Clinical Negligence Outcomes
We understand that suffering from clinical negligence can have a significant impact on your life. We have compiled some of our recent cases and outcomes so you can see how we have helped people who may have been in a similar situation. Click each matter to find out more.
Failure to diagnose aortic dissection
Despite presenting at the Accident and Emergency Department with sudden onset central chest pain radiating to the back, with a marked difference in blood pressure between the left and right arm, clinicians failed to suspect aortic dissection and instead diagnosed our client with pneumonia. He deteriorated over a number of days and began to suffer from organ failure. After a delay of four days he was finally diagnosed with aortic dissection and transferred for urgent surgery. As a result of the delay our client suffered organ damage that requires lifelong medication. Earlier surgical repair would have led to a better recovery for our client with fewer long term health issues. We successfully pursued a claim against the Trust responsible and recovered substantial damages.
Failure to prevent myocardial infarction (heart attack)
Our client attended the Accident and Emergency Department, having been transferred by ambulance after complaints of central chest, shortness of breath and numbness in the arm with vomiting. Staff failed to consider that the symptoms our client complained of were consistent with a cardiac condition. Following examination our client was diagnosed with gastroenteritis and discharged. A few days later they suffered a heart attack requiring emergency surgery. Had a cardiac cause of their symptoms been considered days before they would have undergone further investigations, including ECGs and an angiogram. Investigations would have led to a diagnosis of coronary artery disease and they would have undergone either bypass surgery or angioplasty with stenting. Our client would not have suffered a heart attack, which left them with heart muscle damaged and reduced ventricular function. We settled the case with the Trust after securing substantial damages for our client.
Failure to diagnose epidural abscess, resulting in paraplegia
We acted for a client who had developed severe cervical spine (neck) pain, which worsened over a period of ten days. The pain radiated to his arms and around to the front of his chest and began to affect his mobility. The pain became so severe he attended the A&E department at his local hospital where his symptoms were noted and consideration was given to serious spinal pathology. Nevertheless, he was allowed to leave the hospital without investigation or treatment. A day later he was struggling to walk. He attended the A&E department at a different local hospital and his symptoms were noted. He reported a loss of sensation in both legs and was noted to be disorientated. He collapsed while at the hospital and he was admitted but it was not considered there was anything seriously wrong with him. The following day he lost control of his bladder and his legs went completely numb and he suffered a complete loss of limb power. After further delays he was finally referred for an MRI scan, which revealed cervical spine epidural abscess and discitis. He was eventually transferred to a specialist centre for emergency surgery on his spine but he was left with paraplegia and bladder problems. After pursuing a claim in negligence against both hospitals we settled his case for a six figure sum and secured ongoing care and rehabilitation for him.
Failure to diagnose cerebral venous sinus thrombosis (blood clots on the brain)
We acted for the husband of a lady who had presented at hospital with severe sudden onset headache with associated vomiting, unsteadiness on her feet and photophobia (light sensitivity). A CT scan of her brain was performed and was noted to be normal. She was diagnosed with a migraine. However, she was told to return to the hospital the following day for an MRI brain scan and MR venogram. The MRI brain scan and MR venogram were performed the following day and she was told doctors would be in touch if they found anything of concern. She went home and over the following two days began to deteriorate, suffering a worsening of her headache and vomiting and developing increasing confusion. Her family were so concerned that they took her back to hospital and she was admitted. It transpired that the MRI brain scan and MR venogram had not been reviewed two days earlier. They were reviewed by doctors and it was noted that she had cerebral venous sinus thrombosis (CVST); blood clots on the brain. Despite receiving treatment she started to suffer seizures that evening and further scanning revealed she was now suffering from haemorrhage. She sadly passed away two days later.
Experts unanimously concluded that there had undoubtedly been negligence on the part of the Trust in failing to review the MRI scan and MR venogram two days earlier. They were unable to reach a definitive conclusion that earlier intervention and treatment two days earlier would have saved her.However, we decided to trace back her blood test results history at her GP surgery and we discovered that she had had very high platelet and haemoglobin levels (polycythaemia) for at least four years and this had never been treated by her GP. We obtained evidence from a haematologist, who confirmed that had she received appropriate medication and treatment for this condition as late as two to three months before she died, on the balance of probabilities she would not have suffered the blood clot to begin with. We settled the claim with the GP surgery and our client received substantial damages.
