Hospital authorities insisted last night that their decision to pursue a costly lawsuit against a patient to Bermuda’s highest court of appeal, where they lost this week, would not have an effect on taxpayers.

The Bermuda Hospitals Board took its case against Kamal Williams to the Privy Council in London to argue that he should not have been awarded $60,000 in compensation by a court here after suffering a burst appendix, followed by life-threatening septic shock at King Edward VII Memorial Hospital.

The board lost its appeal on Monday and is now liable for legal costs for both sides, a figure estimated by Mr Williams’s lawyer to be at least $500,000.

The BHB’s medical malpractice insurers will foot the entire bill, as previously reported by The Royal Gazette.

A spokeswoman for the BHB, which has already paid the $60,000 in compensation and was not seeking to recoup it, said yesterday: “BHB regrets the pain and suffering that was sustained by Mr Williams. This case was taken to the Privy Council at the request of our insurers to question a point of law, a process that was approved through BHB’s governance process that includes executive and board approval.

“The costs of the appeal and those associated with the outcome of the case are covered by the insurers and do not impact BHB’s finances, and Bermuda taxpayers will not pay in any way for the pursuit of this case to a final conclusion.”

Mr Williams, a father of two from Southampton, suffered damage to his heart and lungs owing to avoidable delays in operating to remove his appendix at KEMH.

The BHB offered to settle the case — initially for $24,000 and then for $40,000 — two weeks before it was due to go to trial at the Supreme Court in 2012. Mr Williams rejected the offers from the publicly funded BHB and eventually won $60,000 in damages, after the Court of Appeal threw out an earlier Supreme Court ruling that awarded him only $2,000.

The Supreme Court judge who heard the patient’s original claim for $100,000 against the BHB considered whether “but for” the hospital’s negligence, he would have suffered those injuries.

The judge found that while KEMH negligently breached its duty of care to Mr Williams, the patient failed to prove that the complications during and after his operation were probably caused by the failure to diagnose his illness and treat him swiftly.

The Court of Appeal later ruled that the correct test to apply was whether the hospital “materially contributed” to his injuries.

The “material contribution” argument had previously been allowed only in very limited circumstances and rarely involving hospitals. Mr Williams’s QC, Benjamin Browne, argued that his case justified a departure from the “but for” test and responsibility should be attributed to the BHB because of its breach of duty.

The BHB’s lawyers countered that the usual limitations should apply and it would be overly onerous on hospitals to attribute responsibility to them in such cases.

The Privy Council panel found against the BHB. The board spokeswoman said the case was pursued because of concern that the Court of Appeal ruling would set a precedent.

“BHB appealed to the Privy Council because the Court of Appeal’s ruling changed the law of Bermuda in relation to ‘causation’,” she said. “This ruling would impact not just Bermuda but the UK and other Commonwealth countries. BHB felt it important to query that judgment, and this was also of interest to the NHS in the UK.

“It is in the public interest to question judgments that could potentially increase the cost of healthcare and healthcare premiums in Bermuda, as well as across the Commonwealth.

“The Court of Appeal stated that the ‘but for’ test was too rigorous and that the test for causation was simply one of ‘sufficiency’.”

The spokeswoman added that the Privy Council ruling confirmed that the correct legal test for causation in the majority of personal-injury damage cases remained the “but for” test, even though in this instance, the Court of Appeal ruling was upheld.

“BHB has never sought a return from Mr Williams of his original compensation, which was paid in 2014,” she said. “The case was to review a law of general public importance that relates to causation. We cannot comment on the costs, as they are not fully known, but they will paid by our insurers.”

The spokeswoman was asked but did not provide the name of the board’s medical malpractice insurers.