The case of folic acid - Evie Toombes v. Dr. Mitchell

X | @rali2100 | Linkedin|R Ali

Created: 2024-06-23 | Update:

Tags: Headline case, key legal case 


The case of Toombes v. Dr. Mitchell was a landmark case in the UK concerning a doctor's negligence in advising on folic acid. Evie Toombes, born with disabilities, sued Dr. Mitchell, alleging he failed to properly advise her mother on taking folic acid supplements before conception in 2001. Evie's mother claimed she would have delayed pregnancy had she been properly informed.

The case hinged on who the judge believed - Dr. Mitchell or Evie's mother - regarding the nature of the pre-conception consultation. The judge ultimately ruled in favor of Evie, finding Dr. Mitchell negligent and liable for damages. This decision set a precedent for the importance of clear medical advice on folic acid for women planning pregnancy.


Comment from NHS resolution 

In essence, the outcome of this case depended upon which witness the judge preferred.  She was clearly impressed by Mrs. Toombes in particular.  There must be huge sympathy for Dr. Mitchell, though, because he had to give evidence about an apparently routine consultation some twenty years earlier, and could only rely on his note, which was brief.  Mrs. Toombes convinced the judge that she recalled the consultation accurately, and overcame the hurdle presented by the midwife’s subsequent record.

Some commentators have suggested that this ruling sets an unhelpful precedent for the NHS, but we disagree.  It is a regular task for judges to have to decide between conflicting accounts.  That is what happened here.  Dr. Mitchell was in the unfortunate, but almost inevitable, position of not remembering a relatively unremarkable consultation two decades previously.  The message from this ruling is that the more detailed the note, the more likely it is that the practitioner will be believed by a court.



Nilsson, A. (2022). Case of Note: Evie Toombes v. Dr. Mitchell (High Court 21 December 2020 – Lambert J. and 1 December 2021 – Judge Coe QC) - NHS Resolution. [online] NHS Resolution. Available at: https://resolution.nhs.uk/2022/03/31/case-of-note-evie-toombes-v-dr-mitchell-high-court-21-december-2020-lambert-j-and-1-december-2021-judge-coe-qc/ [Accessed 23 Jun. 2024].