Medical Negligence Cases

Clinical Negligence Cases

Case 1: Investigation into the death of a 14-year-old girl during an MRI scan

In this clinical negligence case, a teenage girl with autism died following an MRI scan under general anaesthetic. This has sparked an investigation by the Healthcare Safety Investigation Branch (HSIB) into how scanning under general anaesthetic for patients should be reasonably adjusted for those with autism or learning disability.

The findings in this case 

An inquest found that the child, in this hospital negligence case, had been under the care of three specialist consultants for a period of 9 years. She was not referred for the investigation of any underlying disorder by a geneticist, despite her parents requesting this on two occasions and; there being a relevant centre near her home. Her underlying condition which caused her death, cardiomyopathy, was therefore undiagnosed.

What is cardiomyopathy?

The NHS’ definition of cardiomyopathy is that it “is a general term for diseases of the heart muscle, where the walls of the heart chambers have become stretched, thickened or stiff. This affects the heart’s ability to pump blood around the body”.

It is a condition usually inherited and is thought to affect 1 in 500 people in the UK.

Autism, learning disability and medical assessments

The HSIB study found that children “with autism, learning disabilities and/or learning difficulties often find clinical environments distressing, which may be reflected in their physiological observations. This may result in diagnostic overshadowing, where problems such as autism (or a medical condition) are attributed as the cause of other new problems, rather than considering other underlying causes, thereby leaving other co-existing conditions potentially undiagnosed.”

This was especially relevant in this case, where the child presented to the hospital on the day of her MRI with a high heart rate and raised blood pressure. This was attributed to her distressed presentation, even though at the time of the test she was calm. During the MRI scan there were four occasions where she needed intervention due to changes in her heart rate.

Recommended change

Following the HSIB investigation, the following recommendations were made to change the way medical practitioners handle similar cases:

There should be a development in the role and competency framework for learning disability liaison nurses to ensure that people with learning disabilities and autistic people receive optimal care which respects and protects their rights.
A system should be developed for sharing care plans for patients with autism, learning disabilities or learning difficulties to enable reasonable adjustments to be made, e.g. a standardised care passport

Our specialist medical negligence solicitors act around the treatment of people with autism.  In one case, a 26-year-old man died from a hypoglycaemic attack.  He lived alone and could not manage his diabetes, and had suffered over 100 hypoglycaemic attacks. Still, the mental health services did not communicate or liaise with the general medical services regarding his care.

Caught between two different medical services, their view was that he could manage his own condition. In reality, this was incorrect; his autism caused him to mismanage his diabetes, sadly leading to his early death.

Case 2: Failure to diagnose acute myocardial infarction

In this medical negligence misdiagnosis case, Stephanie Prior was instructed to bring a fatal medical negligence claim against North Middlesex University Hospital NHS Trust on behalf of the dependents and the estate of her husband, the deceased. The claim was regarding treatment received by the patient in July 2015.

A 42-year-old male and father of two young children attended North Middlesex Hospital A&E department in the early morning hours. He reported a four-day history of central chest pain radiating to the right side of his chest and right shoulder. IK had an ECG done which revealed sinus tachycardia and some abnormality. He was triaged, and a further ECG was performed along with blood tests.

He was seen by a registrar who diagnosed him with an exacerbation of asthma. He was discharged home with antibiotics, steroids and an inhaler. He continued to experience shortness of breath when he returned home. Despite being unable to sleep, he insisted on going to work later that morning. He collapsed at work that afternoon and upon arrival, the paramedics confirmed his death. A post-mortem report stated the cause of death as

1a. Acute myocardial infarction,

1b. Coronary artery atherosclerosis.

The Defendant admitted liability but disagreed on issues pertaining to quantum – specifically the deceased’s life expectancy and future earnings.

After negotiation, damages awarded: £250,000.

NHS negligence cases:

Case 3: Injury Caused During Treatment

In this doctor negligence case, our medical negligence solicitors were instructed to pursue a claim against Chelsea & Westminster Hospital NHS Trust for injury caused during treatment while our client was under their care.

Our client (DB) was diagnosed with a full rectal prolapse that required surgery. The operation was performed and was successful in terms of prolapse. However, DB’s left ureter was accidentally cut during this operation, which went unnoticed. No note of this was made in the operation notes, and no mention was made post-operatively.

Two days after the operation, DB had a high temperature, and following investigations, DB had a chest infection. In fact, DB was suffering from a urinary tract infection, but fortunately, the antibiotics she was given were also effective against this. DB began to complain of abdominal pain four days after the surgery but doctors attributed this to her wounds and DB was discharged home when the infection seemed to subside.

DB attended Chelsea & Westminster Hospital A&E department with a 5-day history of urine incontinence on 12 April 2015. She was discharged to attend an outpatient appointment with her surgeon but returned to A&E three days later as she had increasing abdominal pain. This point had resolved the incontinence issue. It was noted that she had a distended abdomen and the working diagnosis at the time was one of suprapubic peritonitis and sepsis. Blood tests revealed infection and a further CT scan showed there was an abscess in the pelvis that was subsequently drained. Further investigations followed as DB continued to have a high temperature and a nephrostomy was performed. DB underwent further procedures over the next few months, including the insertion and removal of a ureteric stent, the replacement of a mid-ureteric stent and a ureteric re-implantation in September 2015.

