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Halloween Fundraising for the Teesside & District Society for the Blind

Each year we reach out to our clients for recommendations of a local charity to support and pick one at random to support for that year. This year we are fundraising for the Teesside & District Society for the Blind, a fantastic independent local charity that assists over 2,000 blind and partially sighted people across Teesside and the surrounding areas. We have a donation box in our reception all year but we are always looking for an excuse to hold a fundraising day for such a worthy cause and Halloween offered the perfect opportunity.

The office got a chilling make over and all the staff got into the Halloween spirit with some great costumes. It’s not every day you get to work to see a witch falling out with the photocopier or chat to a ghoul at the water cooler.

As well as an impressive selection of homemade cakes, brownies and other treats for sale (and a selection of low calorie alternatives which didn’t prove quite as popular!) we had a competition to guess the name of the witch’s cat and a trick or treat tombola. In keeping with the trick or treat theme there were some great prizes on offer alongside some not so fantastic ones, although you can really never know when a selection of kitchen sponges and a washing up brush might come in handy.

Thanks to the efforts and generosity of our staff and the other tenants of the Cleveland Business Centre the day was a great success and raised over £220 for the Teesside & District Society for the Blind. Every donation is appreciated and helps this charity continue to provide its vital support and assistance to the blind and partially sighted community of Teesside. If you would like any further information on the charity or to make a donation please get in touch and we can provide you with their contact details or arrange to forward this on your behalf.

Now we just need to find an excuse for November….Thanksgiving anyone?

Dan Richardson – November 2016



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Come and join us for our Halloween Fundraising Day – 31 October 2016

On Monday 31 October 2016 we are holding a Halloween themed fundraising day in aid of our nominated charity for this year, Teesside & District Society for the Blind.  The staff will be dressed up and activities include a Trick or Treat Tombola and a Name the Witch’s Cat game.  There will also be a variety of cakes and sweets for sale.  Come and join in the fun!


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

The only Teesside firm top ranked for Clinical Negligence by Legal 500

We are the only firm in Teesside to be ranked Tier 1 for Clinical Negligence work by the prestigious Legal 500 Guide to the UK Legal Profession.  The guide, one of the leading independent guides to the profession, notes that

“Armstrong Foulkes LLP’s well-regarded boutique practice is led by ‘honest and straightforward’ managing partner Hilton Armstrong, whose recent cases include a catastrophic brain injury resulting from oxygen starvation at birth. Kathryn Watson and Ashleigh Holt are also recommended”

There are only three other firms in the whole of the North East of England, Yorkshire and Humberside who also have a Tier 1 listing and they are based in Leeds, Sheffield and Newcastle.

See more at:

Hilton Armstrong – October 2016

Difficulties facing Claimants

Clinical negligence claims are receiving increasing attention by the government.  Claimants and their solicitors are being criticised for the perceived disproportionality between the amount of compensation the Claimant recovers and the legal costs which have to be spent in order to get that compensation.

In an attempt to keep Claimants’ costs to a minimum, in recent years many changes have been made to the way claims are funded and conducted.  These changes include:

  • Limiting the type of case for which Legal Aid is available
  • Making the Claimant pay some of the legal costs out of their compensation.
  • Setting budgets for how much each side is allowed to spend on investigating and running the
  • Setting a new test of proportionality so that a Judge can disallow or reduce costs even if they were reasonably and necessarily incurred.

The NHS Litigation Authority, who deals with all clinical negligence claims against NHS Trusts, has recently published their annual report for 2015/16.  Criticism for the legal costs of bringing such claims is a continuing theme throughout the report.  The Chief Executive states that “the increasing disproportion in claimant legal costs and examples of excessive costs being claimed are highlighted in last year’s annual report and that trend continues this year” and that this is “against a background of high claims volumes including high numbers of claims being brought where there was no negligence.”  This latter statement is misleading as figures in the report indicate that Claimants were successful in over 70% of the clinical negligence claims closed in the past year.  The report also confirms that the number of clinical negligence claims reported each year has been steadily falling since 2013/2014.

Despite all the criticism regarding the costs of bringing clinical negligence claims, little mention seems to have been made as to why the costs are increasing.  No mention is made of how regularly the NHS Litigation Authority denies liability at first but then goes on to settle the claim after much additional work has had to be done thereby increasing the costs.  All of this drags claims out and increases costs unnecessarily.

