What our clients say…
I felt comfortable with Ruth and I trusted her. Ruth kept me up-to-date with every detail. I would strongly recommend Switalskis, and Ruth in particular.PL
Thank you for all the help and advice.Clinical Negligence Client
Our Clinical Negligence lawyers are specialists and our team has expertise in all types of medical negligence claims.
Here are just some of the cases where our legal experts have been successful in helping clients to secure compensation and achieve justice. Click on a case study to read more.
Mrs Wilkinson, Theo’s mum, asked Switalskis Solicitors to investigate the standard of care she received during labour and delivery to identify whether there were any failings in the obstetric management and whether anything could have been done to avoid her son’s death. In the meantime, the hospital carried out their own internal investigation, which identified a number of failings in the midwifery and obstetric management. In particular, the midwife failed to categorise the CTG (a recording of the fetal heartbeat and the uterine contractions during pregnancy) as pathological (demanding immediate attention). The midwife failed to ask for more specialist help quickly enough, when a decision should have been made for delivery by caesarean section in view of Mrs Wilkinson’s history of reduced fetal movement, a very abnormal CTG trace and the fact she was not in established labour.
Sian Morris, Senior Legal Executive at Switalskis, obtained expert medical evidence which identified failings in the midwifery and obstetric care. After sending a Letter of Claim to the Trust outlining Mrs Wilkinson’s claim the Trust admitted that Theo should have been delivered sooner and had that occurred, he would have survived. It was agreed, however, by the experts that had Theo survived, he would have been brain damaged and his life expectancy would have been significantly reduced. Nevertheless, he would not have died when he did. Although Theo’s mother would have had to face the utter tragedy and devastation of losing her son, she could have been properly prepared and counselled and supported through the process – and would have been able to better come to terms with what happened. As it was, the trauma of losing her baby was significantly added to by the way in which he died.
The retained swab caused the Claimant to develop a large abscess and a pseudoaneursym (a collection of blood in between the two outer layers of an artery). He collapsed whilst in hospital in July 2013 and had to undergo emergency surgery to repair the pseudoaneurysm. It was not possible to remove the swab at that time so the Claimant was again admitted to hospital in August 2013 when the swab was removed and a large abscess was drained; approximately 1 litre of pus was drained from the abscess.
After the swab was removed and the large abscess drained, the Claimant continued to have problems with loss of appetite, weight loss, lethargy, poor sleep and altered bowel habit. He also suffered from depression.
The Defendant Trust admitted liability for the retained swab at the outset of the claim. However, an admission concerning the pseudoaneurysm was not made until 2017.
Court proceedings were issued but the claim was subsequently compromised with the Claimant receiving damages for his injuries and financial losses.
No action was taken by the Defendant Trust until the lump on the Claimant’s head burst some months later, whilst she was at work. The Claimant was then admitted to hospital for an emergency craniotomy to wash out the wound and remove the piece of infected bone flap. She remained in hospital for over 2 weeks.
The Claimant suffered Post Traumatic Stress Disorder as a direct result of the fluid-filled lump bursting. She also suffered an exacerbation of her pre-existing anxiety and panic attacks. The Claimant felt that she had not been listened to by the Defendant Trust and formed the impression that she was viewed as a “drama queen”.
The Claimant obtained supportive expert evidence on breach of duty and causation from a Consultant Neuroradiologist, a Consultant Neurosurgeon and a Consultant Psychiatrist.
The Defendant maintained a denial of liability throughout the entirety of the claim.
Numerous unsuccessful attempts were made to engage the Defendant in ADR (alternative dispute resolution). This included a Part 36 offer by the Claimant over 6 months before trial; invitations to enter Judgment with damages to be assessed following a joint experts meeting (when it should have been clear to the Defendant that their own expert evidence could not support their denial of liability); and invitations to arrange a round-table meeting.
The Defendant eventually put forward a Part 36 offer less than 6 weeks before the trial was due to commence. A settlement was thereafter agreed between the parties such that the claim concluded 2.5 weeks before trial.
Following the delivery, the Claimant developed a huge abscess as well as septicaemia (blood poisoning), multi-organ failure, extensive skin damage, a blood clotting disorder, toxic shock syndrome and acute respiratory distress syndrome. She was seen in hospital and taken to theatre the same day for urgent surgery to drain the wounds.
After her surgery she was transferred to the Intensive Treatment Unit where she was sedated and ventilated. She was kept on ventilation and support for several days, and she remained on the Intensive Treatment Unit whilst she recovered until she was then transferred back to the High Dependency Unit.
After that, the Claimant was transferred to another hospital for plastic surgery to deal with the extensive skin damage she had suffered on her thigh and lower leg. She also needed skin grafts. Sadly the skin became infected again and she had to have two further surgeries to deal with the infections and the skin damage.
As a result of the Defendant’s negligence the Claimant has been left with severe, chronic pain in her left lower leg and extensive severe scarring to her left lower leg as well as scarring to the face, neck and right arm.
Very sadly her pain will not improve and no further treatment will improve her scarring. In addition the Claimant has developed a heart problem as a result of the blood infection. She also suffers with anxiety and depression as a result of what happened to her.
Switalskis Solicitors helped the Claimant with her claim which the Defendant has admitted was their fault. The Claimant has been awarded various damages payments to allow her to start her rehabilitation and to try and rebuild her life.
In 2011, the Claimant (a retired gentleman in his 60s) was admitted to hospital for what should have been a fairly straightforward operation to remove nasal polyps. He underwent Functional Endoscopic Sinus Surgery (FESS) where a high powered piece of equipment is used to remove the polyps.
