Category Archives: Case studies

Failure to monitor fetal heart beat leads to stillbirth

Mrs P was 38 weeks pregnant with her second child, a daughter, when she became concerned that she that she had not felt the baby move.  She was referred to hospital by her community midwife and a Consultant Obstetrician admitted her to hospital for the her labour to be induced.  This decision was reversed later the same day by a locum Registrar and Mrs P was discharged.  During the night Mrs P felt her baby move but the movements then stopped and by the following morning Mrs P was feeling contractions.  She was admitted to the delivery suite at the hospital after lunch again with a view that her labour would be induced.

At 18.30 pm the continuous monitoring of Mrs P’s baby was stopped.  Mrs P was moved to a ward later that night and was told that her labour would not be induced until the next morning.  Mrs P’s baby was not monitored again until 9.25 am the following day but the midwife was unable to locate the heartbeat and an ultrasound scan confirmed that Mrs P’s daughter had died.

Mrs P gave birth later that day.  Mr and Mrs P thought their daughter looked perfect.  They were able to dress and bathe her.  At their request no post mortem was carried out and no cause for her death was identified.  Mrs P subsequently suffered a major depression and required counselling.

We were instructed to investigate the standard of care Mrs P had received.  However, in this instance the hospital also commenced early investigations.  An early Letter of Claim to the Trust was following by a full admission of liability in failing to monitor Mrs P’s baby after 18.30 and deliver her earlier so that she would have survived.  Despite the early admission NHS Resolution acting on behalf of the Trust failed to make reasonable offers of compensation in settlement and refused to negotiate so we were forced to start court proceedings.  However, solicitors instructed to act for the Trust made an increased offer which was accepted by Mrs P.

The compensation awarded to Mrs P was made up of a sum for her pain, suffering and loss of amenity but was also to compensate her for past and future financial losses she had and would incur such as the cost of a layette which is the items a new baby needs such as vests and bottles and future counselling.

What we were unable to recover for Mrs P is a statutory bereavement award (currently set at £12,980) because her daughter was not been born alive however the Court regularly awards a sum “equivalent” to a bereavement award and our assessment of the damages recovered in this case included this and ultimately was not challenged by the Defendant.

No amount of compensation can replace what this family lost but in pursuing this claim Mrs P has ensured that she is able to keep her daughter’s memory alive.

A stillbirth is an unimaginable and devastating outcome of what should be the happiest of times.  If you have suffered an injury as a result of treatment given to you during your pregnancy or the delivery of your child, please contact us to discuss this further.

Ashleigh Holt – March 2018

Surgery abandoned due to a lack of beds

Due to abdominal pain Mr M was scheduled to have his gall bladder removed at the James Cook University Hospital in early 2015. It was intended that this procedure would be “keyhole” surgery with the option to convert to open surgery should this become necessary. If the “keyhole” surgery was successful then Mr M would be treated as a day case and allowed home the same day, if an open procedure (traditional “non-keyhole” surgery) was required then he would need to be kept in hospital overnight and so would need an inpatient bed.

Mr M attended James Cook University hospital as arranged and was taken down for surgery shortly after. Before he was put under general anaesthetic there was some concern as there were no inpatient beds available, but Mr M was nevertheless put to sleep and his surgery was started. It quickly became apparent that Mr M would in fact require the open version of the surgery and so needed an inpatient bed. As no beds were available Mr M’s surgery had to be abandoned.

When Mr M came round after his surgery he was told what happened and sent home. Mr M suffered cuts and bruising where his surgery had been started and was in pain for almost 2 weeks, during which time he was unable to work.

A few weeks after the abandoned surgery Mr M returned to the James Cook University Hospital and his gall bladder was removed successfully by open surgery.

Although Mr M was always going to need the open version of the surgery we were able to argue that his initial surgery should not have been started when no inpatient beds were available. Although it was intended that the procedure would be tried as “keyhole” surgery the need to convert to open surgery was always a possibility. Due to the hospital’s failure to make sure a bed would be available if he needed it prior to the surgery Mr M received an unnecessary general anaesthetic and suffered two painful cuts.

After coming to see us we were quickly able to put the case to the hospital, who admitted they were at fault straight away. After a short negotiation Mr M agreed to settle the claim for £3,500, less than a year after we took the case on. Thanks to an early admission of liability (legal blame) by the hospital we were able to settle this claim quickly and ensured that Mr M received the compensation he was due as early as possible.

While not all cases will proceed as quickly as this Armstrong Foulkes’ years of specialist experience working exclusively in medical negligence ensures that we are always in a position to give you the best possible advice in relation to your claim.

Dan Richardson, October 2017

Pressure sores whilst in intensive care

Mrs J was admitted to hospital in October 2012 with sepsis and multi organ failure and she was not expected to survive.  She required admission to the intensive care unit where she remained for 2 months, for much of which she was in a coma.  Fortunately, she pulled through but when she regained consciousness, she was told she was paraplegic as a result of her condition and had developed pressure sores to her sacrum, buttock and heel which took a long time to heal.

It was the evidence of nursing expert that the pressure sores developed because of the hospital’s failure to reposition her whilst she was so unwell.  The hospital claimed that she was too unwell to be moved and if they had tried to reposition her, she probably would have died.  However, our expert was of the opinion that if this was the case, she should have been nursed on a specialist bed and mattress which would have turned her and the pressure injuries would have been prevented.

The hospital defended this case throughout and only accepted our offer of settlement for a 5 figure sum a few weeks before Trial.  The claim was limited to damages for the pain and suffering Mrs J experienced as all of the expenses she had would have been incurred in any event as a result of her paraplegia and not because of any negligence on the part of the hospital.

Kathryn Watson, August 2017

Wrongful removal of a testicle

Kevin was in his mid fifties, single, and had a small benign cyst on his left testicle.  He had put up with it for a number of years.  Eventually he was advised that he should have it (the cyst!) removed.  Tests had confirmed that there was no cancer.  He received assurances that this was all that was to happen.  He went to hospital for what he expected to be a normal procedure for removal of this benign cyst.

