silk at the top of his game.”
The Legal 500
“He is exceptionally talented and knowledgeable, and has great attention to detail.”
Chambers & Partners
“Christopher has excellent client care skills and is a first-rate advocate.”
Chambers & Partners
“He has fantastic client care skills and he’s very clever. He’s a star there. Exceptionally hard-working, he is user-friendly, intelligent, committed, and demonstrates good judgment. Also produces excellent pleadings.”
Chambers & Partners
“An outstanding silk who is at the top of his game. He has meticulous forensic rigour and phenomenal attention to detail. He is also supremely intelligent and very tactically astute.”
Chambers & Partners
“He is the full package; phenomenal attention to detail, wonderful with clients and brilliant to work with.”
The Legal 500
“He’s extraordinarily good and very patient with clients – he debunks the mysteries associated with litigation, makes things understandable and puts them at ease. He’s exceptionally detailed. His preparation for conferences is second to none and you always know he’ll have got to grips with everything.”
Chambers & Partners
‘A truly brilliant advocate, always on top of the detail and approachable with a very easy manner.’
The Legal 500
‘Streets ahead in use of technology and makes the most complex information digestible.’
The Legal 500
“He has an incredible technical ability and exceptional advocacy skills.”
Chambers & Partners
“He’s fantastic on quantum and his pleadings are a master class in succinctness.”
Chambers & Partners
“Highly experienced. He takes an innovative approach to the complex cases and is so easy to work with”
Chambers & Partners
“Standout practitioner who is revered for his analytical prowess and who has extensive experience of handling clinical negligence claims of great value and complexity. He is ferociously bright and a formidable opponent.He’s always meticulously prepared and gets fantastic results.”
Chambers & Partners
“He is a very, very clever man. Exceptionally bright and capable. A super brain and a nice man too.”
Chambers & Partners
“He is extraordinarily bright, brilliant at detail and using innovative technology”
The Legal 500
“Very organised and very analytical. He is incredibly thorough and an excellent advocate.”
Chambers & Partners
Has the ability to explain ferociously complex cases in simple, straightforward language. His forensic approach to the issues means no stone is left unturned.” “He’s absolutely excellent, and addresses and anticipates everything.”
Chambers & Partners
“He brings a forensic analysis of the papers yet a commercial approach to the litigation process.”
The Legal 500
“Tirelessly hard-working with a fresh and always compelling view of the fast-emerging law in this area. A joy to work with. He is an original thinker. He comes up with ideas that haven’t been thought of before. It’s always good to have him on your side.”
Chambers & Partners
“Excellent judgement and a great manner.”
Chambers & Partners
“An impressive silk receiving instructions from the biggest firms in claimant-side product liability. He was formerly senior counsel in the fetal anticonvulsant litigation. He brings to the table a very clear, straightforward, logical approach. He can make very complicated matters appear so simple. He’s a tremendous strategic thinker.”
Chambers & Partners
“His attention to detail and preparation is phenomenal.”
The Legal 500
“A charming silk with unsurpassed conference preparation.”
The Legal 500
“Christopher Johnston QC is quite superb, according to market commentators, many of whom referred to his excellent pleadings. His ability to explain very complex ideas in simple ways is a true sign of quality and his tenacious, detail-oriented style makes him a real favourite.”
Chambers & Partners
“The hugely clever Christopher Johnston QC”
The Legal 500
“Christopher Johnston QC of Serjeants’ Inn is especially adept at cases involving injury caused by medical or pharmaceutical products and devices. Peers say he is very bright and approachable.”
Chambers & Partners
“New silk Christopher Johnston QC’s pleadings and conferences are always astonishingly well prepared; he rigorously addresses every single detail and you can always be completely confident in his judgement.”
The Legal 500
“Christopher Johnston QC, a recent silk who heads the clinical negligence team. He is reliable, clever and good with clients, and has a busy practice which often focuses on complex claimant cases.”
Chambers & Partners
“Christopher Johnston regularly acts for both claimants and defendants when very large sums of money are at stake. He has an exceptional grasp of the medical issues and is known for invariably making the right moves in a case.”
Chambers & Partners
“Christopher Johnston is widely admired for his user-friendly manner: He is a joy to work with and clients love him. He is also credited with achieving consistently excellent results, with a number of interviewees commenting that his pleadings are extremely accomplished. Solicitors rely on him.”
