Sudden arrhythmic death

Sudden Cardiac Death in clinical negligence claims.

Expert witness reports on sudden cardiac death claims, including fatal claims and inquests. Most arise where family history, syncope or ECG abnormalities pointing to an inherited channelopathy or cardiomyopathy were missed.

Instruct a cardiology expert Call 0800 161 3395
  • Missed SADS risk
  • Inherited arrhythmia syndromes
  • Channelopathies & cardiomyopathies
  • Bolam · Bolitho · Montgomery
what we cover

Sudden cardiac death and the legal questions it raises.

Sudden cardiac death in adults and adolescents often stems from undiagnosed channelopathies, cardiomyopathies or coronary artery anomalies. Our consultants assess whether the clinical pathway adhered to current ESC guidance on ventricular arrhythmias and the prevention of sudden cardiac death.

Most instructions arise where family history, syncope or ECG abnormalities were overlooked, or where implantable cardioverter-defibrillator (ICD) referral was delayed. The decisions are tested against the current ESC standards for risk stratification, investigation of syncope and primary prevention.

  • Breach questions typically address ECG interpretation, family history assessment, and referral thresholds for specialist cardiac evaluation or genetic testing.
  • Causation questions turn on whether earlier diagnosis would have led to ICD implantation or pharmacological therapy, and whether that would, on the balance of probabilities, have prevented the fatal arrhythmia.
  • Inquests often require expert evidence on whether the death was preventable through timely cardiology intervention, including Article 2 inquests where the duty to protect life is engaged.
  • Paediatric cases involve distinct guidance for inherited arrhythmia syndromes and require subspecialist paediatric cardiology instruction.
Clinical scope

The clinical questions our cardiologists answer.

Reports address the cardiology decisions in issue against current guidance and the Bolam and Bolitho standard.

Included in scope

Questions addressed

  • Whether the ECG demonstrated features of inherited arrhythmia syndromes such as long QT, Brugada or early repolarisation, and whether these were acted on.
  • Whether family history of sudden cardiac death or premature coronary disease was adequately explored and referred for cascade genetic testing.
  • Whether syncope or presyncope was appropriately risk-stratified, including exercise-related symptoms and triggers.
  • Whether referral for cardiac MRI, ajmaline challenge or electrophysiological study was indicated and timely.
  • Whether, on the balance of probabilities, earlier diagnosis or intervention would have prevented the fatal event.
Out of scope

Not covered without separate instruction

  • ICD implantation technique or device programming, which sits with electrophysiology instruction on device-related complications.
  • Post-mortem examination interpretation where the pathologist’s findings are disputed, which requires separate instruction from a forensic pathologist.
  • Examination of surviving family members for cascade screening, which requires a separate condition and prognosis report.
  • Quantum, dependency claims and bereavement damages, addressed through dedicated reports where the case progresses to that stage.
Common cases

Common scenarios we report on.

These patterns recur in sudden cardiac death claims, most turning on primary care or emergency department decisions.

  • Primary care · Family history

    Missed familial sudden cardiac death risk

    Patient presented with syncope or palpitations; family history of sudden death in a first-degree relative was documented but not referred for cardiology assessment. Fatal arrhythmia followed. The report addresses whether the history met the threshold for specialist referral and cascade genetic testing.

    Often paired with: Breach of Duty Causation

  • A&E · Syncope

    Exercise-related syncope discharged without cardiology review

    Adolescent or young adult presented with exertional syncope; the ECG showed borderline QT prolongation but was interpreted as normal. The patient was discharged without referral to electrophysiology. Sudden death followed within months. The report examines whether the symptom pattern and ECG warranted admission and specialist assessment.

    Often paired with: Breach of Duty Causation

  • Primary care · ECG

    Abnormal ECG not acted on

    Routine ECG demonstrated a Type 1 Brugada pattern or epsilon waves suggestive of arrhythmogenic right ventricular cardiomyopathy. The findings were not recognised or referred for cardiology opinion. The report addresses whether the ECG met the criteria for urgent specialist assessment and whether earlier intervention would have altered the outcome.

    Often paired with: Screening & Merits Breach of Duty

  • Delayed ICD referral

    High-risk patient not referred for ICD

    Patient with hypertrophic cardiomyopathy and multiple risk factors was under cardiology follow-up but not referred for ICD implantation. Sudden death occurred before planned review. The report tests whether the risk stratification met the threshold for primary prevention ICD and whether earlier implantation would have prevented the fatal event.

    Often paired with: Causation Condition & Prognosis

Reports

Report types commissioned for this condition.

These cases typically progress from screening into full liability work, with causation and preventability the central battlegrounds.

Approaching a deadline?

Instruct an expert in sudden cardiac death.

Send a short note on the alleged failings with the records bundle. Quotation returned the same working day; fast-track available where the trial window, inquest hearing or limitation deadline requires it.

Instruct a cardiology expert Call 0800 161 3395

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