Unfortunately, the piece of equipment penetrated the area surrounding the Claimant’s eye. The ENT surgeon did not make a note that significant bleeding (intra-orbital haemorrhaging) had occurred at the time of the operation; he did not make a note of this until much later on. However, he arranged for an eye specialist (ophthalmologist) to assess the Claimant’s vision when he was back on the ward, and assess the muscle around his eye (the medial rectus muscle).
Immediately after the surgery, the Claimant experienced double vision in his right eye. He was discharged home with a plan to return to the hospital for a more detailed eye examination. He was then advised that a missing or floating piece of muscle could be the cause of his eye problems. Arrangements were made for the Claimant to undergo surgery to repair the defect in his eye orbit that had been created during the nasal polyp surgery.
However, in the meantime the Claimant began haemorrhaging severely from the nose and was choking on blood. He was taken by ambulance back to hospital and readmitted. The Claimant underwent surgery, when a maxillofacial surgeon noted a 30 x 30mm defect in the medial orbital floor. This was repaired, but the surgeon noted that it looked as if some of the eye tissue had been removed and some arteries were missing completely.
The Claimant was referred to an ophthalmologist at a different hospital, who undertook further surgery on the eye to try and assist with his constant double-vision. The surgeon removed the plate and found that there was virtually no muscle left for him to repair. Despite the surgeon’s best efforts, the Claimant continued to experience double vision, which is likely to be permanent.
A claim was brought against the Trust responsible for the surgeon who carried out the Claimant’s original operation. Supportive expert evidence was obtained from an independent ENT surgeon and an independent ophthalmic surgeon. The ENT expert was of the view that, at the time the eye orbit was breached with the micro debrider, both orbital fat and the medial rectus muscle were sucked into the equipment by the oscillating blade. He was also of the opinion that causing such an injury was due to substandard care. The ophthalmic expert concluded that the Claimant would not have had any eye problems at all if the initial FESS operation had been performed properly. However, as a result of the substandard care, he suffered constant double vision due to “a virtually complete lack of movement of his right eye.” He also had sensory abnormalities around the eye.
A detailed letter of claim was sent to the NHS Trust responsible for the hospital where the injury had been caused. The Defendant Trust admitted liability for the Claimant’s eye injury in their letter of response.
Negotiations commenced, which resulted in the Claimant receiving significant damages.
In her early thirties, she decided to correct the deformity and sought advice from a Consultant Orthodontist and Maxillo-facial surgeon. She was advised that she could undergo a combination of orthodontics and surgery to correct her facial deformity and biting problems.
VA was later operated on at St Luke’s Hospital, Bradford. Unusually, her surgery took nine hours as opposed to the estimated maximum of four hours.
After the procedure, VA experienced excruciating pain, facial swelling, problems with biting and lip numbness. She also noticed that her jaw felt uneven and seemed to be sloping. The defect developed and this made her feel extremely self-conscious in addition to affecting her ability to eat and talk.
She subsequently attended various follow up appointments and was re-assured on each occasion that she was recovering well. VA felt as though she was being ignored and eventually, a CT scan was performed after 6 months which confirmed that one of the brackets used to secure the left jaw had broken as well as evidence degenerative changes to the right jaw joint. VA was told that she should not undergo another procedure to correct the issue as the risks outweighed the benefits. She therefore continued with conservative management (pain killers, elastics and Botox) for a period of time.
As a result of VA’s ongoing pain and deformity, she eventually underwent an MRI scan which showed that her right jaw joint had completely disintegrated and her left jaw joint was also affected. She later contacted another surgeon for a second opinion and was advised that she needed a total joint replacement.
Corrective surgery eventually took place 4 ½ years after the initial procedure.
Switalskis Solicitors assisted VA in proving that the original surgeon was negligent in not using enough screws when securing the plates to VA’s jaw. This caused her ongoing pain, facial deformity and her jaw joints to twist and break.
VA will need another two operations in the future to replace her jaw joints and to also correct the displacement of her chin caused by the damage to her jaw.
Sunny Sandhu from the Switalskis Clinical Negligence team was successful in securing £85,000 for Mrs Allen on 24 May 2017. This will go towards the severe pain and suffering she has endured as a result of the negligence and pay for the revisionary surgeries she will need in the future.
During her pregnancy she was found to have a platelet count below the normal range which continued to fall. This should have been detected by the GP and Midwife to ensure that the pregnancy was classified as high risk. There was also additional failure to record her past family history of angina, lupus, blood clotting, epilepsy, kidney factors and the risks posed due to her young age of 17. The lack of sufficient recording meant that such risks were not taken into consideration for the client’s pregnancy. There was also insufficient medical testing of her urine and blood.
Expert evidence indicated that she should have been managed by consultant led care as she was a high risk pregnancy.
At 32 weeks gestation she went into premature labour, after which she became acutely unwell with significant hypertension, marked disturbances in her renal and liver function as well as a severe coagulation disorder. She was diagnosed with suffering from pre-eclampsia, HELLP syndrome and Antiphospholical syndrome following the birth of her child.
She then went into multi-organ failure and as a result she was left with significant permanent renal damage. The medical evidence obtained by Switalskis considers that she will go into complete renal failure by the end of 2016 and as a result, her life expectancy will be greatly reduced. There is a real risk that her life will be limited to 5-10 years after she begins dialysis.
In addition to securing a lump sum for damages, Switalskis have ensured that she will be properly compensated by the Defendant as her condition deteriorates as she will receive yearly payments of compensation.
Her quality of life has been greatly reduced as a result of the problems which could have been avoided with the appropriate GP, Midwifery and Obstetric care.
With the help of Switalskis Solicitors, she was able to obtain damages in order for her to regain some quality of life that had been lost. Switalskis has facilitated the purchase of a new property in the settlement negotiations and she will receive 24 hour care for herself and her child when required.