After the operation the Consultant was doing his ward round with the trainees.  He announced to his colleague and Kevin that everything had gone to plan but to be safe he had removed the testicle, not just the cyst.  At first Kevin thought he hadn’t heard him correctly.  To say Kevin was angry was an understatement – he was absolutely furious.  Loss of his testicle was something he had wanted to avoid, and assured would not happen.

He came to see us about a claim.  The claim was pursued on a ‘no win no fee’ basis.  Within 8 months and shortly after starting court proceedings we secured a settlement of £15,000 plus payment of legal costs.  In monetary terms this the going rate for a loss of a testicle case as there were no complications or future concerns.

Hilton Armstrong – June 2017

Delays during labour lead to hysterectomy for first time mum

Miss G, aged 22, was admitted to hospital to give birth to her first baby.  Her labour was slow and she was given a drug called Syntocinon to try and progress the labour but this failed.  Despite being fully dilated the baby’s head had not descended.  The delivery team discussed using forceps but it was eventually decided that they would need to proceed to an emergency Caesarean Section.  Miss G was delivered of a healthy baby boy but within 3 hours of her son being born she was rushed back to theatre.  Her heart rate was excessively fast, her blood pressure was low, her abdomen was distended and she was bleeding into a drain which had been placed during the earlier procedure.  Miss G required open surgery that evening.  She was found to be bleeding from an extension of the uterine incision which had not been repaired at the time of the Caesarean Section.  This was repaired and the bleeding stopped but over the next few days she remained very unwell and she was commenced on antibiotic therapy.

A week after her son was born Miss G required a second open surgery as a bowel injury was suspected.  No injury to the bowel was identified but the following day she was taken to theatre again for a third open surgery where it was found that her uterus was necrotic.  The only solution was a hysterectomy following which she was transferred to intensive care.

Miss G was discharged from hospital after 3 weeks but required a readmission almost immediately when she haemorrhaged and required treatment for a pseudo aneurysm.  She was an inpatient for a further 2 weeks and then discharged home.  The significant surgical wounds to Mrs G’s abdomen were slow to heal and a year after her son was born she required further surgery to repair a hernia and revise her scarring.

We investigated and pursued a claim for Miss G arising out of the long term, life changing injuries she had suffered and the NHS Litigation Authority accepted on behalf of the Trust which managed the hospital that it was negligent to have delayed in not carrying out a Caesarean Section earlier.  By leaving it so late, it made the operation more complex and it was also negligent to fail to repair the extension of the uterine incision.  These failures led to Miss G’s uterus becoming so severely infected that it had to be removed.  The outcome of this was that while she could have further biological children as her ovaries had been retained, she would not be able to carry them without a womb and she would therefore need medical assistance by way of IVF and a surrogate.

The investigation into the extent of Miss G’s injuries was lengthy.  In addition to long term physical injuries, Miss G suffered depression and Post Traumatic Stress Disorder and required medication and therapy.  From her son being born he was cared for almost entirely by his grandparents and aunt.  Miss G missed the first 6 – 8 weeks of his life.  Physically she recovered to return to work 8 months after her son’s birth to her job in a care home but she was unable to cope, mentally and physically,  with the type of work and she found sedentary work in an office.

The solicitors acting on behalf of the NHS made a low offer in the first instance and it became necessary to start court proceedings as an agreement could not be otherwise reached.  The claim eventually settled only 3 months before a trial was set to take place in the High Court at Newcastle upon Tyne District Registry.  In addition to obtaining compensation for her physical and psychiatric injuries, we were able to recover compensation which would allow Miss G to pay for IVF and the costs and expenses associated with having a surrogate carry  at least 2 future children for her.  The claim settled for over £200,000.

Compensation cannot replace what Miss G lost on what should have been one of the happiest days of her life.  However, by pursuing a claim she has secured the ability to extend her family as she had always planned to.

If you have been affected by medical treatment in a similar way or know someone who has suffered like Miss G has please do not hesitate to get in touch.  We are dedicated to helping patients injured through negligence recover compensation and we are happy to discuss your experiences with you and help where we can.

Ashleigh Holt – March 2017

Failure to consider x-ray leads to unnecessary death

Shirley Wise was admitted to hospital in the early hours of a Tuesday morning with diarrhoea and vomiting.  Her treating doctors thought she was suffering from gastroenteritis but requested that an abdominal x-ray be performed to rule out anything more sinister.  The x-ray was performed at around 9:30 that morning but no doctor looked at it.  Unfortunately, because nobody looked at it, it was missed that Mrs Wise was not suffering from gastroenteritis but from gallstone ileus, a condition where a gallstone had eroded through her gall bladder into her bowel.  Had this been picked up, she would have had emergency surgery to remove the gallstone.  Instead, she deteriorated and died in the early hours of Thursday morning.

A claim was brought by her daughter, Tracey Georgeson.  The hospital admitted fault very quickly and settlement was reached soon after.  This included compensation for Mrs Wise’s unnecessary suffering before her death as well as for funeral expenses and other miscellaneous items.

Ms Georgeson has been very keen to make the public aware of what can happen when things go wrong in hospital.  We put her in touch with a journalist from the Evening Gazette who ran a story about this incident last September, which they then updated recently (please click on the links below if you would like to read the articles).

http://www.gazettelive.co.uk/news/teesside-news/daughters-heartache-over-alleged-hospital-11858518

http://www.gazettelive.co.uk/news/teesside-news/grans-hospital-death-could-been-12516562

If you suspect you or a family member has been injured as a result of medical negligence and would like some advice on whether there is a claim to pursue, please do not hesitate to contact us on 01642 231110 and one of our solicitors will be happy to talk to you about your complaint.

