Coote v Kelly; Northam v Kelly

The proceedings concerned appeals from a judgment of the Supreme Court of New South Wales concerning allegations of medical negligence. The appellants, Coote and Northam, were medical practitioners who had treated the respondent, Kelly, for a lesion on the sole of her foot. Kelly alleged that the appellants had negligently failed to diagnose the lesion as a malignant melanoma, treating it instead as a plantar wart, and that this delay in diagnosis and treatment caused the melanoma to metastasise.

The central legal issues before the Court of Appeal were whether the appellants had breached their duty of care to the respondent by failing to properly diagnose and treat the lesion, and whether, if a breach occurred, it had caused the respondent’s subsequent injury. Specifically, the court had to consider whether the lesion was pigmented at the time of treatment, the adequacy of the diagnostic steps taken by the appellants, and whether the melanoma had metastasised prior to the respondent seeking treatment from the appellants. The burden of proof in establishing causation rested with the respondent.

The Court of Appeal upheld the primary judge's findings. It was held that the evidence, including expert testimony, supported the conclusion that the lesion was pigmented and that the appellants had failed to exercise reasonable care in their diagnosis and treatment. The court found that a reasonably competent medical practitioner would have recognised the potential for malignancy and taken further steps, such as a biopsy, rather than treating it as a plantar wart. Furthermore, the court was satisfied on the evidence that the melanoma had not metastasised before the respondent sought treatment from the appellants, meaning the delay caused by the negligent treatment was causative of the spread of the cancer.

Consequently, the appeals were dismissed, and the appellants were ordered to pay the respondent’s costs in the Court of Appeal.