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You are here: BAILII >> Databases >> England and Wales High Court (King's Bench Division) Decisions >> Bevan v Ministry of Defence [2025] EWHC 1145 (KB) (14 May 2025) URL: https://www.bailii.org/ew/cases/EWHC/KB/2025/1145.html Cite as: [2025] EWHC 1145 (KB) |
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KING'S BENCH DIVISION
MANCHESTER DISTRICT REGISTRY
B e f o r e :
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JONATHAN BEVAN |
Claimant |
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- and – |
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MINISTRY OF DEFENCE |
Defendant |
____________________
Mr Tim Meakin (instructed by Irwin Mitchell) for the Claimant
Hearing dates: 22, 23, 24, 25 and 28 April 2025
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Crown Copyright ©
His Honour Judge Bird :
Introduction
Background
Potential Mechanisms of injury
Medical causation
"Having accepted acoustic shock as a clinical entity, stock notices based upon the usual rules of engagement in clinical practise, want competing diagnosis are excluded. That is there has to be a defined acoustic incident from which air symptoms should commence straight away or shortly afterwards, and these need to be outside the physiological or startle response. The ear symptoms should be experienced in or arise from the exposed ear(s). Of particular interest are the ancillary and not necessarily ear based symptoms that can accompany acoustic shock and indeed form part of the disorder, bearing in mind the neuro psychiatric component. These are highly relevant in subsequent disability and illness behaviour."
The criteria are summarised at table 1 as follows.
Acoustic shock diagnostic guide – "Grindleford Criteria"
- There must be a defined acoustic incident (which need not be negligent) (G1)
- Ear symptoms should start straight away or shortly afterwards (G2)
- Ear symptoms should be outside physiological or startle responses (G3)
- Ear symptoms should be experienced in or arise from the exposed ear(s) (G4)
- There may be significant psychological overlay or relationship to illness behaviour
The issued claim and how it has progressed
14. The Defence at paragraph 9 refers to Mr Bevan's "noise induced tinnitus or hearing problems caused …. as a result of exposure to noise" and goes on at paragraphs 10 and 11 to point out that there has been no diagnosis of NIHL (or any mention of it in Professor Wright's report). The Defence, consistent with the admission referred to above, contains an admission of breach of duty but puts the Claimant to proof in respect of causation and quantum.
"I believe the initial noise exposure almost certainly caused the tinnitus. Tinnitus in itself, causes a flight or fight response….. Thus, an initial symptom secondary to exposure can engender anxiety and in Mr Bevan's case it is my firm belief that his subsequent lack of care and medical management along with any appreciation of his stress disorder is causal of the conversion state with a non-organic hearing loss"
Where the changing course of the case leaves us
Lay evidence
A brief outline of Mr Bevan's relevant military career and health
Noise exposure at GD
"the CBRN was blaring in my ear so often that I was going round the test track with my thumb hovering over this button, pressing it consistently as the CBRN went off along with the cacophony of other alarms….There were usually only seconds where no alarms were going off, during which the engine noise itself was loud, and whining. This in itself felt unnaturally loud for example, I wasn't able to talk to the driver when the vehicle was moving, and it was so difficult to communicate. The headsets seemed to amplify this noise as well. However, it was the alarms that were really bad. It felt farcical."
Findings on exposure
When did the Tinnitus begin?
41. Mr Bevan was seen at the Queen Elizabeth Hospital Edgbaston on 7 December 2020 by Mr Jameel Muzaffar a Specialist Registrar in ENT and Lt Col Linda Orr a well-respected ENT surgeon. Mr Muzaffar dictated a letter to Mr Bevan's senior medical officer (with a copy to Miss Orr) and reported that when seen, Mr Bevan "…. denies tinnitus or any subjective change in his hearing."
The December 2020 letter
March 2021 and the first recording of tinnitus
50. Professor Wright reports that Mr Bevan "states that his tinnitus started during the Ajax project sometime early in 2021. It has increased in severity since then and now he says it is "terrible…hate it." It is more severe in the right ear than left and fluctuates increasing to a level where he really can't hear anyone around him. This lasts about 30 seconds and can occur two to three times each day. The tinnitus stops him sleeping so he plays YouTube videos to help him off to sleep. He does wake during the night but thinks this is more because of his mental health issues and anxiety. On a scale of trivial mild moderate severe very severe Mr Bevan rates his tinnitus as severe."
The ENT experts
Findings on onset of tinnitus
The up-to-date position at examination
Acoustic Injury?
Conclusion