Chambers & Partners
cases & work of note
Examples of Chris’s work includes the following:
Amputation claims
- Claims involving complex amputations and highly specialist prosthetics
- Above knee amputations in both legs as a result of failure to diagnose absence of peripheral pulses in legs
Anaesthetic claims
- Permanent spinal injury following epidural haematoma
- Failure in anaesthetic management in caesarean section resulting in maternal death
Birth Injury
- All aspects of birth injury – claims involving midwifery failures, obstetrician failures, system failures
- Cerebral Palsy – caused by hypoxia, infection and kernicterus
- Microcephaly
- CTG trace misinterpretation
- Antenatal scanning errors
- Inappropriate use of induction agents (for example, Syntocinon)
- Management of breech delivery
- Shoulder dystocia
- Injury from streptococcus
- Management of triplet pregnancy, caesarean section performed prematurely
- Failure of informed consent (Montgomery consent) in cases involving vaginal delivery, caesarean section, induction agents, risk of streptococcus
Brain Injury
- Cerebral Palsy – caused by hypoxia, infection and kernicterus
- Meningitis
- Brain haemorrhage – subarachnoid, subdural, extradural
- Failure to diagnose raised intracranial pressure
- TIA/strokeHydrocephalus
- Failure to diagnose Infective endocarditis
- Failure to diagnose viral encephalitis
- Failure to diagnose brain aneurysm
Cancer misdiagnosis and late diagnosis
- Significant experience in delay in diagnosis of cancer cases
- Failure to biopsy ulceration resulting in failing to diagnose and excise squamous cell carcinoma
Cerebral Palsy
- Cerebral Palsy – caused by hypoxia, infection and kernicterus
Consent
- Consent to use of novel medical implants
- Consent to high risk surgical procedure
Fatal claims
- Failure to advise flu vaccination in pregnancy resulting in death
- Failure to manage haemorrhage in delivery resulting in maternal death
- Failure in anaesthetic management in caesarean section resulting in maternal death
- Failure to admit to hospital when suicide risk presenting in the community Fall in hospital resulting in death
- Failures in resuscitation cases
- High value damages assessment following death of high net worth individual
Fertility claims
- XX v Whittington in the Supreme Court
- Delay in diagnosis of cervical cancer
- Claims for surrogacy
- Claim for surrogacy in California
- Post-operative management of hysteroscopy procedure resulting in infertility
GP negligence
- Substantial experience of cases involving delay in diagnosis of cauda equina syndrome
- Extensive experience of delay in diagnosis of cancer cases
- Pre-conception advice cases including Toombes v Mitchell (wrongful life claim from disabled woman allegedly born as a result of negligent pre-conception advice given to her mother) Monitoring of anticoagulation treatment
- Monitoring of lithium medication
- Failure to attend seriously ill patient resulted in delayed diagnosis of swine flu and consequent death
Hip implant treatment
- Failure of hip prostheses
- Claims for mixed and matched components
- Failure of informed consent
Maternal injuries and deaths
- Failure to advise flu vaccination in pregnancy resulting in death
- Failure to manage haemorrhage in delivery resulting in maternal death
- Failure in anaesthetic management in caesarean section resulting in maternal death
- Permanent spinal injury following epidural haematoma
- Failure to diagnose and repair anal tearing after delivery
- Permanent sphincter damage and incontinence problems caused by the negligent management of forceps delivery
Meningitis
- Significant experience of cases involving delay in diagnosis of meningitis causing permanent brain damage and/or hearing loss
- Failure to treat sepsis or serious infection / meningitis
Multi-party mediation
- High value clinical negligence claims involving multiple parties resolved in mediation
Neonatal claims
- Significant experience of claims involving negligent hydration/feeding of neonates resulting in injury / inadequate assessment of failure to thrive
- Extensive experience of failure to diagnose retinopathy of prematurity claims
- Hypoglycaemic injuries
- Hyponatraemia (low sodium) injuries
- Accidental suffocation injury – “Sudden Unexplained Postnatal Collapse”
- Delay in diagnosis of congenital hypothyroidism
- Failure adequately to monitor for respiratory distress resulting in cardiac arrest
Paediatric claims
- Delay in diagnosis of meningitis causing permanent brain damage and hearing loss
- Failure to treat sepsis or serious infection / meningitis
- Failure of diagnosis in Accident and Emergency departments
Psychiatric management
- Attempted suicide resulting in catastrophic injury
- Failure to ensure patient was unable to escape from hospital
- Failures of care in the community
- Management of severe bipolar disorder with psychosis in the community
- Management of psychosis
- “Suicide watch” in the community
- Attempted suicides by jumping
- Failure to identify physical cause for psychotic presentation
- Failure to admit to hospital when suicide risk presenting in the community
Radiology
- Failure to diagnose spinal abnormality on scanning
Spinal injury
- Delay in diagnosis of cauda equina syndrome
- Surgical management of cervical disc compression
- Delay in diagnosing spinal infection (discitis)
- Surgical removal of thoracic disc prolapse.