Due to the changes that have been made to the way these claims are to be pursued, the further changes that are proposed (including introducing fixed fees for claims with a value up to £250,000) and the difficulties Claimants are faced with in bringing their claims, it is important to instruct a solicitor who is experienced in clinical negligence claims.  Here at Armstrong Foulkes, we have specialised in clinical negligence for 24 years.  Clinical negligence claims take up 100% of our workload.  It is all we do here.  If you think you may have suffered as a result of medical or dental negligence and would like some advice, please contact us on 01642 231110 and one of our solicitors will be happy to talk to you about your potential claim.

Kathryn Watson – September 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

Pressure sores are avoidable

Generally, yes.  Put simply the Department of Health says if you cannot answer yes to the question “Was everything done in order to prevent the sore?” then you cannot say that the sore was unavoidable.

Pressures sores and pressure ulcers can develop in the home or in hospital and will generally always be tended to by nursing staff including district nurses.  The best treatment is a combination of pressure relief by way of positioning and pressure relieving aids and use of the correct type of dressings.  Only in rare cases will surgeons get involved.

Pressure sores can be painful and debilitating.  In some cases they can be fatal particularly when they become infected and they can lead to overwhelming sepsis. 

The level of treatment, care and support needed as a result of pressure sore creates a huge social burden.  Patients can be rendered disabled meaning once the medics and nursing staff have retreated, someone needs to step in and take over and provide care and assistance where it wasn’t needed before.  Treating avoidable pressure sores is not simply a drain on the NHS but on society as a whole.  Yet, at Armstrong Foulkes we routinely investigate a number of cases each year concerning the development and management of pressures sores to patients buttocks, sacral areas and heels.  In some of these cases the patient is critically unwell.  They have perhaps had major surgery rendering them unable to move and reposition themselves and they need extensive care and for the reasons set out above this must include care of their pressure areas.

In some cases the patient is in hospital for something quite minor but without the correct mattress or cushion they develop a pressure sore that will take months of treatment and care to heal but took only a few hours to develop.

Here are some examples of the cases we have dealt with in recent years concerning pressure sores which should have been avoided:

Mr B – A 66 year old man had surgery to treat an aortic aneurysm and developed a sacral pressure sore due to the failure to provide him with an adequate mattress and cushion and a failure to reposition him sufficiently.  He remained at risk of future breakdowns and even 5 years later could not sit in a chair without pressure relief.  He recovered £55,000 in compensation.

Mrs B – A 77 year old woman admitted to hospital with a suspected urinary tract infection and other pre-existing medical conditions which put her at increased risk of pressure sores developed sores to both her heels when the nursing staff failed to adequately assess her risk of developing sores.  Without this assessment they then failed to put in place any care plan to prevent the development of sores.  Mrs B required years of treatment to her heels and her mobility became very restricted.  She recovered £34,000 in compensation.

Mr K – A 40 year old man was admitted to hospital for treatment of his testicular cancer.  He suffered a significant sacral sore.  The scar tissue itself became stuck right down to the bone.  The sore healed within 4 months but was painful on a daily basis.  He was the main carer for his disabled daughter and he was unable to provide the same level of care and assistance she needed as a result of a failure to provide a pressure relieving mattress.  Mr K recovered £80,000 in compensation.

Mr L – Mr L suffered from Multiple Sclerosis and had limited mobility.  He developed pressure sores to his heels when he was admitted to hospital overnight and was not nursed on a pressure relieving mattress.  He had continuous pain and his mobility was further limited.  In the first instance he recovered £47,500 in compensation.  This became a shocking case when only a couple of years later we were contacted by Mr L’s widow.  Her husband had passed away from an unrelated illness but in the final few months of his life he was tormented by the unnecessary development of pressure sores again because of a short admission at the same hospital during which he was not provided with adequate pressure relieving aids and care.  Mr L’s widow secured a further payment on behalf of her late husband’s estate.

Pressure sores are NOT minor or “non-serious injuries”.  Even once they have healed they can leave you with scars, pain and sensitivity and major restrictions on your daily life.  On top of that there is usually a risk of future breakdown.  At Armstrong Foulkes we would advise anyone who has suffered a pressure injury while in hospital or has had a pressure sore at home which has been looked after by community nurses to look into this further.  We are happy to discuss any such cases.  Please call us and speak to one of our solicitors on 01642 231110.  Alternatively please get in touch with us via our Contact page.