Failure to interpret abnormal ECGs led to fatal heart attack
Mrs J attended hospital in 2011 with tachycardia (fast heart rate) and shortness of breath, which led to investigations including a test for diabetes, which was positive. This was not conveyed to either Mrs J or her GP. While in hospital she was diagnosed with a pulmonary embolism (a blood clot on the lungs) and was discharged with blood thinning medication. Three years later, in 2014, she was admitted to hospital again with chest pain and shortness of breath. Serial ECGs were performed which were all recorded as “abnormal”. No action was taken by doctors, although they did diagnose her with diabetes. Repeat ECGs were taken over the following six days, all recording abnormal findings but they were not acted upon by doctors. On the sixth day, Mrs J suffered a myocardial infarction (heart attack) and sadly passed away. We represented Mrs J’s family in a claim against the Trust, not only for the negligent failure to act on the serial ECG abnormalities over a period of six days, but also, with the help of an expert, we established that the failure to inform Mrs J and her GP of the original diagnosis of diabetes and the lost opportunity for appropriate medication and management three years earlier caused or contributed to the development of cardiovascular disease. This was ultimately the cause of her ECG abnormalities and heart attack and on the balance of probabilities could have been avoided. We settled the claim with the Trust and Mrs J’s family recovered a five figure sum.
Negligent prescription of contraceptive pill led to recurrence of breast cancer
Our client was diagnosed with breast cancer in September 2011 and underwent successful excision (removal) of the tumour. This was followed by a course of chemotherapy. While she was undergoing chemotherapy she sought advice from her GP surgery about suitable contraception. She was prescribed Desogestrel (a progesterone only pill, or POP) in February 2012. She completed her course of chemotherapy and happily in late 2012 CT scanning confirmed that there was no sign of recurrence of breast cancer. She was delighted that she had been successfully treated. She continued to take Desogestrel throughout 2012, 2013 and 2014. In August 2014 her GP discovered that national guidelines (UK MEC 4 and BMF guidance) that had been available at the time the prescription was given warned that patients should not be given hormonal contraceptives (such as Desogestrel) for five years post cancer of the breast. The GP stopped the prescription of Desogestrel. In September 2014 our client discovered new nodularity in her right breast and biopsy confirmed a recurrence of her breast cancer. We successfully pursued a claim against her GP practice for the negligent prescription of Desogestrel, having established with the help of expert oncological evidence that but for taking this hormonal contraceptive for two and a half years, she would not have suffered a recurrence of breast cancer. The claim was settled for a six figure sum.
Failure to diagnose and repair a detached retina
Our client attended the eye unit of his local hospital with a history of a three day loss of vision in his right eye. Vision in his left eye was already compromised. An ophthalmic assessment was carried out and it was noted only that he had a “squint”. It was suggested that this could be corrected with surgery on a non-urgent basis. He returned to the eye unit twelve days later for review and was seen by a different ophthalmologist, who realised that in fact our client had suffered a retinal detachment. Retinal detachment requires surgery to repair it within seven days of occurrence. As the diagnosis was made fifteen days after it had happened, surgery was not successful and our client permanently lost the majority of the sight in his right eye, made worse by the fact that he already had little vision in his left eye. A claim was submitted to the Trust and with the help of expert ophthalmic evidence we recovered a six figure sum for our client.