Kathryn Watson – February 2017

Delay in Diagnosing Stomach Cancer

Catherine was 53 when she died of stomach cancer.  2 years earlier her GP had referred her to hospital after she went to see him complaining of a feeling of fullness in her tummy.  She had an endoscopy, and biopsy, and was told all was clear and that she probably just had an ulcer.  This came as a great relief to her husband, Keith, and their children.  Unfortunately, as they were to find out a year later, the Pathologist had made a mistake when examining the biopsy.  She was not in the clear.  She had cancer which needed operating on.  By the time this was discovered it was too late and she died 2 months later.

The hospital were quick to admit that the Pathologist had made a mistake but defended the claim on the basis that even if the cancer had been diagnosed earlier, Catherine would still probably have died.  Shortly before a trial date was fixed we managed to persuade the hospital’s Solicitors to settle out of Court for £57,500.  As Catherine did not work and the children had grown up, it is a sad fact of the English legal system that compensation to the Husband in cases such as this can never reflect the true value of his loss.

Hilton Armstrong – 11/01/2017

The Misery of Pressure Sores

In 2014 Mr G suffered a serious stroke, leaving him effectively paralysed down his right hand side. He was initially treated on a specialist stroke ward before being discharged to a nursing home but a few weeks after his discharge Mr G developed an infection and required readmission to hospital.

On this occasion he was admitted to an elderly care ward, rather than the stroke ward he had been on previously and the nursing care he received left much to be desired. While previously Mr G had been regularly repositioned while on the stroke ward to prevent the development of pressure sores, on the elderly care ward he was left lying in one position for long periods of time.

This lack of care resulted in 2 pressure sores developing on Mr G’s heels.  Once they have been allowed to develop pressure sores can take a very long time to heal and they can be extremely painful.  Sadly Mr G passed away a few months later.

Mr G’s family asked us if anything could be done about the treatment he had received. After investigating his treatment, we wrote to the hospital and put our allegations to them that it was substandard for to have failed to put adequate measures in place, such as a pressure relieving mattress or a system of positional changes, to prevent the development of Mr G’s pressure sores.

In their response the hospital admitted that they had failed to provide Mr G with an adequate level of care and made an offer to settle the claim, which was accepted by Mr G’s family.

Pressure sores continue to be a significant problem.  They can delay someone’s recovery and prolong hospital stay.  The healing process can be lengthy and they have a huge social cost.  Even once healed, the after effects can be debilitating and in some cases pressure sores can prove fatal.

If you or anyone you know has suffered pressure damage as a result of poor nursing care please get in touch with us to see how we can help you.

Dan Richardson – October 2016

Injury through failure to be seen by a Consultant

Mrs B was referred to hospital by her GP for possible removal of a gallstone.  In his referral letter, her GP made it clear she had previously undergone major gynaecological surgery including a hysterectomy and surgery to remove her fallopian tubes and ovaries.

At hospital, Mrs B was seen by a junior doctor who listed her for keyhole surgery to remove her gallbladder.  This was performed by a Registrar and during the operation he found dense adhesions from the previous surgeries and her bowel was found to be stuck to the back of the abdominal wall.  A Consultant was called to assist and he made the decision to abandon the procedure.

Mrs B was very unwell after the operation with nausea, pain and a fever.  It was thought she had a bowel injury and so the next day was taken back to theatre for open surgery when it was found that she had a “through and through” kebab style injury to her bowel.  During this surgery, a further injury to her bowel was caused.  It was decided to attempt to treat the injury conservatively but due to a lack of improvement, she underwent further surgery when her bowel was resected.  She suffered from an MRSA infection and was eventually discharged home 8 weeks after her admission.

She now has a 40cm scar running the length of the abdomen and she continues to feel bloated with abdominal swelling and persistent nausea.  She also suffers from an increased frequency to pass urine.

The Professor of surgery we instructed to assist us with this claim identified a host of errors in the treatment Mrs B received.  He was critical that she saw only a junior doctor initially given her medical history, that a Consultant surgeon did not perform the first operation given the likely difficulties that they would face, that they injured the bowel and that they failed to diagnose this injury at the time making the surgery the next day even more difficult resulting in further injury to the bowel.  The defendant admitted all of this and the claim was settled for a 6 figure sum.

If you think you may have received negligent medical treatment and would like some advice on whether there is a claim to pursue, please telephone us on 01642 231110 to speak to one of our solicitors who will be happy to advise you.

Kathryn Watson – August 2016

Care Home Neglect

Mr G suffered with Alzheimer’s disease. Although his family were initially able to manage him at home, in the middle of 2013 they made a difficult decision to move him into a care home on the basis that the Managers of the home were able to assure his family that as specialists in dementia care the home would be able to cope with his needs including occasionally challenging behaviour.

On admission Mr G was clean and well-presented but over the first few weeks and months he appeared progressively more and more dirty and dishevelled and his family began to have concerns regarding the care he was receiving, and particularly whether Mr G was being restrained and whether appropriate force was being used when this was necessary.

Despite previously having had little difficulty walking Mr G soon appeared to be struggling to walk. After speaking with the care home staff it became apparent that the care home’s chiropodist was refusing to treat him and the care home had failed to arrange an alternative. When the family took Mr G to see his old chiropodist it was noted that he was wearing socks 4 sizes too small, and they must not have been removed for some time as his skin appeared to have begun to grow through them.

In late 2013 Mr G’s family arranged for him to move to a different care home. By this time he was also doubly incontinent and had sores on his buttocks.  Thankfully the new placement provided the care and support that Mr G  needed and he went on to make a good recovery to the relief of his family.

We brought a claim against the operator of Mr G’s initial care home for failing to adequately care for Mr G. The care home quickly admitted that it had not been a suitable placement for Mr G in the first place, that the staff were not adequately trained and that the level of care provided  had been substandard. After negotiations Mr G’s claim was settled for £5,500, £2,000 of which was paid to his family to be used to meet his immediate needs. The remaining £2,500 was paid into Court to be used for Mr G’s benefit in the future.

Dan Richardson – June 2016

Delay in Diagnosing Gall Bladder Cancer

This is another sad case where an avoidable error started a chain of events that led to a tragic conclusion.