Ashleigh Holt – August 2016

What losses and expenses can we recover in your claim?

A question we are often asked is “what financial losses can I recover?” In English law compensation is broadly separated into General Damages (those relating to the pain, suffering and impact of the injury itself) and Special Damages (specific, identifiable expenses incurred as a result of the injury or which will be incurred in the future).

Putting a value on general damages is not an easy task; many factors need to be taken into account such as the duration of the injury, the degree of pain that you suffered and what impact this has had on your life. To guide our assessment of general damages we look to previous cases and consider the amounts awarded. As no two medical negligence cases are alike it is often not possible to find directly comparable cases and our assessment needs to take into account the unique facts of every specific case, identifying the key differences between cases and applying our experience to understand how this affects the value of the claim.

The other element to make up the compensation you are awarded is special damage, i.e. those financial losses and expenses you have incurred as a result of your injury. These could, amongst many other things, be a loss of earnings resulting from time taken off work, travelling expenses for hospital appointments which would not otherwise have been required, prescription charges and the cost of any equipment bought to assist you in adapting to your new situation. A claim can also be made for the time spend caring for you, even if this care was provided by a friend or family member who was not paid. Another common special damage we recover is the costs of future treatment, which can have a huge impact in terms of your recovery.

The special damages we seek to recover can vary greatly from case to case and depend on the specific needs and losses of the client. In the past, for example, we have been successful in recovering the costs of pain management courses to ensure our clients have the best possible support during their recovery. In cases where a client’s fertility has been affected we have also been able to recover the costs associated with IVF and surrogacy.

It is important to keep a record of any costs incurred (and ideally keep any receipts) as special damages can dramatically affect the potential value of a claim.

The years of specialist experience at Armstrong Foulkes ensure that we can always seek to recover the maximum compensation for you, supporting you as you recover from you injuries and ensuring you are not left out of pocket by the negligence of medical professionals.

Dan Richardson – July 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

Claimants Travel Expenses

Can a Claimant recover his expenses for attending a medical expert or visiting his lawyer?

If the other side ask you to attend for a medical examination by their own doctor then you will be able to recover your travel and other expenses (lost earnings, food etc.) from them. They should pay these within 28 days of the examination.

  • If you have to see a doctor for a report that your own Solicitor needs then the position is more complicated. It is usual for your Solicitor to reimburse your expenses in attending if you can give him the receipts. Sometimes if the expenses are high, for example you have to travel to London then he may give you some money beforehand if you cannot afford to pay yourself. The difficulty arises when you try to claim these expenses from the other side if you win your case.   The Defendants regularly object to paying them.
  • The way forward in this scenario is for your Solicitor to claim these expenses in your case against the Defendant. However, this means that there has to be a deduction from your compensation to reimburse the Solicitor for what he has paid to you. If that didn’t happen you would be paid twice, once by the Solicitor and once by the other side in your compensation.
  • You cannot claim your expenses in going to see your Solicitor. This is because those costs are considered to be the normal costs of being a litigant and therefore not recoverable.

Hilton Armstrong – June 2016

Armstrong Foulkes raises over £1,000 for Middlesbrough MS charity

After handing over all of the money we raised in the last year to The Middlesbrough MS Therapy Centre I can confirm that Armstrong Foulkes raised a total of £1,142.37.  If you have been following our endeavours you will see that we got into the Wimbledon spirit by selling strawberries and cream, we had a Christmas Jumper day and we had a week of Easter related fund raising activities including a “name the bunny” game, a tombola and cake stall all of which were kindly organised and run by our staff.  The funds raised from these events have been topped up with further money raised throughout the year from dress down days and kind donations from our staff, clients and friends of Armstrong Foulkes.

Alan Riddiough, Centre Manager told us “It is increasingly more difficult to obtain large donations these days and your efforts are very much appreciated.  The Charity provides Oxygen Therapy, Physiotherapy, Reflexology, and various other treatments to M.S. sufferers at our Therapy Centre. All monies raised goes to help and support sufferers of Multiple Sclerosis.”

