A Brain Injury Case Report18 May 2021 | Stephanie Prior
F sustained a brain injury leaving her with severely impaired mobility and wheelchair dependent.
In November 2013, F, 76, tripped and fell on some stairs when she was on her way out of a hospital following a routine out-patients appointment. She suffered a significant brain injury.
A CT scan taken after her fall at the hospital showed a subdural haematoma with some mass effect and midline shift. She was treated conservatively for 2 days until her condition deteriorated and she was transferred to a specialist neurological unit. She continued to be treated conservatively until she deteriorated further and after 7 days following her original fall she underwent a decompressive craniotomy and evacuation of the haematoma and frontal contusions. When the skull vault was opened the brain was noted to be pulseless.
Following the operation, F remained in hospital until she was transferred to a rehabilitation unit until October 2015. She was then transferred to a nursing home.
The care at the nursing home was poor and F was very unhappy there. She was moved to an alternative nursing home and it was a great improvement on the previous care home but nevertheless does not fully cater for her needs.
A claim was pursued on F’s behalf by her daughter as litigation friend, as a consequence of the delay in F undergoing surgical intervention following her fall. The Defendant NHS Trust admitted that F should have been operated on within 2 days of her fall. We argued within 1 day of her fall.
F’s case was that if she had been operated on sooner she would have made a good recovery and would have achieved independence and would have been able to return home.
The Defendant’s case was that the primary brain injury, caused by the fall, namely the intra cerebral contusions and a subdural haematoma causing brain swelling on the right, would have caused significant brain damage in any event; but that earlier decompression would have avoided “some of the left sided weakness”; she would not have been able to return to the normal activities of daily living or independence given the severity of the initial head injury and her age.
Proceedings were issued and served on F’s behalf and then a stay of proceedings was agreed between the parties to allow them time to gather evidence and try to settle the claim. Expert evidence was obtained from a Consultant Neurosurgeon, care expert, case manager, neuro-rehabilitation expert, physiotherapist, neuropsychologist, accommodation expert, technology expert, and neuropsychiatrist. A professional deputy was also appointed to manage F’s financial affairs and a forensic accountant was instructed to advise on settlement proposals.
An important factor in the pragmatic conclusion of this case is the fact that F is married to J and they have been married since 1962; they have been unable to live with each other since her accident in 2013, save for occasional weekend visits to the family home. This has been highly distressing for both of them and the rest of the family.
Following settlement of F’s case, her family are keen to move her back home so she can live with her husband. Adaptations will be required to their home and 24 hour nursing care package will be put in place before F is moved back home, after over 5 years of living apart from her husband.
The final settlement Order was very complex and ran to 23 pages including a retention agreement and PPO provision for the remainder of F’s life. Her predicted life expectancy at time of settlement was 6 years according the expert evidence.
The settlement for the brain injury claim was a seven figure sum.