Tag Archives: Ashleigh Holt

Premature death of County Durham lung cancer patient

Mrs N was aged 69 when she developed pain in her right shoulder blade.  Her GP arranged for her to have a chest x-ray at a local hospital in April 2013 and this was reported as normal.

Mrs N’s back pain continued.  By the end of 2013 she was suffering some breathing difficulties which were attributed to a chest infection.  When antibiotics failed to improve her condition a second chest x-ray was arranged.  This revealed nodules on her lungs which required further investigation.  She was referred for a CT scan and to a Chest Physician under the 2 week wait rule.

Sadly, the outcome in January 2014 was that Mrs N was suffering from lung cancer.  It was in both lungs and had spread to her spine.  It was at this stage that the Chest Physician realised that the April 2013 x-ray had also shown a mass in Mrs N’s right lung and that this had been missed.

The hospital investigated this error and confirmed that they had contracted out the work of reporting her x-ray to an outside service provider who has missed the lesion.  They could only apologise.

Mrs N commenced treatment and responded well initially.  She was a very fit lady and coped well with the treatment however a follow up CT scan showed that the cancer was progressing.  In February 2015 the cancer was found to have metastasised to her brain and Mrs N passed away in May 2015, aged 72, leaving behind her husband of over 50 years who continued with the claim on her behalf.

The NHS Trust responsible accepted that they had breached their duty to care to Mrs N very early on however they disputed that the 9 month delay made any difference to her treatment or prognosis.  As a result Mr N was forced to issue Court proceedings against the Trust in August 2016.

Mr N’s case, supported by an independent Clinical Oncologist was that

a) His wife’s cancer should have been diagnosed in May 2013.

b) There was no evidence that the cancer had spread by this time and his wife would have been offered surgery to remove the cancer followed by chemotherapy.

c) As a result of the delay in diagnosis, the cancer had been allowed to spread so that surgery was no longer an option.

d) His wife’s life had been shortened by more than 2 years as a result.

The NHS Trust disputed the Claimant’s evidence but only months before a trial at the High Court was due to start, the matter was settled in 2018 in Mr N’s favour when he agreed to accept a 5-figure sum in damages.

The motivation for Mr N was never compensation.  He feels that he has finally got justice for his wife but he continues to miss her every day and he feels robbed of the time he should have been able to spend with her.

Delaying a diagnosis and treatment of cancer of any kind can mean the difference between life and death.  If you have been affected in this way, please get in touch with one of our solicitors to discuss if there is anything we can do to help.

Ashleigh Holt – June 2018

The problems for and with Junior Doctors

The title “Junior doctor” can relate to someone just out of medical school or someone who is as much as 5 years out of medical school.

In many hospitals across the UK you will find very junior doctors covering hospitals, particularly at night, with very little support however the responsibility for clinical decisions will still always lie with senior medical staff.

Having such junior staff in very busy departments such as the Emergency Department (ED, formerly A&E) can present a problem for the hospital but also the patient.  This short article will deal with just a few of the issues arising from junior doctors.

  • Junior doctors can be overly cautious.  Just by the nature of the career they have chosen to follow, we know they are high achievers in life and have so far done very well.  They are terrified of making mistakes and this is likely to happen when they start treating real patients.  Much of the work in ED is making numerous decisions and not making the right one can be a terrifying prospect.
  • Junior doctors can be inclined to inherit another doctor’s thinking rather than apply their own judgement.  This can be a particular problem when they are involved in handovers and at the end of shifts.  This can also be a factor in cases involving recurrent attending patients if the junior doctor does not look beyond what his colleague wrote in the notes a week before and he/she fails to listen to the patient or carer.  This can lead to the correct diagnosis being missed.
  • Junior doctors are overworked particularly during night shifts when they are tired and more likely to make a mistake and there is less supervision.
  • Junior doctors by their nature are very inexperienced and this will be apparent in their judgement.  They will struggle with young children as patients.  Quite often this is because the junior doctors have never been around young babies or infants and in most cases will not have started families themselves.  They also struggle with neurological injuries and issues particularly involving the spinal cord or patients with multiple injuries.  All of this increases the risk of them forgetting/missing something.
  • Junior doctors can be pressured to make unsafe clinical decisions.  In many cases the junior doctor will ask for a speciality review (e.g. surgical review for a patient with suspected appendicitis) or ask for some complex imaging such as an MRI.  However in many cases the junior doctor is unable to assert themselves to get someone to see their patient or to get agreement for a scan to go ahead and they accept what in some cases turns out to be unsafe advice to discharge the patient.

