Beatty v. Cullingworth: Medical Malpractice in the Nineteenth Century
The first operation in our Time Travelling Operating Theatre is inspired by the case of Beatty v. Cullingworth, a medical malpractice case from the late nineteenth century. The case was brought by twenty-three year old nurse Miss Alice Jane Beatty against surgeon Mr Charles James Cullingworth, and a detailed account was published in The British Medical Journal.
The operation in question was an ovariotomy – the surgical removal of one or both ovaries – which Cullingworth performed on Beatty in 1892 to treat a painful ovarian cyst.
Charles Cullingworth was a well-regarded physician and surgeon. He had been professor of obstetrics at Owen’s College in Manchester and senior obstetric physician at St Thomas’s Hospital in London. Over the course of his career he published many times on various gynaecological conditions as well as writing several guides for nurses. He first encountered Alice Beatty at St Thomas’s Hospital in 1892 where he examined her and ascertained that her right ovary had become prolapsed and it would have to be removed in an ovariotomy.
In her court testimony, Alice Beatty recounted that following this examination she had firmly told the surgeon that he was to remove only the damaged right ovary. She further said that if Cullingworth found both to be diseased, he was to remove neither, as she was engaged to be married and wanted the best chance of having children. During the operation, Cullingworth judged the left ovary to also be liable to disease and in consultation with his surgical assistant he decided to remove both.
Following the surgery Beatty called off her engagement, as it would have been impossible for her to bear children, and brought several legal actions against Cullingworth. During the court battle, Cullingworth contested Beatty’s accusations, claiming that he thought she had consented, and that he would never have agreed to perform the operation if Beatty had not allowed him ‘a free hand’ to do what he thought was best during the operation.
Several expert witnesses were called throughout the trial to examine Cullingworth’s notes and ascertain whether there was any cause to remove both ovaries. One of these was Sir T. Spencer Wells, a highly esteemed obstetric surgeon who had performed over 1000 ovariotomies in his career. Wells, though noting Cullingworth’s excellent surgical skills, testified that he thought Beatty would have been in no danger if the surgeon had removed only the one ovary and further consulted with the patient on the state of her second ovary. Cullingworth though was adamant that she had consented, and any hesitation she might have shown was due only to anxiety about the surgery. The British Medical Journal noted Cullingworth’s certainty on this:
After a lengthy trial the judge and jury found in favour of Cullingworth and were unanimous in their condemnation of Beatty for bringing the action against the man who they deemed to have saved her life. Fellow medical men even began a fund to help Cullingworth pay his legal costs. In fact, when the British Medical Journal published an advertisement with a list of contributors, the first donor listed was none other than Sir T. Spencer Wells.
This did not deter Alice Beatty though. In the year following the trial the nurse established the ‘Society for the Protection of Hospital Patients’ to campaign against surgeons and physicians treating hospital patients as research objects. She continued her work in this area throughout her life and even published on her experiences of medical malpractice in a book titled Medical Tyranny: A Personal Experience.
[Quote 1 & 2 from ‘Beatty v. Cullingworth, British Medical Journal, 21 November 1896, pp. 1546–1548. Quote 3 ‘Cullingworth Fund’ from British Medical Journal, 19 December 1896, p. 1800.]
Further Reading
‘Beatty v. Cullingworth’, British Medical Journal, 21 November 1896, pp. 1546–1548.
Alice Jane Beatty, Medical Tyranny: A Personal Experience (London, 1912).
Charles James Cullingworth, A Manual of Nursing, Medical and Surgical (London, 1885).
Claire Brock, ‘Risk, Responsibility and Surgery in the 1890s and Early 1900s’, Medical History, Volume 57, Issue 03 (July 2013), pp. 317–337.
Sally Frampton, ‘Patients, Priority Disputes and the Value of Credit: Towards a History (and Pre-History of Intellectual Property in Medicine’, Medical History, volume 55, issue 3 (July 2011), pp. 319–324.
