Treatable Mesenteric Ischaemia Missed on Scan Leads to Death of Hospital Worker Case
In 2017 we were instructed by Mr N to investigate the treatment his wife had received prior to her death at age 54. She had received treatment from her GPs, the local hospital Trust and the local Ambulance service but by the time her condition was diagnosed, it was too late.
Mrs N was diagnosed with Peripheral Vascular Disease in 2015. In May 2017 she developed abdominal pain and cramping. She began vomiting and suffered diarrhoea and was losing weight. Her GP referred her to a Gastroenterologist under the 2 week wait rule in June and she had a CT scan and gastroscopy which ruled out any cancer.
By this time Mrs N was too unwell to be able to return to her job as a Ward Assistant at the hospital where the investigations were taking place and her condition continued to deteriorate.
In July an ambulance was called and a Rapid Response Paramedic attended just after midnight to find Mrs N on her hands and knees because of the pain. The Paramedic took a history and a detailed examination and gave Mrs N Morphine and Codeine before offering Mrs N the option of being transferred to hospital. However, she clarified this offer by indicating that there was a four hour wait to be seen and once seen she expected the staff would just send Mrs N home with advice to see her own GP the next day. Mrs N chose to stay at home and saw her GP who felt assured by the outcome of the recent investigations.
Three days later, Mrs N was admitted to hospital. A CT scan showed that her bowel was obstructed due to chronic mesenteric ischaemia, i.e., the blood supply to her bowel was restricted. She was taken to theatre, but her entire small bowel was found to be gangrenous. The situation was not reversible and Mrs N passed away.
This investigation was extremely difficult. Mrs N had been involved with various medical disciplines in the last few weeks before her death. We investigated the standard of the reporting of the CT scan, the standard of advice provided by the Paramedic and the standard of care provided by the GPs.
Our expert evidence indicated that any failings by the GPs involved were not negligent however the reporting of the CT scan was negligent in that the diagnosis of mesenteric ischaemia had been missed. Further, our evidence concluded that if it was accepted that the Paramedic had advised Mrs N about waiting times and likely treatment options and this had influenced her decision to stay at home rather than attend hospital, this was also negligent.
To be able to tell the story of what would have happened to Mrs N but for negligence, in addition to Radiology, General Practice and Paramedic evidence, we also obtained evidence from independent experts in Gastroenterology, Vascular Surgery, Emergency Medicine and General Surgery.
The evidence and putting it together was particularly complex, but we were able to demonstrate that had the scan been correctly interpreted, there would have been a working diagnosis of mesenteric ischaemia. This would not have been considered an emergency but when her condition deteriorated, she would have been offered a procedure to treat the chronic mesenteric ischaemia before it became acute and fatal.
The case was put to both the hospital Trust and the Ambulance Service. Both denied liability and court proceedings were commenced. The claim was robustly defended by both Defendants particularly on breach of duty although it was largely accepted that if the mesenteric ischaemia had been identified on the scan, Mrs N would have likely survived.
Court proceedings were commenced in November 2021. We had undertaken all of the steps that had been ordered by the court and the continued defence of the claim was unwavering, but we were confident in the evidence of our experts and we were prepared to attend trial and ask the Judge to determine the case.
By 2024 it was clear that the case would be won or lost based on which side’s radiology evidence was preferred. A lengthy trial was pending in October. Between the parties, it was agreed that we would attend a round table meeting to see what issues could be narrowed or resolved. The meeting took place just before the seventh anniversary of the death of Mrs N and a six figure settlement was agreed in Mr N’s favour. There was no admission of liability.
Financial compensation cannot restore what someone has lost when that loss is a person however Mr N was only in his early 50s at the time of his wife’s death. He had a daughter living at home and now a home to run and maintain on his own and with Mrs N went the services she provided and her financial contribution to their family life. The financial settlement could not replace her, but it could give Mr N security.
At Armstrong Foulkes we aim to get the best possible outcome for our clients. Mr N got the answers he was looking for and a settlement.
Ashleigh Holt, September 2025