Following her discharge, DB felt low in mood and attended her GP in January 2016. In February DB reported bladder problems. She developed recurrent urinary tract infections. DB was anxious as she was concerned that the stent, inserted in the ureteric reimplantation procedure in September 2015, had not yet been removed.  The stent, which should have been removed within 6-8 weeks following the operation, was eventually removed in September 2016. However, in October 2016, DB had already developed two hernias secondary to the re-implantation procedure. DB, therefore, had to undergo a further operation to correct these.

Expert evidence was obtained from a Consultant Urologist and Consultant Colorectal Surgeon. Following the serving of a Letter of Claim, the Trust admitted liability and made an early Part 36 offer in the sum of £40,000, which the Claimant did not accept.

A joint settlement meeting followed, where the NHS compensation payout was £100,000. The NHS Trust also provided a letter of apology addressed to the Claimant.

Hospital negligence cases:

Case 4: Failure to diagnose and treat Ogilvie’s syndrome

Our client suffered the consequences of a delayed diagnosis of Ogilvie’s syndrome following the birth of her daughter by caesarean section in September 2015.

Ogilvie’s syndrome is an acute intestinal pseudo-obstruction, the symptoms of which include: abdominal pain, nausea, vomiting, bloating and constipation. If left untreated, it can lead to serious, life-threatening complications such as colon perforation, sepsis and tissue damage.

Following the birth of her daughter, our client experienced persistent abdominal pain and distension. Her condition deteriorated further over the next week, and there was a failure to perform an x-ray of her abdomen and to escalate her care to the surgical team. Five days after the birth of her daughter, a CT scan was performed, which showed intramural gas in the caecum. However, this was not reported to the senior doctor.

As a result of the 9-day delay in diagnosis and treatment, our client went on to suffer a perforation of her bowel which required surgical intervention (She was required to undergo a laparotomy and right hemicolectomy, along with an end ileostomy ten days following the birth of her daughter). If diagnosed promptly, Ogilvie’s syndrome can be treated conservatively with medication. Our client required a prolonged hospital stay which was extremely worrying and stressful for her and her family.

Following a Letter of Claim being sent to the Hospital Trust, limited admissions of liability were made. The hospital admitted that there was a failure to perform an x-ray at an earlier stage, and that a CT scan should also have been performed earlier. However, the hospital were of the view that earlier x-rays would not have led to the pseudo-obstruction being revealed and that our client would have required surgical intervention to treat her condition in any event.

Expert evidence was obtained from a Consultant Radiologist, a Consultant Obstetrician and Gynaecologist and a Professor of Colorectal Surgery. The experts’ reports were all supportive of our client’s case in respect of both breach of duty and causation. As a result of the denial of liability, court proceedings were issued in April 2019. The hospital served a defence to the birth injury claim. However, after a period of negotiation, the case settled out of court for a five-figure sum

Following the settlement of her case, our client commented:

“I am very satisfied with the services provided by Osbornes Law. Throughout the duration of my case (over 3 years) they were extremely responsive and kept me up to date with all the developments and provided explanations. When the Defendant returned with an offer, they worked hard to increase it. I am a very satisfied customer of Osbornes Law”

Case 5: Brain-Injured Woman Awarded 7-figure Damages

Our client, a 76-year-old woman, tripped and fell on some stairs when she was on her way out of a hospital following a routine outpatient appointment. She suffered a significant brain injury.

A CT scan after her fall showed a subdural haematoma with some mass effect and midline shift. She was treated for 2 days with non-surgical treatments, but her condition deteriorated, and she was transferred to a specialist neurological unit.  She continued to be treated conservatively, again utilising only non-surgical options until she deteriorated further. After another 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.

Postoperatively, our client remained in hospital until she was transferred to a rehabilitation unit, almost two years later, when she was transferred to a nursing home.

The care at the nursing home was poor and our client 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, it did not fully cater for her brain injured state. The care homes had been largely funded by the local authority but with the family providing top up funding.

Our client’s brain injury left her with severely impaired mobility and wheelchair dependent. Her left arm is so weak that there is no useful movement. She can communicate but her memory and concentration are impaired. She suffers from anxiety and distress with regular tearful episodes. There are occasional seizures. Our client was left unable to litigate or manage her finances.

The outcome

Our client had been married since 1962, but she could not live with her husband for over 5 years due to her fall, with only occasional weekend visits to the family home. This was highly distressing for both of them and for the rest of the close-knit family.

Following the settlement, her family are now working towards moving their mother back home, so she can live with her husband again.  Adaptations will be required to their home, and a 24-hour nursing care package will be implemented before this can happen.

The final settlement Order for this case was very complex as our client’s predicted life expectancy at the time of settlement was six years, according to the medical experts consulted.