This year we asked our clients to help us again pick a local charity we can help and I am pleased to announce that this year Armstrong Foulkes will be supporting Teesside & District Society for the Blind, a small independent charity assisting over 2,000 local blind and partially sighted people in the Teesside and surrounding areas and we can’t wait to get started!

If you are interested in the work that either charity does or you would like to make a donation please visit the websites at and

Ashleigh Holt – May 2016

Easter Themed Fundraising for the Middlesbrough MS Therapy Centre

Each year at Armstrong Foulkes we choose a local charity to support from nominations made by our clients.  For the past year, we have been supporting the Middlesbrough Multiple Sclerosis Therapy Centre.  For further information about the services they provide, please see their website at

As we have now been supporting this charity for almost a year, the time has come for us to choose a new local charity to support but we wanted to give one final fundraising push in order to raise as much money for the users of the Middlesbrough MS Therapy Centre.  Our Easter related fundraising activities included a “Name The Bunny” competition to win a Hotel Chocolat Easter gift bag, a tombola and a cake and sweet stall.  People were very enthusiastic with their involvement and very generous with their donations (although one did want to check before buying a chocolate cornflake cake that we had used Kellogg’s cornflakes!).  In total from this event alone  we raised over £230.



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The Middlesbrough MS Therapy Centre will shortly let us know how much we have raised in total over the past year so watch this space.  For the next 12 months, we will be supporting Teesside & District Society for the Blind.  This charity was nominated by one of our clients who lost her sight in 2011 as a result of medical negligence.  She attends the centre 3 times a week and it has been a huge support to her over the recent years.  If you would like more information on this charity, please visit their website at

Kathryn Watson – April 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

Meet our newly qualified Assistant Solicitor

After almost 5 years of academic and practical legal training on 01/02/2016 I completed my training contract with Armstrong Foulkes LLP and qualified as a solicitor. As is apparent from our other news and views articles I certainly picked an interesting time to train as a medical negligence solicitor. During my training, changes have been made to the legal aid system, meaning that it is no longer available for the vast majority of medical negligence claims.  The more usual personal injury claims have also become less profitable, meaning that many law firms who have not traditionally undertaken this kind of work are now trying their hand at it.

During this time of change I feel very lucky to have had the opportunity to train and qualify with a specialist firm who exclusively undertake medical negligence work. This has allowed me to focus almost entirely on this complex area of law and while no two claims are alike I have gained experience of a huge variety of medical negligence cases, from substandard dental work to delayed cancer diagnoses, neglect in care homes, the provision of unnecessary or incorrect medication and even surgical fires.

The firm’s dedication to excellence in legal practice and client care, as recognised by our recent Lexcel accreditation, has provided the best possible environment for me to learn and develop as a solicitor. Now that I have finally qualified I look forward to continuing to use my knowledge and training in this specialised area of law to continue Armstrong Foulkes’ track record of excellence in   helping the people of Teesside obtain redress when their medical care goes wrong.

Dan Richardson – February 2016

Armstrong Foulkes LLP secures top accolade from national Law Society

We have recently secured the national Law Society’s legal practice quality mark, Lexcel.

Lexcel is developed specifically for the legal profession.  It is an optional, recognised accreditation scheme for law firms and in-house legal departments which gives assurance that a practice meets high client care and business management.

To gain and retain Lexcel accreditation, practices must undergo a rigorous initial then annual application and assessment process.  This includes conducting background checks and an on-site visit from an independent experienced trained Lexcel assessor.

While we are proud to have secured Lexcel, it is our clients and staff who are the main beneficiaries.  They can be assured that the way we manage the practice has their interests at heart and runs efficiently.  There is a lot of choice in the legal services market, but being Lexcel accredited demonstrates our commitment to client care and best practice.

Jonathan Smithers, President of the Law Society of England and Wales, said: “Gaining and maintaining Lexcel is a considerable feat.  There are many facets of being a Lexcel accredited law firm, including excellence in client care.  A real commitment to customer service in today’s evermore competitive legal services market is vital.”

“By undergoing the rigorous Lexcel application and assessment process, practices can show the positive steps which they are taking to help clients in the increasingly diverse and complicated legal services market.”

“The scheme is a beacon of quality to clients and potential clients alike.”

We join more than 1700 other legal practices in England and Wales with Lexcel accreditation.  The practice management accolade has also gone international, with firms in Scotland, the Middle East, Poland and the Republic of Ireland having gained accreditation.