The client initially made complaints of pain in the base of her thumb on her left wrist for which she later underwent surgery. Post-operation she developed an infection which went undiagnosed for some time, resulting in compartment syndrome. As a result of the negligent delay in diagnosis, she developed sepsis and consequent renal failure and required admission to the intensive care unit.
She later developed acute necrosis and underwent numerous wash out procedures. She then had a muscle graft and developed a large seroma on her wrist which required three surgical drainage procedures.
Once discharged from hospital she was unable to move her hand and sustained numerous infections and experienced unbearable pain. After almost a year of repeat infections and being given numerous antibiotics, she underwent an amputation of her left forearm.
She now experiences severe pain, anxiety, depression and alcohol dependency as a result of the trauma. She also suffers from phantom sensations after the amputation and requires constant support and assistance.
The case has been settled and although the settlement figure can’t always compensate for the loss of her forearm and the suffering she has had to endure, it will help to provide her with the support she needs to live the rest of her life.
Mr N was so unwell at home that 10 days later he had to be taken by ambulance to Dewsbury District Hospital as an emergency. Mr N had suffered a toxic megacolon and renal failure and had to undergo emergency surgery. During the surgery it was discovered that he had widespread peritonitis. Mr N also had a heart attack during the surgery. He required a total colectomy and he now has an ileostomy and an anal stump. In addition, he was left with a large abdominal wound which later burst open. The wound took a long time to heal and left a scar. He was kept in hospital for six weeks; 2 weeks in Intensive Care; 2 weeks in High Dependency Unit and 2 weeks on the ward.
Mr N instructed Switalskis Clinical Negligence team to investigate a claim against the Mid Yorkshire Hospitals NHS Trust. During the investigations it was discovered that on the first visit, the hospital should have kept him in for monitoring and referred Mr N to the gastroentereology team. He would have received antibiotics and recovered well. He would have avoided the surgery; the colectomy, ileostomy and the anal stump.
Ruth Heathcote of the Medical Negligence team in Huddersfield helped Mr N settle the claim out of Court for £100,000.
However, in fact, at that appointment the doctor failed to diagnose a ruptured patellar tendon which was clear from the x-ray and Mrs N’s ongoing symptoms.
The tendon rupture was eventually identified 13 months later. Mrs N required surgery to repair the tendon and she had an extended recovery period following the operation.
Mrs N also developed psychological symptoms due to the instability and weakness in her left knee. She was particularly affected by pain, poor sleep and the impact that her physical impairment was having on her daily functioning and leisure activities.
The Defendant admitted a failure to diagnose the ruptured tendon at the outpatient clinic. If the patellar tendon tear had been identified earlier, Mrs T would have received earlier treatment and had a shorter recovery period. She would have avoided 13 months pain and suffering, the extended recovery period and the worsening of her psychological symptoms.
Solicitor Ruth Heathcote of Switalskis Clinical Negligence team helped Mrs N settle the claim out of Court.
D’s husband suffered from acid indigestion and constipation. In addition to feeling generally unwell, he complained of stomach pain, headache, backache and nausea. He visited his GP a number of times and was eventually referred to his local hospital.
During the following two years he became increasingly unwell. He underwent an endoscopy and other procedures, with no discovery. After being admitted to hospital as a day patient for a biopsy, he was called into hospital for an appointment when he was told that he had cancer. D’s husband deteriorated rapidly and soon after diagnosis required 24-hour care. He died in a hospice, the death certificate showing carcinomatosis and carcinoma of the stomach as the cause of death.
D’s former solicitors had not progressed the case very quickly, and D was constantly chasing them for updates. Several lawyers dealt with the case and a claim form was issued just before the three-year limitation period expired.
D continued to chase her former solicitors for updates. She received a letter apologising for the delay and advising that the solicitors would seek an independent expert medical opinion. They did not mention the status of the Court proceedings. However, the former solicitors failed to serve the Claim Form within the four-month window to do this, and had made no application to extend the validity of the Claim form. This meant that the claim could not go ahead because the three-year limitation period had expired.
With the help of our experts, D pursued a claim for professional negligence against her former solicitors.
After obtaining an expert medical opinion from a consultant surgeon, it became clear that that it was unlikely the original claim for medical negligence would have succeeded. D’s husband had developed an aggressive form of cancer which initially had minimal symptoms and even it it had been diagnosed earlier, it would not have been contained within the stomach at the point where surgery could have offered a chance of survival.
However, this was no longer the focus of the claim. The focus was the effect on D of the actions of her former solicitors. A consultant psychiatrist’s report concluded that D suffered from anxiety and depression and that over the course of two years, the delays in investigating the potential claim by her former solicitors had made these conditions worse. We were able to recover damages in D’s case after issuing proceedings for the loss of chance, and also for the distress caused by the negligent delay in progressing the original medical negligence claim.
When AB was 15 years old, his parents sought advice. They were concerned about the future, and in particular who would care for their son when they could not do so themselves. The Defendant in the case was Bradford Teaching Hospitals NHS Foundation Trust. The Trust admitted liability for AB’s brain injury in 2012, and there was a judgment in his favour in December the same year. However, finalising the case and reaching agreement took until November 2013.
The settlement provides:
a capital lump of £2.65m
annual payments for care of £78,500 per year for 10 years and then £125,000 per year for the rest of AB’s life.
The Trust has formally apologised in writing to AB and his parents for the damage caused.
AB now has the assistance of a case manager, a physiotherapist and an occupational therapist. For more than a year, he has been seeing a neurologist on a private basis and she has helped him gain more control over his seizures than he has had for some years.
