This case is the leading modern authority on gross negligence manslaughter. It confirmed that:

• The proper test is the Bateman/Andrews “gross negligence” test, not the Lawrence recklessness test.

• For involuntary manslaughter by breach of duty, the jury must decide whether the defendant’s conduct was so bad, having regard to the risk of death, as to amount to a criminal act or omission.

• Seymour was disapproved; gross negligence is the general test for all types of manslaughter by breach of duty.

• The defendant, Adomako, was an anaesthetist during an eye operation.

• The patient was connected to a ventilator through an endotracheal tube.

• The tube became disconnected, meaning the patient could not breathe.

• For several minutes, Adomako failed to notice the disconnection despite multiple obvious signs: no chest movement, no ventilator readings, patient turning blue, blood pressure dropping.

• The patient suffered cardiac arrest and died.

• Expert evidence stated that any competent anaesthetist should have noticed the problem within seconds and that the defendant’s standard of care was “abysmal” and a “gross dereliction”.

• He was convicted of manslaughter.

What is the correct legal test for involuntary manslaughter by breach of duty? Specifically:

• Should the jury be directed using the gross negligence test from Bateman and Andrews?

• Or must the direction include the Lawrence definition of recklessness?

• Appeal dismissed. Conviction upheld.

• The correct test is gross negligence manslaughter:

  1. Was there a duty of care?

  2. Was there a breach?

  3. Did the breach cause death?

  4. Was the breach so gross as to be criminal, having regard to the risk of death?

• It is not necessary to direct the jury using the Lawrence definition of recklessness.

• Seymour should no longer be followed; the gross negligence test applies generally.

1. In manslaughter by breach of duty, the ordinary principles of negligence determine duty and breach.

2. Once breach causing death is established, liability turns on whether the negligence was gross, meaning:

   • The defendant’s conduct departed from the proper standard of care

   • In a way that involved an obvious and serious risk of death

   • And was so bad that it should be judged criminal.

3. This is a jury question, based on all the circumstances.

4. Judges need not use “recklessness” in the technical Lawrence sense; the ordinary concept of gross negligence suffices.

5. Seymour is disapproved; gross negligence is the correct universal test for manslaughter by breach of duty.