Criminal Law Week

Is an optometrist who fails to carry out a routine examination of the back of a patient’s eye guilty of gross negligence manslaughter when that failure leads to the death of the patient?

Nov 8, 2017

The following article is written for Police Professional by the editors of Criminal Law Week. Criminal Law Week is used by criminal justice professionals – including police officers, the CPS, judges and lawyers – to stay up to date with changes in criminal law. Published 46 times a year, each issue summarises important cases and legislation, keeping you on top of the latest developments regarding offences, police powers, the rules of procedure and evidence, and more. Incisive commentary is also provided by James Richardson Q.C., the editor of Archbold. Our online service gives you access to all Criminal Law Week issues, from 1997 to today. These are pulled together in a fully-searchable database, complemented by annotated key criminal legislation. For more information about Criminal Law Week, or to sign up for a free trial of our online service, please visit or call 01483 414 599. Is an optometrist who fails to carry out a routine examination of the back of a patient’s eye guilty of gross negligence manslaughter when that failure leads to the death of the patient? No, said the Court of Appeal in R v Rose (CLW/17/33/12). The defendant, Honey Rose, was a registered optometrist. She worked part time at a Boots Opticians in Ipswich. On February 15, 2012, Joanne Barker took her children to the Boots Opticians for routine eye tests and examinations. Her son, Vincent, was aged seven, and had suffered a few headaches over the Christmas period. The defendant was on duty. She carried out the sight test on Vincent after retinal images had first been taken by an optical consultant/assistant. Following Vincent’s examination, the defendant recorded no issues of concern and said that Vincent did not need glasses. She specified that the next appointment should be in 12 months. Five months later, on July 13, 2012, Vincent was taken ill at school and vomited. The school rang his mother at about 2.50pm and she collected him and took him home. His condition deteriorated during the afternoon. Around 8pm he was discovered to be cold to the touch and was clearly very ill. The emergency services were called and paramedics attended. He was rushed to hospital. By the time he arrived he was in cardiac arrest. Despite every effort to resuscitate him, he died. Vincent had previously been a healthy, thriving and active boy, who had never before attended hospital. Following a post-mortem examination, the relevant experts agreed that the cause of Vincent’s sudden death was acute hydrocephalus (ie, acute build-up of cerebrospinal fluid within the normal ventricles of the brain because its normal outlet had been blocked). This was secondary to gliosis (a process leading to scarring of the nervous system), which caused obstruction of part of the fourth ventricle of the brain. It was agreed that the obstruction in Vincent’s brain had been a longstanding chronic problem, but the case was unusual in that Vincent had not presented with many associated symptoms of hydrocephalus, such as headaches and vomiting. Hydrocephalus requires early surgical intervention to drain the fluid and to prevent it from accumulating, either by creating a bypass or inserting a shunt. A specialist neurosurgeon prepared a report on the case. In her opinion, Vincent’s condition was treatable, had it been diagnosed, at any time up until the point of his acute deterioration and death on July 13, 2012. An optometrist has a statutory duty of care to examine the internal eye structure as part of a routine eye examination. The purpose of the examination is to detect signs of abnormality or disease, including life threatening problems evident from the optic nerve. An examination of the internal eye structure and back of the eye is normally carried out either with the use of an ophthalmoscope or a “slit lamp”. Both instruments allow the optometrist to obtain a very good view of the optic disc, which is circular in a healthy person. The condition of the eye can also be checked by looking at “fundus” photographs, which are taken by a spe

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