Case Study: Taylor v Woodgate – Records vs Recollection

In a recent decision, the District Court of NSW was tasked with resolving a factual dispute between the Plaintiff and Defendant regarding the advice, warnings and treatment provided in relation to a hip replacement procedure and subsequent revision procedure.

Summary

The case, Taylor v Woodgate [2025] NSWDC 89, involved allegations of negligence by the Plaintiff against an orthopaedic surgeon for injuries suffered due to the failure by the surgeon to provide adequate warnings of the risks of a total hip replacement surgery and for performing the revision surgery to an unreasonable standard. Ultimately the resolution of the factual dispute was central to the Court’s determination as to whether a breach of duty had occurred.

Facts

The Plaintiff, Mr Taylor, had a lengthy medical history of hip issues since childhood.

In October 2010, Mr Taylor first consulted with the Defendant, orthopaedic surgeon Dr Ian Woodgate (the Surgeon), in relation to pain in his left hip.

On 10 May 2011, the Surgeon performed a total left hip replacement (the procedure) on the Plaintiff using an acetabular cup, femoral neck and femoral head made from cobalt-chromium-molybdenum alloy (CoCrMo alloy), and a Size 2 femoral stem made from titanium alloy.

On 30 August 2011, Mr Taylor underwent a revision of the left total hip replacement (the revision procedure), also performed by the Surgeon.

Post-operatively, Mr Taylor continued to consult regularly with the Defendant and what was discussed at these consultations would ultimately be heavily disputed by the parties.

Mr Taylor contended that his recovery was complicated by chronic pain, restricted movement, a loose femoral stem, and a significant discrepancy in his leg length.

The claim of negligence

Ultimately, the claim was condensed down to five key issues for the Court’s determination:

1. the Surgeon’s failure to adequately assess Mr Taylor pre-operatively including advice on the risk of complications, and the nature of the mental-on-metal short stem prosthesis which he recommended for the procedure (the first issue);
2. the Surgeon’s failure to take the appropriate steps during the revision procedure to identify and eliminate the loosening of the femoral stem of the hip implant (the second issue);
3. the Surgeon’s failure to provide Mr Taylor with appropriate and reasonable post-operative management (the third issue);
4. the Surgeon’s failure to correctly interpret the radiological imaging, and recognise progressive loosening of the femoral stem (the fourth issue); and
5. whether Mr Taylor would have had pain-free and functional use of his leg had a conventional stem been used in the procedure (the fifth issue).

Each party called on their own expert orthopaedic surgeons to give evidence – the Plaintiff called Dr Doig, and the Defendant called Dr O’Sullivan.

However, the experts ultimately produced a joint report (the orthopaedic joint report) and gave evidence concurrently at the hearing. The orthopaedic joint report demonstrated that both experts were in substantial agreement on the issues.

Decision

Issue one: pre-operative management and use of short stem

The joint orthopaedic report was crucial in assessing the suitability of the short stem prosthesis. Weber SC DCJ noted that both experts found that it was not unreasonable for the Surgeon to have recommended a short stem implant, and that the use of such a prosthesis constituted reasonably competent and widely accepted professional practice for an orthopaedic surgeon in 2011.

Further, the Surgeon successfully relied upon his clinical records, whereby the notation “R&B”, proved sufficient evidence of his discussion with Mr Taylor about the risks and benefits of the procedure. As such, the Plaintiff failed to establish that there was a breach of duty in relation to the first issue.

Issue two: appropriate steps during revision procedure

Weber SC DCJ was satisfied with the Defendant’s evidence that he routinely performed revision procedures and had consequently developed an “organised and methodical” surgical technique. Importantly, both experts concurred that the Surgeon had performed all the necessary and reasonable investigations in assessing that the femoral stem was not loose. Therefore, the Court rejected the Plaintiff’s claim with respect to the second issue.

Issue three: post-operative management

The challenge for the Court in relation to the third issue was to resolve a factual dispute between Mr Taylor’s oral evidence and the Surgeon’s written clinical records.

Ultimately, His Honour found that the Surgeon’s clinical records were more reliable than Mr Taylor’s recollection to the extent of any inconsistency between the two. His Honour was satisfied that the Surgeon had maintained detailed and contemporaneous clinical records of Mr Taylor’s post-operative visits, which accurately documented his functionality and activities during his recovery.

The Surgeon made additional submissions challenging Mr Taylor’s credibility, particularly regarding his reports of his post-operative pain, which were alleged to be disproportionate and exaggerated. The Court accepted the Defendant’s submissions and accordingly, breach was not established in relation to the third issue.

Issue four: interpretation of radiological imaging

His Honour preferred the joint opinions of Dr Doig and Dr O’Sullivan who agreed that there was no radiological evidence of movement in the femoral stem between August 2011 and August 2017. As such, breach was not established in relation to the fourth issue.

Issue five: whether the Plaintiff would have had pain free and functional use of his left hip with a conventional femoral stem

His Honour found that, on the balance of probabilities, the use of a conventional stem in the procedure would have yielded the same results for Mr Taylor. Further, it was noted that Mr Taylor had undergone further surgery to insert a conventional stem in 2019, following which he continued to experience similar pain in his left hip.

Held

The Court ruled in favour of the Defendant, finding that the Plaintiff had failed to establish that any breach of duty occurred. The Plaintiff’s recollection was undermined by the Defendant’s clinical notes and joint expert evidence of the parties.

The Plaintiff was ordered to pay the Defendant’s costs.

What can we learn from this case?

This case illustrates the challenge Plaintiffs must overcome in proving causation in medical negligence claims. It is not enough to merely demonstrate unsatisfactory treatment outcomes; rather, the Plaintiff must establish a direct causal link between the alleged negligence and the harm suffered.

This case also serves as an important reminder for medical practitioners to be consistently vigilant in maintaining contemporaneous patient notes and documentation.

In resolving the factual dispute regarding the communication between Mr Taylor and the Surgeon, His Honour placed greater weight on the Surgeon’s clinical records than on Mr Taylor’s recollection of events.

Weber SC DCJ’s approach in this regard highlighted the evidentiary value of thorough and accurate documentation. The Surgeon’s records of his interactions and observations of Mr Taylor’s condition and activities ultimately served as the best defence against the alleged negligence.

You can read the judgement here.

For more information about this important case law, or to discuss your circumstances and entitlements in a medical negligence claim, contact Brave Legal on 03 9070 9816.