The NHS is attempting to minimise mistakes and provide all staff with more support systems and standard operating systems.  For example, many hospitals/Trusts now have specialist teams set up to deal with patients suffering from life threatening and changing conditions such as strokes, sepsis or cardiac arrests.  They are trying to ensure that there is more senior review available and they continue to introduce safety netting policies to cover a range of situations however calamitous mistakes continue to be made and in some cases the mistake was avoidable.

If you are concerned about any treatment or care you have had which you believe has caused you to suffer an injury, please do not hesitate to contact us and speak to one of our specialist solicitors.

Ashleigh Holt – May 2018

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

Legal 500 Tier 1 ranking – We’ve done it again!!

Armstrong Foulkes has proudly retained its Tier 1 ranking in The Legal 500 2017 database of lawyers and solicitors in the UK.  No other firm specialising or working in clinical negligence in the Teesside area has been awarded this accolade and as specialists in this field we are elated that this has come just after celebrating the 25th anniversary of Armstrong Foulkes opening its doors in Middlesbrough.

After interviewing our clients and other legal professionals we work with Armstrong Foulkes LLP is described as having “an unrivalled and enviable reputation in the region of clinical negligence work.”  The three partners in the firm were acknowledged for their efforts in this field.  Joanne Davies is set apart with her “excellent understanding of medical issues and always gets outstanding results”.  Ashleigh Holt is described as “highly efficient” and Hilton Armstrong who leads the firm is “a clever, committed and passionate advocate who achieves excellent results in an unfussy manner”.

Joanne Davies said “We are proud and delighted that the firm has been recognised for the specialist service we provide in this type of claim and particularly pleased that the dedication of our solicitors on behalf of our clients has been both highlighted and praised.”

Ashleigh Holt – November 2017

Our 25th anniversary!

On 1 October 1992, Hilton Armstrong and Peter Foulkes set up Armstrong Foulkes, with their intention being to set up a firm of solicitors specialising in clinical negligence and personal injury.  At the time, there were no other firms in the area that specialised in clinical negligence and we were the first firm in Teesside to have a legal aid contract for clinical negligence and the only one to have such a contract for many years.

Peter retired on 1 October 2013 when Joanne Davies and Ashleigh Holt became partners and Armstrong Foulkes became Armstrong Foulkes LLP, a limited liability partnership.

Throughout the past 25 years, the firm has gone from strength to strength and is nationally recognised as being a leading clinical negligence firm.  We are described in Chambers and Partners, which ranks lawyers worldwide, as a “specialist boutique with a superb reputation for handling complex clinical negligence claims. Advises and represents clients on a wide range of matters, including child brain injury and surgical negligence cases, and also handles claims concerning delayed diagnoses.”  The top firms are ranked from Band 1 to 6 (with 1 being the highest ranking achievable) and we are pleased that we continue to hold a Band 1 ranking and have done for many years now.

The firm now comprises 5 fee earners – Hilton, Joanne and Ashleigh (the partners) and Kathryn and Dan (solicitors).  We also have 4 support staff – Liz (who has been with the firm since the outset), Caroline, Jan and Honor.

Hilton says specialising in clinical negligence suits his personality as it requires great attention to detail.  This is a trait of his that is recognised in Chambers and Partners as he is noted to be “technically very competent, very thorough and will go the extra distance to investigate a case to see if there is something in it.”  As well as ranking firms of solicitors, Chambers and Partners also ranks the top solicitors in the country and Hilton continues to hold a Band 1 ranking.  Ashleigh and Joanne are also recommended.