Hilton Armstrong – 21 January 2016

Personal Injury Small Claims limit set to rise

In his Autumn statement the Chancellor of the Exchequer revealed plans to increase the personal injury small claims limit from £1,000 to £5,000.  In short, this means that if you have suffered personal injuries which are not valued at more than £5,000 you will recover only limited legal costs and so if you want to pursue a claim you will probably need to do so without legal representation via the small claims court

The main driving force for this is to control whiplash claims and thereby reduce the insurance premiums paid by motorists (we’ll see about that!).  It is not clear if this will be applied across the board and encompass medical negligence claims and if the driving force is to control motoring insurance premiums for public companies then we strongly disagree that it should however if it does it will be another kick in the teeth for victims injured through the negligent acts or omissions of those they have put the utmost trust in.

For example, someone who suffers a seemingly straightforward collapsed lung through the negligent placement of a needle would struggle to bring a claim as on the face of it the injuries they had suffered would appear minor and probably not worth compensation of £5,000 and therefore the injured patient would not be able to afford the legal representation they require.  If they go it alone, how would they prove that the needle had been inserted negligently?  How do they prove what the ill effects of that negligent treatment are and how can they be sure that they are not at risk of future complications?

The onus is on the Claimant to prove their case and without having access to expert legal representation genuinely injured patients are at risk of being unable to pursue a claim.  Not everyone has the ability to do this on their own or for themselves – I’m sure that many of us could try and swot up on how to fit a new bathroom or plumb in a toilet and yet plumbing is a thriving business because most of us want to make sure the job is done properly and so we approach an expert to do the job for us.  There really isn’t any difference.

At Armstrong Foulkes we consider all types of medical negligence claims.  We have helped many injured patients over the years who have suffered low value injuries however the ability to get justice or an acknowledgement of what happened is usually priceless.

There is no set date by which the limit will rise but if you are concerned about medical treatment you have received which you believe has caused or worsened an injury please get in touch.

Ashleigh Holt – January 2016


I am once again pleased and proud to say that the firm and its solicitors have once again been ranked in and recommended by both legal directories.  We always try to provide the best service to our clients for Clinical Negligence claims and it is nice to be recognised as the specialists in this field in the Middlesbrough and Tees area.

Chambers & Partners

The “Chambers & Partners” Guide to the best lawyers in the UK is released annually. We have been included in recent years and recommended as a Top Ranked and Leading Firm in Clinical Negligence work in the North East. Again, you may have seen this logo on the home page of our website.

We are delighted to share with you news that we have been included once again in the “Chambers & Partners 2015” hardback and online directory. The firm is recognised as a Band 1 firm (top ranked) in the North East Clinical Negligence Section and the only Band 1 (top ranked) firm to be recommended for this type of law in Middlesbrough & the surrounding areas. We were also pleased to see that all of our partners, Hilton Armstrong, Joanne Dennison and Ashleigh Holt received personal recommendations for their service to clients.

The feedback included in the guide from our clients and barristers with whom we have worked is:

“Fantastic people who have a reputation for winning their cases.”

“A truly specialist firm.”

If you would like any further information please do not hesitate to contact us or to view the recommendation on the link below:


Legal 500

The “Legal 500” is an independent guide to legal firms and individuals, who are included in the online and hardback directory only if they are recommended for their work in their particular area of law. Each Legal 500 guide released every year is separated into not only areas of law but also into geographical areas. We have been privileged to be included as a leading clinical negligence firm in our area for many years and you may have noticed the “Legal 500 – Leading Firm” logo on our home page confirming this.

We are delighted to announce we have once again been included in the 2015 Legal 500 Guide we are listed as one of only 3 “Top Tier” Clinical Negligence firms in the North of England. We are described as ‘genuinely specialist medical negligence firm’ and ‘highly efficient in its conduct of cases’ – See more at:

We are proud to be the only clinical negligence firm from Middlesbrough and the surrounding areas to be included in this guide. We were also delighted to see all three of our Partners once again recommended personally for their work.