Simon was 56 years of age when he had his gall bladder removed.  As is usual, this was then sent to the Pathology labs to check if there was any evidence of cancer.  He returned to see the Consultant a few weeks later and was told that the operation had been a success; he had been given the ‘all clear’ and so could return to work.  Unfortunately, as later transpired the Consultant had read the pathology report wrongly – he should have told Simon that there was evidence of cancer in the removed organ and immediately referred him to a specialist for extensive surgery.

Two months before his death Simon suffered severe abdominal pains and investigations were undertaken.  However, it wasn’t until a month before his death that the full details of the Pathologists report were realised.  By that time Simon was very poorly and his condition was inoperable.  He died 7 months after being given the ‘all clear’.

The hospital could not avoid admitting that the Pathologists report had been “incorrectly interpreted” by the Consultant.  However, they defended the claim on the basis that even if they had acted immediately it would have been too late to operate – they were saying Simon would have died anyway.  This was most distressing to the family.

Luckily the Surgeon we retained for the claim was a national expert on gall bladder cancer and could say with real authority that had Simon been operated on he would have survived with a normal life expectancy.  The claim settled a few days before the trial was due to start.

Hilton Armstrong – March 2016

58 GP appointments with a persistent infection and yet no referral to hospital

In December 2011, Mrs N developed a severe pain in her stomach for which she was admitted to hospital. It was thought she was suffering from appendicitis but during keyhole surgery no cause for her pain was found and she was later discharged home.

Unfortunately, she subsequently developed an infection around her tummy button as a result of a suture that had been used during the surgery. This is not considered negligent and is known as a recognised complication of any surgery, all that is needed is removal of the suture by the surgical team at the hospital. However, despite going to see her GP on 58 occasions about the infection over a 20 month period, he failed to refer her back to hospital for this treatment. The infection only resolved after Mrs N managed to remove the suture herself using a mirror and a pair of tweezers.

We brought a claim against her GP for failing to refer her back to hospital earlier with an ongoing infection around her tummy button. His medical defence organisation acting on his behalf accepted this failure to refer her had been substandard and the claim was settled for a four figure sum.

If you suspect you have been injured as a result of medical negligence and would like some advice on whether there is a claim to pursue, please do not hesitate to contact us on 01642 231110.

Kathryn Watson – December 2015

Set Alight under General Anaesthetic

PH underwent a surgical procedure in March 2014 to reposition a stoma from one side of his abdomen to the other.

It had previously been discovered that PH was allergic to the Betadine usually used to clean and prepare the skin around the surgical site and so the alcohol based Chlorhexidine skin preparation was used instead.

During the surgery, and whilst still under anaesthetic, a swab soaked in Chlorhexidine was left on PH’s abdomen and ignited by a surgical cutting tool. The surgical drapes and his skin caught on fire. The fire was extinguished and the drapes removed. The surgery was completed as planned but PH was left with burns and blistering on his abdomen.

PH remained in hospital for 6 days before being discharged and the burn injury took some time before settling down causing a great deal of unnecessary pain and discomfort for PH. PH has been left with permanent scarring to his abdomen as a result of the burns.

In addition to his physical injuries, unsurprisingly, PH also suffered a psychological reaction as a result of what happened to him whilst under anaesthetic. Thoughts about been set on fire whilst under anaesthetic, how things could have ended a great deal worse and concerns about undergoing any surgical procedures in the future were very distressing. PH has undergone psychological therapy to help him come to terms with the incident.

PH instructed Armstrong Foulkes LLP and compensation was recovered to represent his unnecessary pain and suffering from the burn injuries and the psychological reaction.

Incidents like this are wholly avoidable and by raising a complaint to the hospital and pursuing a claim for personal injuries through Armstrong Foulkes LLP the defendant hospital has now put measures in place to make sure this terrifying incident never happens again.

Andrew Walker – October 2015

Multi million pound settlement for 9 year old cerebral palsy sufferer

AA was a healthy baby born to her delighted parents and 3 siblings in 2005. At 6 months she was making noises and playing with her hands. She would hold onto her toys and reach for things as she was expected to. When she became unwell and was not herself her mother recognised this and took her to a local hospital. As well as vomiting, AA’s mother reported that she had seen blood in her daughter’s nappies however the examining doctor remarked AA to be “well” and diagnosed viral diarrhoea before sending her home.

Within 20 hours, when AA was seen again, she was so severely dehydrated with respiratory and circulatory failure (and renal failure) she required resuscitation. However, during the course of this she developed brain damage as a result of insufficient blood and therefore oxygen getting to the brain. She was discharged home after 18 days but it was not until sometime later that the extent of the severe brain damage she had suffered was realised.

Now aged 9, AA suffers from cerebral palsy, severe learning difficulties and epilepsy. She has very little function in any of her limbs and it is unlikely that she will regain any meaningful mobility. She has severe cognitive impairment and severe learning disability. She has no speech or communication (although her mother and siblings intuitively understand her) and she will always need 24 hour care and supervision.

Armstrong Foulkes were instructed by AA’s family to investigate the standard of the treatment given to AA when she first attended hospital. We instructed an independent expert in A&E medicine to consider the decision to send AA home. He was of the view that it was substandard. The doctor who saw AA had not taken adequate information from her mother and did not give enough notice of her concerns or to the symptoms she described as having seen.

The doctor failed to consider AA’s rapid pulse and did not appear to appreciate how quickly a child with an illness like this could quickly deteriorate and become very dehydrated. He made no attempt to describe AA’s proper condition in terms of hydration and circulation and he should certainly not have described AA as “well” when there was nothing to support this.

Many other observations which should have been carried out were not. Very simply, the examination and assessment that was carried out did not take into account the abnormalities that were observed and recorded and did not demonstrate that AA was well enough to be sent home when instead she should have been referred to a specialist paediatrician.