Failure to diagnose squamous cell carcinoma of the penis
Our client presented to his GP with a history of problems passing urine. He had also noticed a yellowish discharge from his urethra and that there was a crusting lesion over the tip of his penis. Having ruled out infection and sexually transmitted disease, his GP referred him to a urologist for further investigation. The urologist did not address the crusting lesion, did not perform a biopsy and instead focused solely on is urinary flow. It was decided that his meatus / urethra was narrowed (a stricture) and without considering the cause of this narrowing performed an operation to widen the meatus. Our client continued to have problems and the crusting lesion was still present. He was referred to a urologist at a different hospital, who noted the lesion and performed a cystoscopy. However, no biopsy of the lesion was taken and his investigations were inconclusive. The urologist suggested referral to a urological surgeon at a third hospital so that further investigations might establish the cause of his ongoing urinary problems and the crusting lesion. The urological surgeon decided, without performing a biopsy, that the lesion was balanitis xerotica obliterans, a skin condition which could be treated with steroid cream. Our client used the steroid cream for a period of twelve months but there was little improvement in the appearance of the lesion. He returned to his GP for further advice and at this point his symptoms had been ongoing for three years. His GP referred him to a dermatologist, who expressed concern that no biopsy had ever been taken. A biopsy of the lesion was arranged, which unfortunately revealed that our client had squamous cell carcinoma. He had to undergo extensive penile surgery resulting in serious disfiguration, an outcome that could have been avoided had an earlier diagnosis been made. This was an extremely complex claim that was contested until shortly before trial. However, the defendants eventually made an offer and the claim was settled for a five figure sum.
Failure to diagnose fracture to spine and ribs
Mrs L attended hospital after falling down a full flight of stairs at home. She had back pain and pain across the ribs. A CT scan of her head and x ray of her chest were performed however both were clear. Even though she had back pain, no investigations of her back were undertaken. She was examined by an occupational therapist, who requested that she be reviewed again before discharge. Mrs L was discharged without the occupational therapist knowing and without her back pain being properly investigated. She was discharged home by a nurse practitioner. For around fourteen days Mrs L struggled with pain and immobility. She was readmitted to a different hospital where her back was x-rayed and she was found to have two fractures to her spine, one of which had burst, and two rib fractures. These had been undiagnosed and it was not until then Mrs L received appropriate treatment and pain control. The original injury was severe however for fourteen days her pain was not managed, leading to additional pain and suffering that she would not have had if the fractures had been found. The claim settled for a four figure sum for her exacerbated pain and suffering.
Failure to diagnose bowel obstruction
Our client experienced sudden onset severe abdominal pain, not alleviated with strong pain killing medication, abdominal distension and bilious vomiting. The pain became so severe that she was taken by ambulance to hospital. After a brief examination she was told that she was suffering from an episode of irritable bowel syndrome and was discharged with advice to rest and to take IBS medication. She remained very unwell and was actually taken by wheelchair to the hospital exit by a nurse, who left her there to be collected by her mother. Over the course of the day at home her condition deteriorated and her abdomen became more distended. The pain worsened to the extent that her mother telephoned for an ambulance again. She collapsed as paramedics tried to transfer her to the ambulance and she suffered a seizure. After some delay at the hospital she underwent CT scanning, which revealed a serious bowel obstruction. She was also noted to have peritonitis with extensive ascites and was acidotic. There were further delays before she finally underwent surgery many hours later. By this time the damage to her bowel tissue was so extensive that a sub-total colectomy was required. She remained in hospital during a difficult and protracted recovery. We submitted a claim to the Trust on the basis that there was a negligent failure to consider our client may have had a bowel obstruction on first attendance and that the diagnosis of irritable bowel syndrome had been negligent, not being consistent with the symptoms with which she had presented. Had bowel obstruction been considered on the first admission, investigations would have led to early CT scanning confirming this and she would have undergone caecopexy, a far more conservative procedure. She would not have developed peritonitis, ischaemic bowel as far as the splenic flexure and would not have required a sub-total colectomy (removal of a substantial part of the bowel). The claim was settled for a five figure sum.
Failure to diagnose and treat retained placenta after delivery of baby
Mrs S had given birth to her daughter prematurely. Whilst in the shower after delivery she began to bleed excessively and a midwife came to help her. The bleeding stopped and she was given iron supplements and discharged home the day before the birth. Two weeks after her delivery Mrs S began to bleed heavily again and was admitted to hospital by ambulance. It was noted that she suffered a ‘massive’ post partum haemorrhage losing two and a half litres of blood – although it may have been significantly more. She was taken to theatre where it was noticed that part of the placenta was left behind after the delivery and she required five blood transfusions. When she was discharged from hospital Mrs S found events very difficult to deal with and she was commenced on anti-depressants. An opportunity had been missed to identify the retained placenta when she began bleeding in the shower on the day the baby was born. With the assistance of an independent expert midwife the claim settled for a five figure sum.