We continue to strive to offer our clients an excellent service and it is always reassuring when this is recognised both by the barristers and other professionals we work with and more importantly as a result of feedback given by our own clients. If you would like any further information please do not hesitate to contact us or to click on the link below:


Joanne Dennison (Once again Proud Editor!) – December 2015

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

Hips and Knees

Did you know:

  • 40% of all medical negligence claims against the NHS are orthopaedic claims.
  • Fingers / wrists / arms / shoulders / ankles / knees / hips etc.
  • 17% of all orthopaedic claims relate to Hip and Knee Replacements
  • 10% = Hip Replacements

Ø  7% = Knee Replacements

** McWilliams et al. JBJS 2013

The impact orthopaedic claims have on those unfortunate enough to suffer them affects every aspect of their daily lives. Our client’s complain of a severe limit on their mobility (even just getting around the home), their inability to work and they often require assistance from carers or loved one’s just to be able to cope.

A number of issues can arise in Hip and Knee Replacements:

  • Nerve Injury
  • Infection
  • Vascular Injury
  • Dislocation
  • VTE – Venous Thromboembolism / blood clots
  • Leg Length discrepancy
  • Malalignment

It is important to remember that not every complication will give rise to a claim in negligence. Every surgical procedure carries “acceptable complications” which should be discussed with you by the Surgeon at the time of providing your Consent to the procedure.

However, not all complications are “acceptable” and unfortunately sometimes the surgery has been performed to an unacceptable standard and this causes an injury.

We here at Armstrong Foulkes have extensive experience of orthopaedic claims and we can help you find out if you have received substandard care and if you have grounds to bring a claim.

If you think you have suffered such an injury please do not hesitate to contact us and one of our solicitors would be happy to discuss it with you.

Andrew Walker – November 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

A blog from Armstrong Foulkes’ Resident Equestrienne

The majority of my time outside of work is taken up by horses and I compete regularly in eventing. Whilst I only have the time to compete 2 or 3 as it takes a lot of training and fitness work to make sure a horse is ready to compete, I have several others. These include horses who have since retired or ones that are too young to compete.

Whilst we do on occasion buy horses, we tend to breed our own and are now breeding the second generation of horses. My old eventer Molly (who we bred 14 years ago) now has a 3 year old gelding (boy) and a filly foal (girl).


I am often asked what eventing entails. The competition is made up of 3 phases which are designed to test the horse and rider in different ways. The scores from each phase are combined to produce an overall total. Eventing is one of the very few sports where professionals and amateurs compete against one another as do men and women as there is no distinction between gender.

The 3 phases are:


This is where the horse and rider have to perform a series of predetermined movements to show the horse’s obedience, suppleness, balance and harmony with the rider and judges score each movement from 1 to 10. It can often be difficult to get a very fit horse to perform a relaxed and precise test. I must admit this is my least favourite of the 3 disciplines and yet the one I have to spend most of my time doing.

Show Jumping

This involves one round of jumping over coloured poles that can be knocked down with a maximum time allowed. The aim is to jump a clear round inside the time. There are penalties for knocking a pole down, stopping at a fence or exceeding the time allowed.


 Cross Country

This is a course over several kilometres across the country of very solidly built fences and includes logs, stone walls, ponds and streams, ditches, drops and banks and fences in combination. As well as big solid fences, there are a number of obstacles which test the accuracy and training of the horse and rider such as narrow or angled fences and corners. Both horse and rider need to be fit as this is a test of endurance as well as testing the courage, speed, athleticism and trust in one another as whilst there have been a lot of measures taken to improve safety, this is still the phase where horse and/or rider are most likely to be injured. This is by far my favourite phase as it involves jumping and going fast which really gets the adrenaline up.




I am now at the end of the eventing season. The winter will involve less intensive training but will be used as a solid foundation for the season next year starting in March. I will also use the added time winter brings to bring on my young horses who will start competing next year.

Kathryn Watson – October 2015


Should you be afraid to ask questions about your treatment?

We are often contacted by people whose main concern is that they don’t understand what has happened or why they were treated in a particular way but they don’t necessarily consider the doctor/consultant/nurse/dentist has been negligent. Many people leave hospital or other healthcare providers feeling like they don’t fully understand what occurred or why. Healthcare professionals and the healthcare system can seem intimidating or daunting particularly if you don’t feel physically or emotionally well, as a result many people never ask for further information, others feel troubled by their concerns long after treatment has finished. If you don’t fully understand or you can’t quite stop thinking about an aspect of your treatment or care should you be afraid to ask a question? The firm answer is “NO”, if you are unsure about any of your treatment, diagnosis given or advice provided you should always feel safe and justified  to ask “what, why, when” or “can you explain that to me again”. This applies at an appointment, as an inpatient or even after you are home, as often it’s only then you have time to reflect on what occurred. Doctors and Hospitals generally welcome this as often just asking simple questions can lead to misunderstandings being quickly resolved, reassurance given and avoid unnecessary worry or stress and long investigations weeks or months later.