N had strong views against terminating the pregnancy. She therefore had a 5th child.
A consultant radiologist was consulted in N’s case. The images reviewed suggested that at least one of the left-sided clips did not traverse the uterine tube, however the exact position could not be determined. A laparoscopy might be required to establish whether the the clips had completely occluded the tube. A consultant obstetrician and gynaecologist’s report was obtained in order to investigate further. On the balance of probabilities, it said there was sufficient evidence to suggest the sterilisation failed because the occlusion of the tube was incomplete at the time of the operation.
When court proceedings were issued in N’s case, the hospital concerned denied negligence and suggested the most probable cause of the failure of the sterilisation was the formation of a fistula in the left fallopian tube – an inherent risk of the procedure.
A new consultant obstetrician and gynaecologist was instructed to carry out a further sterlisation procedure and to video record his findings. The report following the second operation concluded that there was no doubt the first operation was substandard. Two clips were applied to the left fallopian tube and neither clip was properly occluding the tube.
N recovered damages for the pain and suffering caused by negligence.
Y had had hip replacement surgery twenty four years before. She suffered severe injury due to negligence in revision surgery to her right hip.
Before the revision surgery, Y was told that she had 4 screws in her femur from the previous right hip replacement. These would need to be removed without damaging the femur itself. After the operation, Y found that the screws had been removed, but the surgeon had not been able to simply unscrew them – he did not have the specialist tool he needed to do the surgery, and had resorted to splitting the femur to remove the screws.
Following the surgery, Y was left with limited mobility.
In Y’s case, the allegations of negligence were:
- that the surgeon failed to make a proper and detailed plan for a complex procedure.
- that the lack of planning meant there was no alternative surgical strategy when the problems arose with removing the screws
- that as a result the surgeon replaced the prosthetic right hip in a negligent manner: he was trying to make the prosthesis pass down the central canal of the femur when, because the screws were still in place, that simply would not hold or succeed. There was also a failure to cement the prosthesis in place which meant the replacement was bound to fail.
- that the negligent surgery caused irreparable, significant long-term damage to the structure of the right hip and prevented Y from obtaining a pain-free and functional right hip.
If the surgeon had planned the procedure properly he would have had the proper specialist equipment for the extraction of the screws, extracted the screws, and either proceeded with the replacement or delayed it until the bone had recovered sufficiently for the replacement to be done.
The case was listed for a 4 day trial and the hospital trust made a number of offers. The claim was settled a month before the trial was due to start and Y received damages for her pain and suffering as well as compensation to pay for future nursing care.
H had been feeling unwell, with a high temperature and vomiting. When his condition did not improve the next day he went to see his GP, who diagnosed a stress-related problem and sent H home to bed. H’s condition did not improve over the next few days and W was sufficiently concerned about his condition to telephone the out of hours GP service.
A locum GP attended H at home in the evening and diagnosed a stress-related condition. He did not perform any physical examination. Sadly, by early the next morning, H had died. A post mortem examination revealed that he had died from an infection of streptococcus pneumoniae (pneumonia).
A GP expert provided a report into H’s case and concluded that the locum GP had failed to treat H competently. H was ill enough to need a home visit. He was suffering from hyperventilation, sweating and vomiting. A physical examination should have been done by the locum GP. H had the signs of developing pneumonia, or some other serious pathology requiring hospital admission, and a physical examination would have shown this. The report concluded a competent GP in that position would have admitted H to hospital.
A consultant in intensive care medicine provided a further report, concluding that at the time the locum GP attended him, H probably had developing pneumonia. There was sufficient evidence to suggest an admission to hospital was needed and if H had arrived at hospital alive, on the balance of probability he would have survived the illness.
In this case, W received a bereavement award and funeral expenses as well as compensation for loss of financial support. Both children received compensation in this case also.
A year later, E sustained an injury to her left knee and attended at the Accident & Emergency Department of the same hospital. E was advised to mobilise and return to hospital if there was no improvement. E’s pain continued and a number of years later she was referred by her GP to hospital. E later had x-rays taken of her pelvis and hips. She was advised that she had deformity of the left hip secondary to a previous SUFE. E was also advised that there was no further treatment that could be provided to her left hip and that she would require hip replacement surgery as a result in the future.
Medical reports were obtained from a Consultant in Emergency Medicine on liability and a Consultant Orthopaedic Surgeon on causation relating to the effects of delays in diagnosing SUFE on both right and left hips on two separate occasions.
The Trust responsible for the hospital accepted that there was a failure to diagnose the SUFE to E’s left hip, but no admissions were made in respect of the delay in diagnosing the earlier SUFE or the right hip. The Trust also reserved their position with regard to causation.
In respect of the first right SUFE it was alleged that the examining doctor, whilst clearly recording the Claimant had a reduced range of movement of the hip due to pain, nevertheless diagnosed a muscular injury without recourse to x-ray investigation. He failed to consider and exclude the diagnosis of a SUFE, despite E (a child) complaining of a traumatic injury and pain to her right hip with an associated reduced range of movement. It was alleged that x-rays would have revealed a SUFE to the right side and E would then have been referred to the Orthopaedic Team for internal fixation such that surgery for internal fixation to the right hip was delayed for a year.
In respect of the second left SUFE, it was alleged that the examining doctor failed to take a full history from E’s mother of the past medical history of a right SUFE. He failed to obtain the inpatient record detailing the diagnosis that had previously been made and had failed to consider the potential for reoccurrence of the SUFE condition to the other hip.
A consequence of the delay in diagnosing the left SUFE, E suffered with a severely deformed left hip joint causing restriction of her hip movement and discomfort. E also suffered with secondary degenerative changes that would require a total joint replacement by the age of 40 and the need for the total joint replacement to be brought forward by 20 years.