Polypharmacy and incorrect prescription of medication
Our client was prescribed Domperidone for over two years despite it being a short term use drug. She was never offered a medication review over this time despite the length of time she had been on the medication or the NHRA warnings that the patient required close monitoring. The claimant had also been put on other medications unnecessarily at the same time and was prescribed Venlafaxine by her GP despite her having a reaction to this previously. As a result, our client suffered vomiting, chest tightness and palpitations. She was subsequently admitted to hospital for observations and then discharged however continued to suffer residual symptoms for a period of time following this. The claim settled for a four figure sum.
Failure to manage diet and fluids in a care home
Mrs M was an elderly lady who due to development of a dementia-like illness was admitted to a care home. She was at high risk of dehydration, malnutrition and pressure sores. Quickly, Mrs M developed a pressure sore on her hip and a month later was admitted to hospital. She was found to have pneumonia and was dehydrated. When she was in hospital she was weighed and found to be 34.1kg (5 stones 3 pounds). She was returned to the care home after hospital admission and her family noted over the next few short weeks that she continued to lose weight. Food charts were not being kept by the care home and her weight was noted to be down to 32.6kg (5 stones 1 pound). Shortly after this she was readmitted to hospital where it was found that she was dehydrated; her tongue ‘bone dry’ and she was unresponsive to pain. She was noted to be very frail and passed away a few days later. A report into the care provided by the care home identified that there were failures in providing Mrs M with sufficient food and drink and that staff were not trained properly for a woman with such high needs. There was also a failure to seek outside help to try to manage Mrs M from other professionals. The report found neglect and ‘institutional’ abuse. Mrs M was widowed and very unwell before she was admitted to the care home. With the assistance of a nursing consultant, the claim settled after court proceedings were issued for a four figure sum.
Failure to assess risk of bleeding before extraction of tooth in a warfarinised patient
Mrs C was taking warfarin to thin her blood after suffering a stroke. She attended her dentist complaining of pain and tenderness in one tooth and was advised that it required extracting. She was known to bleed excessively as she was on warfarin and her INR levels had been checked; but too long before the extraction took place. The tooth was removed however her face and mouth began to swell up and she developed an infection. She was prescribed antibiotics by her dental practitioner without being examined and the swelling was not identified. She was unable to open her mouth and was admitted to hospital. She underwent surgery to drain the swelling to her face and a large haematoma was found. It was alleged that she should not have been advised to have the tooth removed as her INR readings had been taken more than 3 days before the extraction leading to her suffering the haematoma. The INR levels had not been checked appropriately. She suffered no further adverse consequences and the claim was settled for a four figure sum.
Failure to diagnose hepatitis and a case of being “lost in the system”
Our client, a young woman in her twenties, presented to her GP with severe abdominal distension (swelling) and blood tests revealed abnormal liver function. She was referred to a hepatologist for further investigation. The hepatologist examined our client and told her that her abdominal swelling was “puppy fat”. However, it was agreed that she would have a gastroscopy under general anaesthetic . In fact this was never arranged. She was seen six months later by the hepatologist, who arranged blood tests. The results were abnormal and confirmed ongoing liver dysfunction, but it was decided she simply had an infection. A failure to follow up with repeat blood tests led to our client being “lost in the administrative system” for another eight months, by which time her liver function had deteriorated and she was showing signs of jaundice. Her GP referred her to a gastroenterologist at a different hospital but before further investigations could be conducted she was admitted to hospital, having vomited blood and collapsed with severe abdominal pain. She was diagnosed with hepatitis and cirrhosis of the liver with fibrosis stage 6. We submitted a claim to the Trust on her behalf and while our experts could not say definitively that earlier diagnosis and treatment would have prevented fibrosis, her pain and suffering had been prolonged and her condition had deteriorated as a result of the delay. We secured a five figure settlement for her.
