Legal Case Summary
R v Adomako [1995] 1 A.C. 171
Facts
The defendant, Mr Adomako, was an anaesthetist. He was undertaking his role during an eye operation during which the patient was required to be placed under a general anaesthetic. During the operation, and whilst under Mr. Adomako’s supervision, a crucial tube became disconnected from the ventilator and the patient suffered a fatal cardiac arrest. Mr Adomako was convicted of the manslaughter by breach of duty.
Issue
Mr Adomako appealed the conviction and questioned the legal basis of involuntary manslaughter by breach of duty.
Decision / Outcome
Dismissing Mr Adomako’s appeal, it was held that in cases of manslaughter by criminal negligence involving a breach of duty the ordinary principles of the law of negligence applied to ascertain whether the defendant had been in breach of a duty of care to the victim. On the establishment of said breach of duty the next question was that of establishing causation and, and if this could be so established, whether it should be characterised as gross negligence and therefore a crime. This is ultimately a question for the jury, having regard to the risk of death involved, asking themselves ‘was the defendant’s conduct so bad in all the circumstances that it ought to amount to criminal?’
Updated 20 March 2026
This summary of R v Adomako [1995] 1 AC 171 remains legally accurate. The House of Lords’ decision continues to be the leading authority on gross negligence manslaughter in England and Wales, and the four-stage test it established — duty of care, breach, causation, and whether the negligence was sufficiently gross to be criminal — remains good law.
However, readers should be aware of some important subsequent developments. In R v Misra and Srivastava [2004] EWCA Crim 2375, the Court of Appeal confirmed that the Adomako test is compatible with Article 7 ECHR (the principle of legal certainty), rejecting arguments that the test was too uncertain to constitute a criminal offence. This case is frequently cited alongside Adomako and students should be familiar with it.
More recently, the Law Commission has at various points considered reform of gross negligence manslaughter, and following high-profile medical cases there has been ongoing debate about the application of the offence to healthcare professionals. The Government consulted on this area, and the independent review led by Leslie Hamilton (published 2019) recommended reform of the law as it applies to medical practitioners. As of the time of writing, no statutory reform has been enacted, and Adomako remains the governing authority. Students should be aware that this area may be subject to future legislative change.