The partners have yet to decide how we are going to celebrate the 25 year milestone but we have been assured it will be something to look forward to!  In the meantime, in true Armstrong Foulkes style, we have celebrated with cake!

cake

If you would like to speak to one of our solicitors for advice about a potential clinical negligence claim, please telephone us on 01642 231110.

Kathryn Watson, October 2017

Armstrong Foulkes raises money for local centre for the blind

We are pleased to announce that over the last year Armstrong Foulkes has raised over £950 for a local charity, Teesside and District Society for the Blind.  In addition to our “Trick or Treat Tombola” at Halloween and regular “dress down days” we’ve received significant contributions from staff, clients and friends of Armstrong Foulkes.  Centre Manager, Rona Ashton thanked us for our tremendous effort and explained “the money raised will be put towards our costs for providing social activities for the blind and partially sighted people living in the Teesside area.”

The charity was brought to our attention by one of our client’s who suffered sudden blindness as a result of negligent medical treatment.  In 2010 she developed a recurrence of a condition she had suffered 20 years previously, benign intracranial hypertension. This can cause damage to the optic nerves and consequently visual problems.  A simple lumbar puncture would have revealed this and surgery would have halted the progression of her condition but the diagnosis was missed for over 1 year by which time, surgery was too late and our client lost her sight in her mid 60s.

The Blind Centre made a huge difference to our client in that she was able to meet and socialise with people who were similarly affected.  She enjoys regular days out and even holidays with the centre.  She said in the early days it gave her a reason to get up in the morning.  If you are interested in learning more about the charity please look at their website at www.teessideblind.co.uk

Injuries which arise from negligent medical treatment can be devastating and life changing.  If you have suffered physically or psychologically as a result of poor medical treatment, please do not hesitate to contact us.

Ashleigh Holt – 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

“Compensating mistakes is not destroying the NHS!”

It was recently reported in the national press that the Chief Executive of the NHS Litigation Authority has labelled costs of pursuing legal claims for clinical negligence as “taking money away from NHS care”.  In her view “that is just wrong”.  In fairness, she was referring to some very specific cases but it is still this very narrow interpretation of merely one of the demands on NHS funding which can be enough to deter patients from pursuing a claim for injuries they have suffered through no fault of their own.

It is not uncommon to speak to a potential new client and hear them say (in hushed tones) something alone the lines of “I’ve never done this before” or “I don’t really agree with making claims”.  They can almost sound ashamed.

What concerns us as specialist medical claims lawyers is the implied suggestion that victims of medical negligence are the ones robbing the NHS and society of better treatment and care.  There are many myths to dispel and we have simply picked out a few that should be taken into account when considering the other side of the argument:

  1. The suggestion that small claims often have no merit or are trivial is incorrect.  In around 99% of cases an independent medical expert is needed to say that the standard of treatment  was so poor and so bad that no competent medical professional would have acted in that way.  It is not a low threshold.  This is a very high standard of proof and the burden is always on the claimant to undertake these investigations and prove their case.  If there was no case to pursue, we would not do so and when there is no case the Defendants do not pay out compensation or costs.
  2. The NHS is still not throwing its hands in the air often enough despite the recommendations for there to be a ‘duty of candour’ when mistakes and errors are made that fall outside of the realm of accepted practice.  Quite often the costs we incur in a claim are a reflection of how the NHS responds to the allegations put to them.  We look forward to an attitude of openness and transparency becoming the norm but we are simply not seeing this filter through yet.
  3. There is absolutely no evidence that if the cost of claims decreased that the money saved would be put back into treatment and care.  The NHS is one of the UK’s largest employers and it has business interests and competitors like many other organisations.
  4. Finally, avoidable mistakes are still being made and in our practice we see daily reminders that the real cost is to the patients and their families.

At Armstrong Foulkes one of our lawyers will always be happy to speak to you about any injury which results from medical treatment and discuss with you the possibility of pursing a claim.  Please feel free to call us on 01642 231110, e-mail us by completing the form on our Contacts page or drop into our office.

Ashleigh Holt – June 2014