Prescription / Dispensing error causing sickness and hospital attendance
Our client was a young man with a history of anxiety and depression, for which he was regularly prescribed Sertraline, an anti-depressant medication, by his GP. The Sertraline at the existing dose had had some good effect but his GP felt he would benefit from an increased dosage, from 50mg to 100mg. His GP gave him a new prescription, which he took to his local pharmacy. The pharmacist processed the prescription and handed him his medication in a paper bag. The label on the box read, ‘Sertraline 100mg’, with the usual advisory information on it. He took the medication as prescribed but within two days of taking it he began to suffer from shortness of breath, dizziness, kidney pain, abdominal cramps, nausea, diarrhoea, increased anxiety and depression and problems concentrating along with a general feeling that he had flu. He didn’t associate his symptoms with the medication and remained very unwell as he continued to take the medication for a further eight days. On day ten he happened to take a closer look at the box containing the Sertraline and realised that the box itself (rather than the label) on its underside said “Losartan”. Our client searched the internet and discovered that Losartan is medication for high blood pressure. On learning this he called the NHS 111 service. The NHS service advised him to go to the Accident and Emergency Department immediately. He attended hospital where he was kept in for observation and was advised to stop taking the Losartan immediately. He later returned to his GP and was told that because he had had a period of ten days without taking Sertraline it would likely be a further four weeks before they started to work again. Our client therefore also had to then endure the side effects associated with initiating Sertraline again, including nausea, dizziness, tiredness and loss of focus while his body adjusted to the medication again. We submitted a letter of claim to the pharmacy on our client’s behalf and settled the case for a four figure sum.
Negligent care after renal transplant
Our client underwent a kidney transplant, an operation performed regularly at the hospital in which his procedure took place. While the initial transplant surgery itself was uneventful, unfortunately there was a catalogue of errors subsequent to the transplant, including the negligent administration of aspirin to our client, when it was clearly marked in his medical records that he was allergic to aspirin, causing him to suffer a severe allergic reaction, a failure to realise that he was suffering from internal bleeding at the transplant site until he went into cardiac arrest and despite there being a note in his medical records that the transplant ureter was leaking and he was suffering from hydronephrosis, failed to perform surgery to repair the leak for five months. He had a significantly prolonged hospital stay and was very unwell for months, making only a slow recovery afterwards. With the help of expert evidence we submitted a claim to the Trust in connection with the poor standard of care he had received and we settled the case for a five figure sum.
eaving Ametop anaesthetic gel on child’s hand and arm for too long led to burns
Our client was taken by his parents to the Accident and Emergency Department at his local hospital He suffers from asthma and had developed a cough and wheezing. While in the accident and emergency department a topical local anaesthetic called “Ametop” gel was applied to his hand and arm / elbow area on the basis that he may need to be cannulated. He remained in hospital overnight, during which a further layer of Ametop gel was rubbed into his hand and arm. He remained in hospital the following day, when it was finally noted in the afternoon that his hand and arm was red and inflamed. Staff realised that the Ametop gel had been left on his skin for too long and had caused burns. Local anaesthetic gel of this nature should not be left on the skin for more than thirty to forty minutes. Instead it had been left on his skin for around twenty two hours. Our client’s hand and elbow area required topical cream / lotion and antihistamine for a period of around ten days before starting to settle. We submitted a letter of claim to the Trust on the instruction of our client’s parents and the claim settled for a four figure sum.
Misdiagnosis of peri anal absces
Our client attended the emergency department several times with symptoms consistent with a perianal abscess. He was examined by a junior doctor who, despite obvious symptoms and signs, diagnosed our client with haemorrhoids. The presence of a perianal abscess requires prompt incision and drainage; even administering antibiotics is insufficient as an untreated abscess can lead to rapid destruction of the surrounding tissue, fistula and even sepsis. As soon as a perianal abscess is suspected therefore the patient should be admitted for surgical intervention. In our client’s case he was not admitted and not even prescribed antibiotics. He was reassured by the junior doctor that he was safe to travel abroad by plane the following day and so he went on holiday. Unfortunately the abscess rapidly worsened and ruptured while he was on his flight. He was in considerable pain and distress on holiday. On his return he was admitted straight to hospital and had to undergo an extensive surgical procedure to drain the abscess with a far longer and more complicated recovery period than would have been the case had the abscess been diagnosed and treated immediately. With the help of expert evidence we successfully recovered a four figure sum in damages for our client.