E received damages for her pain and suffering. She also received compensation for future loss of earnings.
M attended the Accident & Emergency Department again 3 weeks later complaining of a swollen left leg with pain in the left groin. He was admitted late in the evening and discharged the next day back to the care of his GP.
M was readmitted less than a week later. A review of the x-rays noted changes in his left hip with the possibility of sepsis. The next day M underwent open arthrotomy and washout of the left hip joint. M, having developed septic arthritis of the left hip, required a total hip replacement.
There were a number of doubts about a claim based on the medical evidence, but a compromise was reached so that M received damages for his pain and suffering.
A report was obtained from a Consultant Surgeon. He noted that there had been a rectal perforation. This was a recognised complication of a rectal polypectomy which could not, of itself, be considered negligent. However, in this case there was evidence of a lack of care on the part of the surgeon who had performed a potentially dangerous procedure with a risk of rectal perforation when the medical notes recorded that there had been “limited perspective” (that is, he could not see what he was doing).
Proceedings were issued. The Defendant denied negligence. The expert surgeon instructed on behalf of F and the expert surgeon instructed on behalf of the Defendant met to consider the issues. They could not reach agreement. The claim continued.
Following negotiations, F received damages for her pain and suffering.
V had to call out a GP from the practice because of worsening abdominal pain. V was seen by a locum. She telephoned the practice again and was seen by another locum on 21 January. She attended at the GP surgery on 22 January and was seen by a GP. On each occasion she was reassured that nothing was wrong.
On 24 January V telephoned the GP surgery and was seen by a GP at home. V was then admitted to hospital. A ruptured ectopic pregnancy was diagnosed. V underwent a laparotomy during which her fallopian tube was removed. She was awake for the early part of the operation, although completely paralysed.
A report was obtained from a Consultant Obstetrician & Gynaecologist. His report concluded that the hospital staff were negligent for not investigating properly on the first visit to hospital. He also said that the locum GPs who saw her on 19 January and 21 January were negligent for failing to diagnose ruptured ectopic, as was the GP who saw her on 22 January. Suggested opinion to be obtained from anaesthetist on awareness during operation.
A report was obtained from a Consultant Anaesthetist. He concluded that V’s awareness during initial stage of operation was due to lower dosage of anaesthetic that had to be given because of her condition. The anaesthetist was not negligent in these particular circumstances.
A further report was obtained from the Consultant Obstetrician & Gynaecologist. His view was that if the locum GP diagnosed an ectopic on 19 January, V would not have lost as much blood, the anaesthetist would have been able to administer a “full dose” anaesthetic and V would not have been “aware” for the early part of the operation.
A report was then obtained from a GP expert. He concluded that the locum GPs and the GP were negligent for failing to arrange admission to hospital over the five day period from 19 to 24 January.
V recovered damages for her pain and suffering, including being “aware” during the laparotomy
M complained of chest pains when she attended the A & E department at her local hospital. M was examined and discharged, but she collapsed and died a few hours later. D was in her early teens when her mother died. D was cared for by her paternal grandparents and her grandmother brought the claim on D’s behalf.
A medical report on the standard of care was obtained from an Accident & Emergency Consultant. In summary, he concluded:
- The diagnosis made was of a panic attack and muscle spasm. With M’s history as recorded and with the ECG abnormalities this diagnosis was wrong.
- The description of the pain was such that it required further investigation. A cardiac cause for the pain should have been diagnosed in the Accident & Emergency Department. Failure to consider a heart problem and failure to act on it was below an acceptance standard of care.
- To discharge M was below an acceptable standard. She should have been referred to the medical team for further assessment and investigation
A report on causation was then obtained from a Consultant Physician. In summary:
- He believed M was in the middle of an acute coronary syndrome at the time of the cardiac arrest due to ventricular fibrillation. Shortly after admission, M should have been identified as having “a troponin-positive acute coronary syndrome” and been admitted to a Coronary Care Unit.
- In his opinion, on the balance of probabilities, if M been admitted to a Coronary Care Unit and treated appropriately she would not have died on that evening.
Damages were recovered for M’s pre-death suffering and the funeral expenses. Damages were also recovered on behalf of D for past and future financial dependency, and loss of her mother’s services. As D was under 18, the settlement was approved by a District Judge and the damages were invested in the Court Funds Office.
H originally attended hospital with a history of cellulitis of the right thumb and there was a haemorrhagic granulomatous tissue in the nail bed. An x-ray was taken 2 days later which was reported as normal and diagnosis was made in relation to a wound infection. H returned to the Accident & Emergency Department 2 days later and silver nitrate was applied. He returned again 3 days later when a biopsy was taken. There were repeated attendances for the next year at the Accident & Emergency Department, Trauma and Orthopaedic Clinics before eventually (14 months after H’s first attendance) a biopsy was undertaken under local anaesthetic. The biopsy was reported as demonstrating a malignant melanoma.
H underwent an amputation of the right thumb followed by chemotherapy. H died 7 months after the amputation.
Reports were obtained from a Consultant Histopathologist and a Consultant Oncologist. The experts’ combined view was that, had H received treatment following the first biopsy, there would have been complete removal of the primary melanoma and H’s survival rate would have been at least 10 years. On the balance of probabilities, H would not have died when he did.
The Trust responsible for the hospital accepted that there was a breach of duty, but denied that H would have lived even with earlier treatment.
Compensation was recovered for loss of financial support for the children. As one of the children was under the age of 18 at the time of settlement, it was approved by a District Judge and his apportioned shared was invested in the Court Funds Office.
