R v Adomako – Case Summary

R v Adomako (John Asare)

R v Sullman (Barry)

House of Lords

Citations: [1995] 1 AC 171; [1994] 3 WLR 288; [1994] 3 All ER 79; (1994) 99 Cr App R 362; (1994) 158 JP 653; [1994] 5 Med LR 277; [1994] Crim LR 757.


The defendant was the anaesthetist overseeing a patient’s eye operation. During the operation, the ventilation tube became disconnected. The defendant failed to notice this and did not respond to obvious signs that the patient was going into cardiac arrest. The patient died as a result. The defendant was charged with gross negligence manslaughter. The judge directed the jury that they should only convict if the defendant breached his duty in a way which no reasonable doctor should have. The jury convicted the defendant of manslaughter. The defendant disputed on appeal whether this was a proper direction.

  1. When is a breach of duty ‘gross’ for the purposes of gross negligence manslaughter?

The House of Lords held in favour of the prosecution. The judge’s summing up sufficiently stressed to the jury the high degree of negligence required for a breach to be ‘gross’.

This Case is Authority For…

To demonstrate gross negligence manslaughter, the prosecution must show a breach of duty which was gross and which caused death. The following principles apply:

  • The normal principles of tort apply when determining whether the defendant owed the victim a duty of care and breached it.
  • Whether the breach is gross depends on ‘the seriousness of the breach of duty committed by the defendant in all the circumstances in which the defendant was placed when it occurred’. The conduct must be so bad that civil liability is insufficient: criminal liability is appropriate. This is a question of fact for the jury to decide.
  • Factors relevant to whether the breach is gross include the extent to which the defendant departed from the proper standard of care and the risk of death in doing so.

Lord MacKay (giving judgment for the unanimous Lords) noted that the definition of ‘gross’ negligence has been criticised as circular. This is because it essentially means that conduct is criminal if the jury thinks it is criminal. However, he did not think that the test was too imprecise to be workable.