Negligent delay in review of x rays
Our client who was a minor accidently choked on a peanut whilst playing at home. A worried parent then took him to see his GP who referred him to the hospital for an urgent chest x-ray as they suspected a foreign body. Our client had the x-ray, but due to administrative errors, the imaging was placed in the wrong queue to be reviewed by a radiologist. As this was an urgent matter, it should have been reviewed the same day, where our client would have undergone an urgent immediate bronchoscopy to remove the foreign body. He would have required a short period of observation, and would have been discharged without any further problems. It took the hospital ten days to review the x-ray, and a foreign body was found in his lung. He was recalled to the hospital, and as he was still wheezing, and required transfer to the local specialist children’s hospital. On arrival to the hospital, our client underwent bronchoscopy, where they found that the peanut had started to become embedded in his lung. He also required a five day stay in intensive care. Not long after discharge, he suffered a further collapsed lung, which required further non-invasive treatment. However, due to the damage caused, our client continued to suffer with breathing difficulties, so a decision was made to perform a second bronchoscopy, our client required a further week in hospital. After submitting a letter of claim to the Trust, it was admitted that treatment had been negligent and that the harm had been caused by their negligence. It was also admitted that clinicians had learned lessons from their mistakes and the Trust offered a formal apology to our client along with damages, which have been invested until he reaches the age of 18.
Failure to diagnose anterior cruciate ligament rupture
Our client had suffered a knee injury while at Tae Kwon Do class. He had felt a “pop” sensation at the time of injury and was unable to weight bear. His knee later became swollen. He attended his local hospital, where he was diagnosed with a hamstring sprain. No proper examination had been undertaken and no consideration had been given to a possible knee injury requiring further investigation. This is despite presenting with symptoms consistent with an anterior cruciate ligament injury. He was discharged from hospital but his knee problems did not resolve and he continued to have instability and weight bearing difficulties. After six months he sought further advice from his GP, who referred him to an orthopaedic surgeon at his local hospital. The orthopaedic surgeon arranged an MRI scan of his knee, which revealed an anterior cruciate ligament rupture requiring surgical reconstruction. As a result of the original misdiagnosis, our client had endured a period of six months of pain and suffering before the correct diagnosis had been made. With the help of expert evidence we submitted a claim to the Trust and the claim settled for a four figure sum.
Failure to remove nasal splinting after septorhinoplasty
Our client was referred to an ENT surgeon at a local hospital for a septorhinoplasty, to realign his nose and to improve his breathing. He underwent surgery and two nasal splints were inserted into his nose to secure its position while healing and they were sutured into place. A plaster of Paris splint was affixed externally to his nose. He saw the ENT surgeon for review a week after the surgery and he removed the plaster splint. The nasal splints were not removed. Our client attended his GP two months later, concerned that he was still having breathing difficulties. His GP reassured him that the surgery had only recently been performed and that his breathing would improve. Over the course of the next twelve months he continued to suffer from nasal obstruction, repeated infection and breathing difficulties, which he felt had become worse than prior to the septorhinplasty. He returned to his GP and expressed his concerns. His GP referred him back to the original ENT surgeon, who discovered on examination and he had mistakenly failed to remove the nasal splints fourteen months earlier. On removal our client suffered some bleeding but almost immediately his breathing improved. We submitted a claim to the Trust for a fourteen month period of pain, infection, nasal obstruction and breathing difficulties. The Trust admitted negligence and the claim settled for a five figure sum.
Failure to diagnose and treat a fracture to the finger
Our client was performing repairs to his caravan when a wheel slipped and fell onto his ring finger. The end portion of his finger had been bent unnaturally and his finger began to swell. The swelling and deformity did not improve over the following days and so he attended his local hospital. An x ray was taken and he was told by the doctor that there was no fracture to his finger. He was discharged from hospital. Over the following weeks the pain and swelling did not subside and the deformity remained, restricting his ability to undertake general tasks and to write. A month after the original injury our client received a telephone call from the hospital to inform him that the x ray taken at the time of his original attendance had in fact shown his finger was fractured and advised him to attend hospital as soon as possible. He returned to hospital and was seen by an orthopaedic surgeon, who placed the finger in a splint but advised that the fracture had already healed, leaving him with a permanent deformity and a loss of dexterity in his finger. We submitted a claim to the Trust and the claim settled for a four figure sum.