We then instructed an independent Paediatrician to consider what difference the failure to refer AA to a Paediatrician a day earlier made. He was able to say that referral to a paediatrician would have led to an admission during which AA would have been given intravenous fluids early on when it became clear that she was not getting better. This would have prevented the degree of dehydration which evidently occurred and the brain damaging event.

In 2008 we were able to formally approach the NHS Trust which is responsible for the hospital with the results of our investigations. A full admission of liability and causation was received to the relief of this devastated family.

In a case such as this involving a very young child with such catastrophic injuries it is almost impossible to form a realistic view on the level of compensation that will be suitable until they are much older, perhaps 7 or 8. By this age medical experts can usually give an opinion about the extent of the injuries and how they will affect the child in the future.

Some things were of course obvious. It was clear early on that the family home was not suitable for AA and her needs. We were therefore able to secure a seven figure early payment of compensation to purchase suitable alternative accommodation that could be adapted for AA’s disability needs and also to begin putting in place professional carers and physiotherapists to assist the family.

Over the years AA was seen by many medical experts instructed by us and by the solicitors acting for the hospital including Paediatric and Neurology experts, care and occupational therapy experts, physiotherapists, educational psychologists, assistive technology experts, speech and language therapy experts and accommodation experts. All of this was in order to support the claim we would put forward on her behalf but also to support the alternative position put forward by those acting for the hospital.

In 2014 AA had been seen by all the necessary experts and at age 8 we had a good idea as to what needs she would have for the rest of her life. In order to negotiate a compensation settlement the parties exchanged their medical evidence and full detailed explanations of the various financial claims we had worked out she would need.

Both parties had valued AA’s claim very differently. The expert we instructed estimated that AA would live into her mid 60’s whereas the expert instructed by the hospital did not expect her to live much past the age of 50. Together with other factors such as the extent of care she would need and the extent of the adaptations necessary to her new home, meant that there was an almost £6,000,000 difference in each side’s valuations.

Independent financial advice was obtained and as AA’s life expectancy was so uncertain but also not insignificant, it was felt that the best form of settlement was to have some of the compensation paid in a lump sum with the rest being paid in regular annual payments. These payments would be made to AA for the rest of her life. Whether she lives to the age of 60 or 100, these agreed annual payments will be made to her each year to ensure that her compensation does not run out and that she has sufficient funds to pay for her care, therapies and other expenses associated with her disability.

Three weeks before a week-long trial was due to take place, a settlement was agreed and approved at the High Court. Should AA live as long as our expert anticipates then she will have recovered over £14,000,000 in compensation for her life changing injuries.

No amount of money will ever compensate AA or her family for what they each lost on that fateful day however by seeking appropriate legal advice AA’s family have ensured that their daughter’s needs are met now and in the future and she will receive the proper care and attention she needs for life.

At Armstrong Foulkes we have experience in handling all types of clinical negligence claims involving all types of injuries. From those which are small and minor with no lasting effect to those which are devastating and life altering and serve as daily reminders of the avoidable mistake made in your treatment or care, we can advise you on whether you have a claim to pursue. It is the only type of work we do. We don’t do road traffic claims, trips or slips or accident at work claims but if you have suffered an injury as a result of what you suspect is medical negligence please do not hesitate to contact us.

Ashleigh Holt – August 2015

 

 

 

 

Breast Cancer – the importance of “the triple assessment”

In 2009 Mrs L was referred to hospital by her GP under the urgent 2-week rule after finding a lump in her breast.  She was seen by a Surgeon and underwent an ultrasound scan and a mammogram.  She was diagnosed with a simple skin cyst which did not require treatment.

Over 2 years later the lump was larger and painful.  This time in addition to scanning and clinical examination, she was offered a needle biopsy in order to get a tissue diagnosis.  Sadly, this confirmed that Mrs L was suffering from invasive breast cancer and the lump being investigated was the same lump she had been assured was not cancer 2 years earlier.

Mrs L underwent breast conserving surgery and axillary node sampling which revealed that the cancer had metastasised i.e. spread to her lymph nodes.  As a result, she then needed 6 cycles of chemotherapy and additional radiotherapy  The chemotherapy made Mrs L extremely ill.  She suffered alopecia, stomatitis, constipation, nausea, tiredness and musculoskeletal discomfort.  She was left extremely anxious and the additional treatment she required has left her with a life long increased risk of developing other debilitating and unpleasant conditions.

Mrs L made an excellent recovery and was able to return to work despite the setbacks and she instructed Armstrong Foulkes to investigate whether the treatment she had received was acceptable.

Independent expert evidence was gathered from a Radiologist, a Breast Surgeon and a Clinical Oncologist.  On the basis of their expert opinion, a claim was brought for 2 reasons:

a)            The ultrasound scan in 2009 had been reported incorrectly, and

b)            Mrs L should have been offered a needle biopsy in 2009.  Together with the other investigations – radiological and clinical, a needle biopsy would have formed what is known as “the triple assessment”.

With the triple assessment in 2009, Mrs L’s cancer would have been diagnosed 28 months earlier.  She would have avoided the cancer metastasising and she would have avoided having any chemotherapy at all and  would have only needed radiology to breast and avoided having the area above her collarbone irradiated.

The NHS Litigation Authority acting for the Trust denied any wrongdoing and Mrs L had no alternative but to start court proceedings.  Shortly after, the Defendant opted not to continue to defend the claim and they made an offer in settlement.   After some negotiations, Mrs L accepted a reasonable offer in full and final settlement of her claim.

Ashleigh Holt – June 2015

Hospital fails to learn from its mistakes

In 2007 Mr L developed pressure sores on both of his heels during a stay in hospital due to him not receiving an appropriate pressure relieving mattress. He instructed us to bring a claim on his behalf and as a result we were successful in recovering a significant amount of compensation.

Although Mr L’s wounds eventually healed he was required to follow a rigorous foot care regime in order to stop further sores developing, due to the increased vulnerability identified by our plastic surgeon.

