More than any other organ in our bodies, our brain relies on high levels of oxygen to function and survive. Without adequate oxygen, our brains quickly suffer and can sustain permanent damage within a few minutes. After 5 minutes, severe brain damage due to brain cell death is inevitable and after 10 minutes with insufficient oxygen, most people will die.
Brain injury due to medical negligence occurs more often than you might expect. Most frequently, medical negligent brain injury is due to oxygen deprivation (hypoxia), in babies, children and adults. The cause of the hypoxia varies from case to case: from birth trauma to medication errors, from inadequately treated infection to missed diagnosis.
Generally, there are two main causes of hypoxic brain injury:
- Low or no blood oxygen – when the body cannot take in sufficient oxygen, due to illness or a medical emergency such as a heart attack.
- Low or no blood supply to the brain – this can happen if a blood vessel to the brain is blocked, which happens in the case of a stroke.
Signs of hypoxia should be easy to spot by trained clinical staff and can include:
- Rapid heart rate and breathing
- Shortness of breath and difficultly talking
- Blue lips
Hypoxia is a clinical emergency, but it must be recognised, and its cause identified, before it can be treated. Treatment options depend on the cause but should automatically include oxygen support, via a mask or with a ventilating machine.
However, hypoxia is still missed by medical teams. It is these tragic cases that make the headlines of national newspapers and websites.
What Symptoms Result in Brain Injury Claims?
The consequences of brain injury depend on what area of the brain is most affected. It can be very difficult to regain lost function following a brain injury, so many brain injury cases result in permanent disability, including:
- Loss of speech, vision, hearing
- Memory problems
- Mood disturbance
- Personality changes
- Behavioural changes
Any compensation awarded must consider the injury sustained and the cost of care and rehabilitation. Also included in the calculation is the pain and suffering of the patient, as well as loss of income and potential future income.
Below is a breakdown of the most common causes of medically negligent hypoxia and resultant brain damage.
During birth, both mother and baby are susceptible to medical errors. Inadequate oxygen provision to the birthing baby can result in cerebral palsy. Cerebral palsy affects development and children with this condition can have problems with movement and learning and can suffer from seizures. For mothers, severe, inadequately managed blood loss or secondary infection can cause brain injury.
Misdiagnosis, missed and delayed diagnosis
Misdiagnosis missed and delayed diagnosis cover a gamut of potential causes of brain injury. These include: failing to spot a skull fracture following a head injury, missing the signs of a blood clot or bleeding on the brain, failing to properly manage blood loss, failure to adequately manage the airway, missing bleeding around the heart and into the abdomen and pelvis, and failure to recognise infection.
Many different types of medication error can lead to brain injury. Inadequate prophylaxis against clots and bleeding ulcers can lead to stroke and catastrophic bleeding respectively. Medication errors can affect the heart and lungs which cause a reduction in oxygen levels: for example, over prescription of opiate pain relief can depress the respiratory system while giving the incorrect dosage of heart medication can cause heart arrythmias.
For people who have known allergies to medication, taking these medications can lead to anaphylactic shock, which can lead to hypoxia if not recognised and treated immediately.
Little known is the fact that the administration of too much oxygen can also be fatal. Deaths whilst under general anaesthetic have been reported. A high flow of oxygen given instead of ventilation.
Mismanagement during surgery
There are stages during surgery under anaesthetic where oxygen deprivation can occur: inadequate ventilation during surgical procedures, poor or inadequate monitoring during and immediately after surgery, body tissue damage due to mishandling of surgical instruments and incorrect aesthetic management.
Furthermore, low oxygen levels can lead to an increased risk of post-operative complications including infection, heart failure, pulmonary hypertension and renal failure. Even, ‘modest fluctuations in oxygen delivery may lead to cognitive dysfunction’ and those patients that experience a drop of brain oxygen levels of greater than 25% during surgery showed a decline in Mini Mental State Examination scores after seven days. This decline was still evident 3 months later, in 5-12% of patients.1
Osbornes Law: Specialists Brain Injury Solicitors
For brain injury claims for medical negligence to be successful, it must be proven that the medical treatment provided fell below acceptable standards and that this negligence directly led to an injury. The process of claiming compensation in these cases can be stressful and time consuming, so you need to engage a solicitor who knows what they are doing. Stephanie Prior, Medical Negligence Solicitor at Osbornes Law, leads a team of solicitors who specialise in supporting victims of medical negligence in their pursuit of compensation.
If you believe you or a loved one has suffered brain injury due to medical negligence, it is a good idea to get in touch right away.
IMPORTANT DEADLINE: There is a 3-year limit for starting brain injury claims: from the time of the injury, to the start of legal proceedings.
A brain injury case report
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.
Our Promise to You
- We will review your potential brain injury claims by advising you on the NHS complaints procedure or other alternative procedure if your case does not relate to NHS care and treatment.
- Our brain injury lawyers will not charge a fee for our time in reviewing your case.
- Our brain injury solicitors will assist you with any issues that you may have regarding the complaints procedure or that you encounter in obtaining copies of your medical records.
- We will advise you of the course of action in respect of your case.
For a confidential discussion regarding your situation call Stephanie Prior on 020 7485 8811 or fill in our online enquiry form.