When H went back to the hospital on 8 March for removal of the stitches she was told that the mole on the right calf was a malignant melanoma.
On 23 March she was recalled to see the Plastic Surgeon about possible surgery. He told her that she needed a wide excision and split skin graft, informing her that if she were his daughter he would advise that the operation should go ahead.
On 25 March she was admitted to hospital for a wide excision and split skin graft, skin being taken from her upper left thigh. She remained in hospital for 10 days and she was off work for 9 weeks.
Two years later she completed a proposal form for life insurance. The usual health checks were carried out when considering the proposal, which included making enquiries of the hospital. She was then asked to return to hospital to see the Plastic Surgeon. H told N that they had reconsidered the slides. N was told that the slides had been referred to a panel of experts. Each had a different view, but it was now thought that the mole may have been benign and not malignant.
She was left with a significant cosmetic defect on her right calf.
A report was obtained from a Consultant Histopathologist. His view was that the lesion was a benign melanocytic naevi. The hospital consultant pathologist described it as “a superficial spreading melanoma in situ” and the inference from the report is that this was a confident diagnosis.
Copy reports were obtained from the Melanoma Panel. The Consultant Histopathologist was asked to comment on the reports. His view was that, on balance, the majority opinion was in favour of a benign lesion. The range of views reflected the difficulty in this area both in terminology and in the features that are required to diagnose the very earliest malignant lesion.
The Defendant denied the claim on the basis that the histological diagnosis made by the Defendant pathologist lies within the spectrum of opinions offered by a group of pathologists with a different range of experience in both general and melanoma pathology. Although the majority of the panel favoured a benign diagnosis, a malignant melanoma could not entirely be excluded.
The difficulty from N’s point of view was that she would have undergone a wider excision and split skin graft if there had been any doubt about the diagnosis of the mole and if there was any suggestion that it might be malignant. Even if negligence could be established the claim would most likely have failed on causation.
A settlement was negotiated with the Defendant hospital Trust that took into account the problems with the case. N received some damages for her pain and suffering.
3 weeks after the operation, H attended an outpatient appointment at the hospital. The wound was not inspected and it was noted that there was some serous discharge.
4 weeks after the operation H returned for a further outpatient appointment at the hospital. It was noted that the wound was gaping. H was not informed of the risks associated with a deep wound infection or the likelihood that he had developed such an infection. Instead he was simply asked to come back into hospital for further investigations.
3 months after the operation, H began to develop symptoms of discomfort in and around his right groin and hip extending down to his right knee. Over the next month’s H developed increasingly debilitating right groin, hip and knee pain.
8 months after the operation, H was admitted to the hospital for treatment for a suspected infection of his right pelvis and hip. H underwent surgery to remove the metalwork from his right iliac crest. Examination of his hip joint at the same time confirmed that it had become infected.
A Consultant Orthopaedic Surgeon was instructed. He concluded:
- One month after the operation there could be no doubt that the clinical presentation was of infection involving the metal work used for fixation of the pelvic fracture. A decision should have been made to admit H for washout of the wound and possibly removal of the infected metal work, followed by antibiotic therapy, active against the infecting organism. The treating doctor fell below normally accepted standards by failing to follow this course of action.
- On the balance of probabilities, the hip joint itself was not infected at this stage.
- Failure to diagnose the deep infection in the metal work led to the development of osteomyelitis in the iliac bone. The infection had spread through the bone and reached the hip joint, on the balance of probabilities, by 3 months of the operation. The failure to treat the infection in 1 month after the operation led to such a degree of damage to the bone and joint that later intervention could not save the hip joint. A hip replacement was required.
A report was obtained from a Consultant Microbiologist and he came to the same conclusions as the Consultant Orthopaedic Surgeon.
H received damages for his pain and suffering. He was made redundant over a year before the accident in his late 50s, but we were able to recover future loss of earnings for him. He also received compensation for care, services and the cost of a future hip replacement.
2 weeks later it was noted that the pin sites were discharging pus. A week later he had a debridement of the wound on his left thigh. 3 weeks later it was noted that the pin sites continued to grow staphylococcus aureus. 44 days after the external fixation he was admitted for surgery (for intramedullary nailing).
A week later B was readmitted because of an infected wound. He was taken to theatre for left femur incision and drainage. 2 months later B was referred to a Trauma and Reconstructive Surgeon. B required 4 further operations to including a bone graft from his left iliac crest, causing additional scarring.
A number of allegations of negligence were made based on reports from a Consultant Orthopaedic Surgeon, a Consultant Microbiologist and a Consultant Radiologist:
- Failing to perform intramedullary interlocked nailing during the first surgery.
- Failing to properly apply the external fixator.
- Failing to convert the external fixator to an intramedullary nail within a maximum of 14 days and delaying until 44 days after external fixation.
- Administering the wrong antibiotic.
- Failing to ensure that the fracture was stabilised.
It was alleged that the failure to eradicate sepsis led to the eventual mechanical failure of the intramedullary nail, the development of an infected non-union and osteomyelitis.
B received damages for his pain and suffering. He also received compensation for his loss of earnings and other financial losses.
As part of the hip replacement procedure a 62 mm prosthetic cup was inserted. Post-operatively T was in discomfort and unable to mobilise. Post-operative x-rays showed the uncemented cup was not securely positioned in the acetabulum. It was decided that T would have to undergo revision surgery as the inserted cup was much bigger than the size of the reaming (the process of carving out the acetabulum to make the cup fit) and as a result the prosthesis was unstable and the cup was sitting outside of the socket.
T underwent revision surgery to her left hip a month later when a 52 mm cup was inserted. T continued to suffer with discomfort and restricted mobility but was advised that this would settle following a course of physiotherapy.