Negligent hip replacement surgery
After a number of years with pain and restricted movement, our client elected to undergo total hip replacement. She underwent surgery at her local hospital under the care of an orthopaedic surgeon and she was later discharged. Although there had been no immediate post operative complications our client’s hip dislocated at home, causing excruciating pain. She was taken by ambulance to hospital and underwent a closed reduction (surgery). She was later discharged but suffered another dislocation at home. She had to return to hospital for manipulation under anaesthetic and she was given a hip brace. She was discharged home but three days later suffered yet another hip dislocation. She was taken by ambulance back to hospital and had to undergo full revision surgery. It became apparent that in fact the orthopaedic surgeon who had performed the original hip replacement had malpositioned the acetabular implant and so the revision surgery included a complete repositioning of the hip implant. We submitted a claim to the Trust and after initial denials of negligence the claim settled for a five figure sum.
Our client had previously suffered a subdural haematoma and had become susceptible to seizures. He was prescribed phenytoin, a medication used to control seizures while he was in hospital, with continued prescriptions of the drug to be issued by his GPs. Our client also had a medical history of liver disease and depression, for which he was prescribed the anti-depressant, fluoxetine. The body’s ability to metabolise phenytoin is reduced by certain interacting drugs, including fluoxetine, which can therefore give rise to a consequent increase in blood phenytoin levels. The metabolism of phenytoin is also reduced in people with liver disease (since its metabolism occurs in the liver). It is therefore possible to develop “phenytoin toxicity”, which can cause headaches, dizziness, confusion, memory loss, nausea and vomiting, neurological problems, tremors, fatigue, problems with walking and other symptoms. Our client’s history of liver disease and of taking fluoextine, combined with long term use of phenytoin over a five year period caused him to develop these symptoms. Drug monitoring of phenytoin by blood test is indicated if phenytoin toxicity is suspected. Our client’s GPs failed to monitor his phenytoin levels at any point during the five year period, despite his presenting to them on several occasions with symptoms consistent with phenytoin toxicity. It was only when he was hospitalised with severe shaking and dizziness were his phenytoin levels checked and it was discovered that he had phenytoin toxicity. We submitted a claim to his GP surgery and the claim was settled for a four figure sum.
Negligent laser hair removal
Our client attended the defendant’s beauty salon for laser hair removal. It was her second attendance for removal of facial hair at the premises. The first attendance had been uneventful and had produced good results. However, on the second occasion, the laser caused burns and discolouration to her face. It was established that the reason for the injury to her face was that the settings on the laser had been too high and guidelines for use of the laser had not been followed. We submitted a claim to the defendant on our client’s behalf and the claim settled for a five figure sum.
Failure to diagnose slipped upper femoral epiphysis
Our client, a teenager, suffered injury when he slipped on ice and suffered injury to his left leg and groin. He was unable to weigh bear, which caused him to walk with a limp. After a few months without improvement he attended his GP. He was still limping at the time of the appointment and limped into the consultation room. The GP examined our client briefly while he was still sitting in the consultation room chair. He diagnosed a groin strain and referred him for physiotherapy. He received a physiotherapy appointment two months later, having continued to limp during the intervening period. On attending the appointment the physiotherapist noted his limp and that his left leg appeared shorter than his right. The physiotherapist was immediately concerned and following examination told our client that he needed to return to his GP as soon as possible for referral for further investigation. His GP referred him for an x ray and this revealed a slipped upper femoral epiphysis with a 5cm leg length discrepancy. A slipped upper femoral epiphysis (or SUFE) is a condition more common in teenagers, where the ball shaped part of the thigh bone slips out of place. Surgery is required to correct it. Failure to do so promptly can result in necrosis and hip replacement surgery. Our client underwent left sided percutaneous fixation (surgery) shortly afterwards. We submitted a claim to his GP for failure to perform a proper examination, failure to note the significance of a longstanding limp, failure to perform the Trendelenburg test, which can help identify an unstable hip and failed to suspect SUFE. We recovered a four figure sum for our client for the pain and suffering over a two month period before the correct diagnosis was made.