In 2012 Mr L was readmitted to the same hospital. Mr L had diligently maintained his skin care regime and as a result had suffered no further pressure injuries to his heels. Despite being injury free for around 4 years after only two weeks in the hospital it was noticed that pressure sores had been allowed to develop on both of Mr L’s heels. When his notes were consulted it was quickly apparent that the nursing staff had failed to follow the required skin care regime for the entire time Mr L had been admitted.

Around a month after these second pressure wounds developed Mr L was told that he had contracted MRSA, with the infection having entered his body through the new sores on his heels. As a result he was again admitted to hospital and started on a course of very strong antibiotics with some very unpleasant side effects.

Unfortunately Mr L passed away shortly after this admission for reasons unrelated to the MRSA or his pressure injuries. After his death Mr L’s wife instructed us to bring a claim against the hospital for the suffering her husband had experienced before his death as a result of the pressure sores.

After investigating the claim we formally put our allegations of negligence to the hospital. The hospital admitted that they had been at fault but denied that Mr L’s MRSA was a result of the pressure injury. A very low offer of compensation was made. This was not accepted and as no further appropriate offers were made we issued court proceedings. Shortly after the issue of proceedings, and following further negotiations with the hospital, the case finally settled at an appropriate amount.

This was a very unfortunate case of a man repeatedly let down by the same hospital, and suffering entirely preventable injuries as a result. It is hoped that following Mr L’s second admission better procedures have been put in place at the hospital to minimise the risk of these preventable pressure injuries occurring in the future.

Dan Richardson, April 2015

Mother unable to have more children because of hospital’s mistake!

Mrs M was pregnant and as a result of a previous miscarriage, was monitored regularly throughout her pregnancy. She attended hospital at 29 weeks’ gestation for a routine scan. This showed that her baby’s movements were reduced which was of concern. She was given steroids and was advised to return for review the following day. Unfortunately, it was overlooked that she had raised blood pressure and a significant amount of protein in her urine (proteinuria), both of which are indicative of pre-eclampsia which is a dangerous condition for both mother and baby.

She returned to hospital the next day when it was noted that her baby’s movements had improved. Again, her raised blood pressure and proteinuria were overlooked. She was sent home and the plan was to review her in a few days’ time.

The following evening, Mrs M began to feel unwell and struggled to breathe. She was taken to hospital where she underwent an emergency caesarean section when it was discovered she had a large placental abruption. This is where the placenta comes away from the uterus before the baby is born resulting in internal bleeding. It can also cause harm to the baby if it is deprived of oxygen and nutrients as a result. Fortunately, Mrs M’s son was healthy but she had a more stormy time. She required a further operation shortly after the caesarean section because of ongoing bleeding, admission to intensive care, she developed abnormal renal function and pulmonary oedema and needed a blood transfusion. She was discharged home after 9 days and then advised at a follow up appointment that she should not risk a future pregnancy because of the damage it could do to her kidneys. This was upsetting to both her and her husband as although they have 2 sons, they would have liked a third child. However, they followed the advice given and her husband underwent a vasectomy.

The hospital admitted early on that it was substandard that they failed to diagnose the pre-eclampsia when she first attended hospital. They also accepted that had they acted upon the raised blood pressure and proteinuria, she would have been admitted that day and had the caesarean section before the placenta came away from the lining of the uterus. The claim settled shortly after court proceedings were issued for the sum of £30,000.

Kathryn Watson – November 2014

What’s in the box?

For many years Miss S had suffered with hay fever and had a repeat prescription for Cetirizine 10mgs, an antihistamine.  Her GP issued a repeat prescription and she collected this from her pharmacy and started to use it the next day.

The medication was in the same packaging as normal and had the label for Cetirizine 10mgs on the box along with her details.  A few days after starting to take this medication Miss S began to feel unwell and her face became swollen.  Miss S developed a rash all over her body and face which was very itchy and painful. The rash to her face would also bleed causing scarring.

After about 5 days Miss S checked the medication she had been taking and she discovered that the tablets inside the box were in fact Citalopram 10mgs which is an antidepressant.  When she raised this with the pharmacy she was told these tablets were meant to have been given to a 90 year old patient with dementia!

We often receive enquiries where somebody has been prescribed the wrong medication or given somebody else’s prescription by mistake.  If this is spotted early enough and you are fortunate enough not to take the medication then there is no claim in law as it is not enough to simply show that something has gone wrong.  You also need to prove it caused you some injury and loss.

Unfortunately for Miss S as the box and all of the packaging/labelling indicated it was her normal prescription she took the tablets for a number of days and therefore did suffer an allergic reaction as a result of the mis-prescription.

Miss S received an apology from the pharmacy and a settlement to compensate her for the allergic reaction and the period of infection, rashes, itching and facial scarring which she suffered.

Andrew Walker – October 2014

Prostate cancer diagnosis delayed by 5 years

Mr P was originally seen by a Practice Nurse at his GP surgery in 2005 for a general check-up and advice on his lifestyle.  During the appointment he had blood taken for analysis which included PSA testing for the early signs of prostate cancer.

The PSA level was found to be almost 4 times higher than the normal range and when checked again several months later it was still very much outside of the normal range but his GP failed to make any referral or arrange a further review having advised Mr P that the results were quite unreliable and could have been caused by other things such as riding a bike.

In June 2010 Mr P saw his GP complaining of passing blood in his urine.  A PSA check at this time found his level had rocketed and he was referred urgently to a urologist who made a diagnosis of cancer of the prostate and commenced Mr P on treatment.  Sadly it became apparent that the delay in diagnosis had allowed the cancer to progress and as a result Mr P’s life expectancy was significantly shortened.

Mr P’s GP quickly accepted that he had failed his patient in not referring him to a urologist in 2005 and that a diagnosis at this time would have afforded Mr P a better outcome and prognosis.

Court proceedings were issued and because Mr P chose to settle his claim in his lifetime rather than leave it to his widow to deal with, the main dispute between the parties was about how to deal with Mr P’s “lost years claim”.  A claim for lost years arises when a claimant is denied the opportunity to earn an income as result of their life being shortened due to the Defendant’s negligence.  Mr P eventually accepted £190,000 in full and final settlement of his claim.