As part of the investigations it was established that the revision surgery had also been performed incorrectly in that the cup was inserted into the acetabulum in a virtually vertical position so that the cup was not seated. T had to undergo a second revision procedure to replace the prosthesis with a fully reseated cup.
The Defendant denied liability and causation in respect of both the hip replacement surgery and the first revision surgery.
Condition and prognosis evidence was obtained and Court proceedings were issued. The Defence admitted liability, but denied causation.
Following negotiations, the Defendant agreed to pay an interim payment to cover the cost of the second revision surgery.
After a meeting between the Consultant Orthopaedic Surgeon instructed on behalf of T and the Consultant Orthopaedic Surgeon instructed on behalf of the Defendant, a settlement was reached. T received damages for her pain and suffering. She also received compensation for loss of earnings and care received between the hip replacement surgery and the second revision surgery.
A report was obtained from a Consultant Orthopaedic Surgeon. He was of the opinion that N’s right shoulder replacement had been performed negligently. The humeral component was sitting too high and the humeral head inserted was too large. This was causing N’s ongoing pain and limitation of movement to the arm.
The Consultant Orthopaedic Surgeon was of the opinion that even following revision surgery it was likely that N would have a significant level of residual weakness and loss of function to her right arm. It was unlikely that she would be able to return to work in her previous job.
The Trust responsible for the hospital denied liability and causation, but made a number of offers that were rejected.
The case was listed for trial with a time estimate of 5 days. Settlement was negotiated 2 months before the trial was due to start.
N received damages for her pain and suffering. She also received compensation for her past and future loss of earnings and to enable her to pay for domestic assistance.
Following the surgery Y’s arm became ischaemic and she was advised that an amputation was unavoidable.
Following the amputation, Y was referred to the prosthetic clinic. Y was unable to wear a prosthesis because of pain from the amputation site. Y also suffered with significant phantom limb pain and neuropathic pain to her right side.
Initial medical evidence regarding liability and causation was obtained from a Consultant Orthopaedic Surgeon specialising in upper limb and shoulder replacement surgery. He noted that Y had been advised not to undergo a total shoulder replacement to her right shoulder by all of the Orthopaedic Consultants that she had seen prior to the Orthopaedic Surgeon who carried out the replacement procedure. This was due to degenerative changes as a result of previous radiotherapy to Y’s arm.
The expert Consultant Orthopaedic Surgeon was of the opinion that, despite the significant risks involved in the surgery and given Y’s continuing level of pain, it was reasonable to offer the shoulder replacement surgery.
A report was obtained from a Consultant Vascular Surgeon. He noted that there were delays in dealing with an absent radial pulse. He was of the opinion that if the nursing records were correct, and if Y had been returned to theatre 6 hours earlier, she would not have required the amputation the following day. However, the bypass graft was unlikely to have functioned properly in the long-term and Y would have required the amputation in the next 5 to 10 years in any event.
The Defendant accepted that there was a delay in returning Y to theatre and that the delay had brought forward the need for an amputation by 10 years.
Y received damages for her pain and suffering. She also received compensation for the significant level of care that she required.
P instructed former solicitors to conduct a claim for medical negligence on her behalf arising out of the treatment.
P’s former solicitors issued Court proceedings just within the 3 year limitation period. The Claim Form was not served within the 4 month period for service.
P’s former solicitors then served the Claim Form, but the date of service was outside the 4 month period allowed for service and outside of the 3 year limitation period.
The surgeon’s solicitors made an application to set aside service of the Claim Form and strike out the claim. This was successful.
P was not able to pursue her original claim for medical negligence. P was left with a claim for professional negligence against her former solicitors.
P’s former solicitors had obtained a report from a Consultant Surgeon. In his report he was critical of the method of treating the anterior anal fistula. He was critical that P was not counselled about the risks of incontinence. He believed the surgery for the anterior anal fistula was not carried out correct and that it was responsible for P’s diarrhoea and incontinence.
P issued proceedings for professional negligence against her former solicitors. She recovered compensation for loss of chance in the original medical negligence action. This covered her claims for pain and suffering; loss of earnings; private healthcare; and other losses.
Post-operatively C began to lose sensation to his lower limbs, which eventually led to him developing cauda equina syndrome with extremely limited bowel function and no bladder function. C was still complaining of loss of sensation in his right and left legs on the next evening. Examination and assessment of the legs demonstrated neurological symptoms and the impression was of a spinal haematoma. C was reviewed over the next few days. C had an MRI scan which diagnosed a haematoma compressing his spine. C then underwent further surgery to evacuate the haematoma.
A report was obtained from a Consultant Spinal and Neurosurgeon. He was of the opinion that there had been a delay in undertaking the MRI scan and therefore in diagnosing and evacuating the haematoma. Had the haematoma been evacuated earlier, C would not have developed cauda equina syndrome and the consequent neurological injuries.
The Defendant accepted that there had been some delay in evacuating the haematoma. No comments were made in respect of causation pending receipt of their expert’s report.
Court Proceedings were issued. The Defence maintained the Defendant’s position in respect of causation that the symptoms C was suffering were all present prior to the decompression surgery and that, with rehabilitation, C’s mobility would improve.
Reports were obtained in relation to C’s condition and prognosis, and also in respect of the value of the claim from various experts including a spinal rehabilitation expert.
C received damages for his pain and suffering. He also received compensation to cover his accommodation, care and other needs.
T attended his local hospital as an emergency with a two day history of abdominal pain and vomiting. This was due to obstruction of the small intestine. T underwent an operation to release part of the small bowel.