Negligent laparoscopic appendectomy
Our client was admitted to hospital with severe abdominal pain and was diagnosed with perforated appendix. He underwent laparoscopic appendectomy. His surgery appeared to have been uneventful but after being discharged he noticed at home that whenever he passed urine there appeared to be fluid leaking from a sinus in his abdominal wall. He sought medical advice at hospital but as there was no fluid leak during his admission he was simply discharged. Months later he developed sudden onset pain in his pubic area and problems with passing urine. He also noticed that there was blood in his urine (haematuria). He was referred by his GP to a urological surgeon. He underwent cystoscopy and this revealed a “lesion” on the wall of his bladder. A biopsy was taken, which revealed no malignancy but no further investigation was undertaken to establish exactly what the “lesion” was. He was discharged again. Over the next two years he continued to suffer from urinary problems, including haematuria. He returned to his GP and he was referred again to a urological surgeon. He underwent cystoscopy again and on this occasion it was discovered that the “lesion” was nylon suturing within the bladder wall. Further investigation led to the discovery that our client’s bladder had in fact been inadvertently stitched to his abdomen during the original laparoscopic appendectomy years earlier. Expert evidence concluded that in this instance such error could not have occurred without negligence. We settled the claim for a five figure sum.
Neonatal abstinence syndrome
Our client’s mother instructed us to pursue a claim against the hospital responsible for her antenatal care whilst pregnant with her son. During her pregnancy she was prescribed codeine for severe back pain by a doctor at the hospital. The doctor did not explain to her that there were complications and risks associated with codeine use and pregnancy. During her final trimester she attended the antenatal service at the hospital on a number of occasions and continued to be prescribed codeine. At no point was she advised to discontinue the codeine. After giving birth it was established that our client was suffering from breathing difficulties and he was transferred to the neonatal unit. He suffered breathing difficulties and irritability for a number of weeks after being diagnosed with neonatal abstinence syndrome, also known in this case as codeine withdrawal syndrome. He eventually recovered. We submitted a claim to the Trust and with the help of expert evidence we successfully recovered damages for our client on the basis that staff responsible for his mum’s care at the hospital had negligently failed to warn her about the risks of fetal dependence on codeine and that had she known of such risk she would have stopped taking it.
Mismanagement of pectus excavatum
Our client had pectus excavatum, which is a medical condition also known as a sunken or concave chest. It is congenital and caused by abnormal development of the sternum and ribs. He was referred by his GP to a consultant cardiothoracic surgeon at his local hospital with a view to undergoing a surgical procedure to correct this condition. There are different surgical procedures available to a patient who wishes to have their sternum and ribs corrected. Our client had researched the treatment options at some length and had decided that, out of two options that were possibly suitable for him; one called a “Nuss” procedure, the other called the “Ravitch” procedure. He chose the Nuss procedure, as this option appeared to involve less invasive surgery. He attended a consultation with a thoracic surgeon, who informed him that she did not personally perform the minimally invasive Nuss procedure, although she had colleagues who did. However, rather than respecting our client’s considered and informed choice of treatment and referring him to one of her colleagues, she advised our client against having the Nuss procedure. Our client accepted her advice and agreed to undergo the Ravitch procedure. Prior to his surgery our client did not undergo chest imaging, other than a single anteroposterior x ray some twelve months earlier. During the actual surgery that it was determined that our client’s sternum was not suitable to for the Ravitch procedure. This could and should have been identified on suitable pre-operative scans, but the thoracic surgeon had failed to arrange them.
The procedure had to be halted part way through. Rather than ending the operation and suturing our client’s chest, the thoracic surgeon decided to create a void between his sternum and his skin. She then packed this void with a Gore-tex patch in the hope of creating a flat chest appearance, while not interfering with the sternum. This process had not been discussed with our client at any stage prior to the operation and he had not given any consent for the procedure to be done in this way, or for the Gore-tex patch to be inserted. Approximately one and a half weeks post operation our client developed signs of infection and he was admitted to hospital. He then had to undergo debridement but the Gore-tex patch was left in. He then developed further infections and it was established that they were caused by the presence of the void and / or the Gore-tex patch; blood was pooling in the void. We submitted a claim to the Trust on the basis that there had been a failure to obtain informed consent to the Ravitch procedure, a failure to perform scans prior to the procedure and that the procedure itself had not been performed to an acceptable standard. The claim was settled the claim for a five figure sum.