Ashleigh Holt – August 2014

Injection injury denies student dream career

This was a nerve injury case which went to trial. The Claimant was awarded £94,386 which was made up of PSLA (£16,000), past loss of earnings (£32,500), future loss of earnings (£40,000), miscellaneous (£675) and interest of £5,211.

Peter was 17 and studying for his ‘A’ levels when he had a sudden onset of stomach pain. His mother took him to an out-of-hours GP surgery where a diagnosis of suspected appendicitis was made. Peter was in pain so the GP gave him a pain relieving injection into his left thigh. He was then taken to hospital and had surgery to remove his appendix.

When he recovered from his surgery he discovered that he had numbness in his left leg just below the knee and into the foot – a “drop foot” injury. This usually occurs when there is some damage to the peroneal nerve which runs all the way down the leg. The only time when this could have happened was when the GP gave him the pain killing injection into his thigh.

He and his mother were not going to do anything about this until they were advised by the Neurologist at hospital that they should go see a Solicitor. In cross-examination the Neurologist denied this.

Peter brought a claim against the GP who gave him the injection, alleging that the needle was inserted into the incorrect area, namely into the peroneal nerve, and this caused his disability. The case was defended throughout and went for a 5 day trial in Middlesbrough County Court with 2 experts on each side. Only £16,000 of the sum he was awarded was for pain and suffering for the injury, the rest was for past and future loss of earnings. Peter had hoped to go into a career with the Forestry Commission but that was not possible as he was now unable to move effectively on uneven ground.

Hilton Armstrong – June 2014

P.T.S.D. After Childbirth

Mrs C was scheduled to give birth to her third child by caesarean section. One week before the procedure was to be carried out her waters broke. She became very concerned as her waters were red with blood. Mrs C’s partner took her straight to the Maternity Assessment Unit (MAU) at James Cook University Hospital. Once inside Mrs C was directed to simply sit in the waiting room, surrounded by other pregnant women and couples, despite being distressed and her lower half being entirely covered in blood. Unbeknown to her at the time she had suffered a placental abruption, this occurs when the placental lining comes away from the uterus causing massive bleeding and endangering both the baby and the mother, it is an emergency situation.

After 15 minutes in the waiting room, surrounded by other patients, Mrs C was finally seen by a midwife. The midwife was horrified with Mrs C’s condition and called for a doctor urgently. As a result Mrs C was admitted and immediately underwent an emergency Caesarean section. Thankfully this was successful and Mrs C gave birth to a healthy baby girl.

Physically Mrs C recovered well from the ordeal; however she began to suffer from panic attacks, constantly running through what happened from the bleed to the birth in her head. She was later diagnosed as suffering from Post-Traumatic Stress Disorder (P.T.S.D.) and began attending Cognitive Behavioural Therapy to help come to terms with the incident.

Mrs C initially spoke to her midwife about the delay in her being seen at the hospital and submitted a complaint through the Patient Advice & Liaison Service (PALS) service. She came to see us after she did not receive a satisfactory response as to why she had not been seen as a priority when she attended hospital in such a condition.

We sought the opinion of independent medical experts as to the quality of Mrs C’s care.  These experts felt that while the placental abruption could not have been avoided the 15 minute delay before being examined was traumatic and unacceptable. It was this entirely avoidable delay, rather than the abruption itself, that had so seriously affected Mrs C and resulted in her anxiety and PTSD.

We put these allegations to South Tees Hospitals NHS Foundation Trust. They admitted that the care had been substandard and soon after made an offer of compensation, which Mrs C accepted.

As a result Mrs C recovered compensation for her long lasting psychological injuries. She was also compensated for the cost of the CBT sessions, both in the past and those she will need to help put this incident behind her. This case shows that sometimes psychological injuries can occur independently of physical injuries, but can be just as damaging with on-going consequences for the patient.

Dan Richardson

Wrong Size Hip Replacements at Wrong Angle

Mr K was advised that he needed to have both hips replaced; it was planned that this would be done in 2 separate operations about 4 months apart. To avoid lengthy waiting lists he was referred for this surgery by Middlesbrough Primary Care Trust’s “Choose and Book” system to an Orthopaedic Surgeon at the Woodlands Hospital, Darlington. This meant that the NHS would pay for his treatment at this private hospital. The same surgeon performed both hip replacements.

Following his hip replacements Mr K. was in a great deal of pain and he found it harder to get around than before the operations. This made it hard for him to continue working and he was off work for long periods of time as he was not fit enough for his job as a youth worker. As he was unable to commit to work with the charity where he was employed he missed out on an opportunity for promotion there.

He approached us over a year after the initial surgery when he felt his concerns were not being taken seriously by the surgeon and he was not being offered any treatment to improve his situation. At the suggestion of his solicitor here at Armstrong Foulkes he requested his GP organise a referral to a particular well-respected surgeon at a local NHS trust for a second opinion. He was advised by this new surgeon that both hip replacements needed to be removed and new ones put in. That surgeon performed repair operations to each side and corrected the problems. After these surgeries Mr K was finally able to walk and move around comfortably and he no longer suffered daily pain. Basically he was in the position he should have been in after his first 2 hip replacement operations.

We investigated on his behalf and he was examined by our own independent medical expert who told us that the first two surgeries were performed negligently as the replacement hips were the wrong size and had been inserted at the wrong angle. The NHS Trust did not accept responsibility for the negligence straight away and we issued court proceedings against them. The case settled shortly afterwards.

Mr K. received compensation for the unnecessary pain he suffered and the fact he had to undergo 2 further operations to correct the problems which he could have otherwise avoided. He also successfully claimed compensation for his lost earnings, the loss of the job opportunity and the care and assistance he needed from his wife before the problems were corrected.