If you do have a question or you don’t understand what happened, what can you do? Well there are several options. You can approach the doctor or consultant directly either at your next appointment or before then via their secretary. If you don’t feel comfortable doing that you can make use of other services designed to assist you. If it relates to hospital assessment/treatment all NHS Trusts have a PALS Department (Patient Advice and Liaison Department) whose purpose is to deal with questions or concerns from patients or their families either during or after their care. Their contact details can be found on the particular NHS Trust’s website, but equally you can call the hospital and just ask for the department or their details. In cases where you have specific questions we always recommend they are asked in written format and a written reply is requested, this is simply to avoid confusion and clients have often expressed to us it helped in months or in some cases years to come that they had that to refer back to or to discuss at the time with friends or family. Obviously some questions are so simple and straightforward or perhaps so urgent that speaking to someone in the PALS team is the more suitable option. If the question relates to a Dentist, GP or other healthcare provider then the Surgery’s Practice Manager can usually assist as the first point of call, again a written approach may be more beneficial if the questions are complex or you prefer this method of communication. There is no right or wrong way to do this, it’s entirely what you feel most comfortable with.

Many people feel wary of approaching the PALS department or the Surgery as they don’t want to be seen as a complainer or a troublemaker, but these services are not only designed for you to complain about treatment but also to assist you if you have questions or need information. Many concerns can be resolved and worry set aside by simply asking them why they did something or what that means for your health. Asking for information should not been seen as troublemaking and in fact a large percentage of enquiries made praise certain aspects of care given and should not be seen as complaining. That said if you do feel that you wish to make a complaint about treatment or advice you should also feel free to use these same services to ask for your complaint to be investigated as this is an important aspect of their work and also entirely justified.

Should you have any questions or want any advice on how to go about asking questions regarding your treatment or whether you should in fact make a complaint please do not hesitate to call us for a free no obligation chat on 01642 231110.

Joanne Dennison – September 2015

Red Bull Soapbox Race

Huge congratulations to our Trainee Solicitor, Dan Richardson, who along with his teammates “The Winterfellas” competed in the Red Bull Soapbox Race on 15th July at Alexandra Palace, London. Out of many applicants they were chosen alongside 64 others to try their luck at the infamous course, thought to be one of the fastest used by Red Bull in their Soapbox Races worldwide. Their “Game of Thrones” inspired soapbox was a labour of love, made from scratch by the team. The footage of their amazing run can be seen on the link below and unlike many of the competitors they managed to complete the course strewn with obstacles intended to cause a lesser team to crash! Although they did not make it to the podium this time, their hard work paid off and they came an impressive 13th out of 65 competitors! We’re all very proud of his achievement!







Red Bull footage is at the bottom of the main page at

Footage from the head camera is on the team page at

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





Wimbledon Themed Fundraising!


On Friday 3rd July as Wimbledon fever was intensifying we decided it made the perfect theme for further fundraising in aid of our chosen charity for 2015, Middlesbrough MS Therapy Centre (see article of March 2015). Our staff prepared and hand delivered portions of strawberries and cream to friends, family and to staff in other offices within the Cleveland Business Centre. It was a huge success and people were very generous with their donations in return for this Wimbledon themed treat on a hot summers day. As well as the sale of strawberries and cream we also operated “Dress Down Friday” in our office allowing staff to come in casual clothing, for a fee of course! In total the firm raised from these 2 activities and generous donations a grand total of £101.20 in aid of Middlesbrough MS Therapy Centre. This will be added to the funds collected as the year progresses and presented to the charity later in the year. Thank you to all those who purchased strawberries and cream or who made a kind donation.

If anybody wishes to make a donation, it’s never too late and we are happy to receive them and forward these on for you. Alternatively if you would just like to find out more about the services provided by Middlesbrough MS Therapy Centre, stop in and speak to our staff or collect a leaflet from our reception desk.

Joanne Dennison – July 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