Four months later T went to see his GP. He was referred the same day to another surgeon. The referral letter stated that the problem seemed to be an incisional hernia in the scar of the laparotomy wound, which was causing discomfort. T was seen in clinic a month later. The surgeon diagnosed an incisional hernia.
Five months later he was admitted for an operation to repair the hernia using mesh. T became unwell soon afterwards. An emergency ambulance was summoned in the early hours of the morning 3 days later. An abdominal x-ray showed obstruction so a decision was made to perform further surgery. Two days later it was found that a loop of the small intestine had pushed its way beside the right edge of the mesh and was stuck, causing the obstruction. The mesh was removed; the small bowel was freed from the mesh but there were numerous adhesions following the previous surgery and, in freeing up the bowel, two holes were made. One of these holes was closed by a simple suture but the other was treated by excision of 5cm of bowel.
T made little progress and was admitted to the Intensive Care Unit. T was diagnosed as having septic shock and received intensive support therapy with fluids and antibiotics, but his condition deteriorated rapidly. He was put on a ventilator because he could no longer cope with breathing on his own. His condition worsened and he died.
A report was obtained from a Consultant Surgeon. He was of the opinion that an apparently straightforward operation was complicated because the small bowel was able to slip through the repair and become strangulated soon after the operation. On a balance of probabilities, this represented a failure of technique. Had the second operation not been necessary, T would not have died.
Liability and causation (of the death) were denied. Proceedings were issued.
The allegations of negligence were that T’s death was caused, or materially contributed to, by negligence on the part of the surgeon. The most probable cause for the loop of small intestine being in the position found at the time of the second operation was disruption to both:
(a) The suture line closing the peritoneal cavity; and
(b) The sutures attaching the prosthetic mesh to the muscles.
This was caused by a lack of surgical skill or care, or both.
In respect of causation, the breakdown of the wound caused peritonitis. This was a non-negligent complication of the operation. The further surgery would not have been required if there had not been any negligence. Peritonitis contributed, more than negligibly, to the sepsis which caused multi-organ failure from which T died.
W received a bereavement award and funeral expenses. She also received compensation for loss of financial support.
J’s INR (International Normalised Ratio – a measure of the blood’s ability to coagulate) on admission was 2, which was too high for surgery. Surgery was cancelled.
While still in hospital J developed central chest pain and an investigation by ECG was undertaken. The impression was of acute coronary syndrome and/or reflex thrombosis.
The next day J reported having lost sensation in her legs. 3 days later an urgent CT scan was arranged and J was transferred to another hospital the next day for specialist treatment. 2 days later a diagnosis was made of an acute spinal subdural and subarachnoid haemorrhage centred at the T8 level. J was paraplegic.
Reports were obtained from a Consultant Haematologist and a Consultant Cardiologist on liability. Reports were also obtained from a Consultant Neuroradiologist and a Consultant Neurosurgeon on causation.
The main allegations of negligence were:-
- Failing to make a proper and competent assessment and diagnosis of J’s condition and thereafter treat her accordingly having diagnosed acute coronary syndrome. On the Defendant’s own presumptive diagnosis of acute coronary syndrome, there was a failure to investigate, diagnose, and treat J competently.
- Wrongly prescribing a combination of heparin in addition to warfarin, which materially over anti-coagulated J and caused J’s spinal bleed. The risk of bleeding increases at all levels of anti-coagulation.
An application was made to the Court for a split trial, with a time estimate of 5 days. This meant that there was a trial on the issues of liability (negligence) and causation of injury. If successful, there would be a further trial to assess the amount of damages.
The claim settled a week before the trial was due to start. J received damages for her pain and suffering. She also received compensation sufficient to enable her to buy a bungalow and adapt it for her needs, and to pay for future nursing care.
Case A – 2007
Cerebral Palsy case. Significant physical and cognitive disability. Settled for global £4,262,000.00
Case B – 2008
Cerebral Palsy case. Difficult liability arguments so settled at 70% of full value. £3,200,000.00
Case C – 2009
56 year old man dies from toxic shock following shoulder surgery. Settled for £1,050,000.00
Case D – 2009
Avoidable still birth. Parents claim settled at £30,000.
Case E – 2011
Mother suffered third degree tear which was undiagnosed at the time of birth. Settled for £280,000
Case F – 2011
Bile duct injury during cholecystectomy (gall bladder removal). Failure to realise so patient developed sepsis. Long term risks of serious complications. Case settled for £425,000.
Case G – 2012
23 year old man with Cerebral Palsy. Advised by previous solicitors no claim. Resurrected the action and settled for £1m lump sum and annual payments of £40,000 for life for care and support.
Case H – 2012
Baby died following delay in delivery after mother’s waters broke over 60 hours previously. Developed infection in the womb. Entirely avoidable. Both parents claims for nervous shock settled for undisclosed amount.
Case I – 2012
Failure to diagnose pancreatitis in young woman in her 20s resulting in her developing diabetes and becoming insulin dependent. Settled at £75,000.
Case J – 2012
48 year old woman had bilateral below knee amputations as a result of failure to diagnose anti phospholipid syndrome (APLS) 3 years before. If had been diagnosed earlier she would not have had to have the amputations. Settled for £1.25m.
Case K – 2012
Still birth case. Baby delivered at home. Both parents suffered nervous shock as father delivered child. Trust admitted liability only after proceedings issued and cases settled for both parents for undisclosed amount.
Liability admitted in 3 x Cerebral Palsy claims and interim payments made. Currently in the process of obtaining housing and therapies for all to improve their quality of life and make sure that each client and their families have all the help and support they need.
Liability admitted in the case of a 20 year old young man with hypoglycaemic brain damage. Interims paid so we are searching for appropriate housing and therapies are being put in place.
Recognition for our Clinical Negligence team
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