Surgical claims
- Surgical management of cervical disc compression
- Surgical removal of thoracic disc prolapse.
- Injury during bowel surgery
- Delay in undertaking neurosurgical procedure,
- Inadequate post-operative follow up leading to malnourishment
- Inadequate post-operative follow up in failing to drain abdominal collections
- Failure to informed consent in spinal surgery cases
- Incompetently performed limb correction surgery
- Failure to diagnose appendicitis
Wrongful birth/wrongful life
- Negligent pre-conception advice resulting in birth of disabled child including Toombes v Mitchell (wrongful life claim from disabled woman allegedly born as a result of negligent pre-conception advice given to her mother)
- Negligent ultrasonography resulting in birth of disabled child
- Failure to undertake screening test for sickle cell disease resulting in wrongful birth of disabled child
publications
He edits Medical Treatment: Decisions and the Law (Bloomsbury Professional, 3rd ed, 2016) and writes for the Medical Law Reports. He wrote “A personal (and selective) introduction to product liability law” (2012) J.P.I.L. 1. He has spoken to wide-ranging audiences including the PEOPIL conference in Malaga, and Europol in the Hague.
Chris’s notable talks include:
- “Use of technology during the Covid-19 pandemic: Top Tips” (with Frances McClenaghan), APIL 13th July 2020
- “Communications and Negotiations”, chairing a series of on-going talks and conversations led by Nicola Hurdley, serving Detective Chief Inspector and Crisis Negotiator (within Chambers from 2016 and externally from 2021).
- XX v Whittington – recovery of surrogacy damages , July 2020
articles
As a contributing editor, Chris has reported on the following cases for the Medical Law Reports:
- Swift v Carpenter, [2020] EWCA Civ 1295, [2020] Med LR 527
Personal injuries – Capital accommodation claims – Quantification of accommodation claims – Valuation of reversionary interest off-set – Point in time to assess reversionary interest – Term certain multiplier for life expectancy – Fair and reasonable, but not excessive, compensation. - NKX v Barts Health NHS Trust, [2020] EWHC 828 (QB), [2020] Med LR 298
Clinical negligence – Obstetrics – Breach of duty in consenting for fetal monitoring – Causation – Duration of hypoxia – Myers hypothesis versus extended Myers hypothesis on hypoxia. - Raqueeb v Barts NHS Foundation Trusts (Costs), [2019] EWHC 3320 (Admin) and [2019] EWHC 3322 (Fam), [2020] Med LR 17
Costs – Whether costs to follow the event in Children Act proceedings – Whether costs to follow the event in judicial review – Exercise of costs’ discretion – Children Act 1989, section 8 – Children Act 2004, section 11(2)(a) – Civil Procedure Rules, rr 44.2, 44.10 – Family Procedure Rules, r 28.1 – Senior Courts Act 1981, sections 31(2A), 51(1)(b). - R (ota CXF) v Central Bedfordshire Council [2018] EWCA Civ 2852, [2019] Med LR 88
Meaning of “after-care services” within section 117 of Mental Health Act 1983 – Expenses travelling to support patient – Use of Mental Health Act Code of Practice to interpret Mental Health Act – Statutory interpretation. - East Lancashire Hospitals NHS Trust v PW [2019] EWCOP 10, [2019] Med LR 218
Capacity – Paranoid schizophrenia with delusional beliefs – Below knee amputation – Best interests’ assessment – Urgent application. - Jones v Taunton And Somerset NHS Foundation Trust, [2019] EWHC 1408 (QB), [2019] Med LR 384
Clinical negligence – Breach of duty – Contemporary responsible body of medical opinion – Obstetric negligence – Choice of tocolytic drug.