Joanne Dennison – February 2014

Hospital treatment causes cardiac arrest and post-traumatic stress disorder

Mr G suffers from a mild form of Chronic Obstructive Pulmonary Disease (COPD) which is a lung condition that causes difficulty breathing.  Although he would get breathless walking up hills, he experienced very few problems with this condition.

One afternoon in November 2010, his condition got worse and he became very breathless.  The practice nurse at his GP surgery recommended he go straight to hospital which he did.  He was diagnosed as suffering an exacerbation of his COPD and he was started on oxygen therapy.  Unfortunately, the flow rate of oxygen given was much too high and this caused his condition to worsen dramatically.  This was not picked up by the doctors until he had become so ill that he suffered a cardiac arrest.  He needed CPR and during the course of this, 4 of his ribs were broken.

Mr G’s physical recovery went relatively smoothly and no permanent damage had been caused.  However, he was so traumatised by the events of that afternoon that he developed post-traumatic stress disorder.  He struggled to come to terms with what had happened and spent much of his time thinking about it which made him very emotional.  He lost all faith in the hospital and as he was adamant he would not go back there, he and his wife moved from their home which they had lived in for over 20 years to be in the catchment area of another hospital.  Fortunately, after receiving counselling, he made a good recovery.

Our expert was highly critical of the treatment provided by the hospital.  He was of the opinion that Mr G’s was not a serious case when he attended hospital and his treatment should be “bread and butter” and “well known to even the most junior doctor”.  He also concluded that Mr G would have been much better if he had just stayed at home rather than go to the hospital as it was the treatment he received and not the COPD which caused his deterioration.

The hospital initially denied they were at fault but shortly after court proceedings were started, they made an offer of settlement and Mr G accepted £30,000 in compensation.

Kathryn Watson – November 2013

Pressure sore causes death

K was in her late 80s when she was admitted to hospital with a pinched nerve in her neck which left her unable to move her arms or legs.  Surgery was not recommended due to her age and she remained in hospital awaiting physiotherapy which unfortunately she was never able to undergo.

Just over two months later she was discharged into a care home but during her time in hospital she had developed a grade 3 pressure sore on her right heel which had become infected.  She sadly passed away a further two months later, with the death certificate recording one of the 3 causes of death as her infected pressure sore.

The case was investigated on behalf of her family/Estate and the hospital accepted that no appropriate risk assessment was carried out during her time at the hospital. They accepted that this would have identified that K was at a high risk of developing pressure sores, and that she should therefore have been nursed on a pressure relieving mattress.  They also agreed that no appropriate care plan was prepared or wound assessment carried out which meant that once the pressure sore had been noticed it continued to deteriorate without the required treatment.

The hospital agreed that as a result of the substandard nursing care she received she went on to develop a grade 3 pressure sore on her right heel which became infected and on the balance of probabilities, contributed to her death. K’s estate accepted £15,000 compensation representing funeral expenses, travel expenses on behalf of her relatives and her pain and suffering up to an including her death.

Andrew Walker

High Street Optician fails to prevent loss of eye sight

In May 2007 Frederick complained of some blurring of the vision in his right eye when seen by an Optometrist at a popular high street Optician for his regular eye test.  In August 2007 he re took the test and was assured there was no deterioration.

In February 2008 Frederick attended an alternative Optician who referred him to the Opthalmology clinic  at a local hospital with raised intraocular pressure in his right eye.  He was diagnosed as suffering from glaucoma.

Frederick had suffered a significant loss of vision in his right eye to a level leaving him functionally blind in that eye.  He had also lost approximately 20 – 30% of the peripheral vision in his left eye. 

It transpired that the intraocular pressure in Frederick’s  right eye had been significantly raised above normal upper limits during the May and August examinations and  that this should have prompted a referral to hospital at this time allowing his condition to be diagnosed and treated allowing him to maintain normal visual acuity in the right eye and avoiding any significant loss of his peripheral visual field in his left eye. 

Court proceedings were started and Solicitors acting for the high street Optician quickly confirmed they would not be defending the claim.  Frederick accepted a settlement of £65,000 in damages plus payment of his legal costs.

 

Ashleigh Holt

Old Age Is No Reason For Substandard Treatment

Pamela was in her seventies when she fell at home and fractured her wrist. She had a cast fitted and was reviewed 6 weeks later when the cast was removed. Her wrist was bent and had healed at 25 degrees. The doctor told her he did not need to re-break it but would refer her for physiotherapy. She felt that the reason the doctor was not doing more was because of her age and that he ignored her request to do whatever was needed to allow her to keep optimum function in the wrist.

She decided to have surgery privately as she leads a very active life and needs good use of her wrist. This cost her over £4,000 and did improve wrist function. However, there is still pain and weakness in the wrist and slight numbness around the thumb.

After court proceedings had been started, solicitors for the hospital accepted that before the wrist was put in a plaster cast, Pamela should have been offered manipulation to reduce the degree of angulation. They also admitted that if her wrist had been manipulated, it would probably have avoided the surgery. It was agreed between the parties that although 50% of her remaining symptoms were due to the corrective surgery, which would not have been necessary if she had been treated properly, the remaining 50% were as a result of the original fracture. As these symptoms would have occurred even with proper treatment, she could not recover compensation for these. Pamela was offered £14,000 which included the cost of the surgery, which she accepted.

Starting surgery without necessary equipment

Arthur had suffered with Rheumatoid Arthritis in his hands for several years. He was admitted to hospital for a procedure in which some of the diseased joints in his right hand were to be replaced with artificial implants. Arthur was prepared for surgery. He was given a General Anaesthetic and the Surgeon set about making the necessary incisions and preparing the bones in the hand to accept the implants.

It was at this point that the Surgeon realised that not all of the necessary components for the surgery had been ordered. No available implants were to be had for a further two days. As a result, the operation had to be abandoned and Arthur had to wait over two weeks for another operation date.

The hospital agreed that this was unacceptable treatment and paid Arthur compensation of £4,250. In addition, they arranged a more robust system to ensure that the correct implants were ordered in good time and that detailed lists of requirements for each operation were available and checked one week before the operation.