Tag Archives: Chambers & Partners

Patients owed a duty of care by non-medical Emergency Department staff

The Supreme Court in Darnley v Croydon Health Services NHS Trust has unanimously decided that patients attending an Emergency Department are owed a duty of care not just by medical staff but also administrative staff such as receptionists.

Briefly, in May 2010, Mr Darnley was assaulted and struck on the head.  He complained of a worsening headache to his friend who took him to the Emergency Department of the Mayday Hospital in Croydon where he was booked in at 8:26pm.  He was told by the receptionist that he would have to wait between 4 and 5 hours to be seen.  19 minutes later at 8:45pm, feeling worse and wanting to go home to bed, Mr Darnley left the Emergency Department without informing anyone.  At home, he collapsed and an ambulance brought him back to hospital at 10:38pm.  He underwent emergency surgery but has been left with permanent brain damage.

The claim arose out of the information given by the receptionist as it was alleged the advice he would have to wait between 4 and 5 hours was inaccurate and misleading as he should have been told he would be seen by a triage nurse within 30 minutes.  At first instance, the Judge accepted the following:

  • Mr Darnley would have remained at the hospital had been told that he would be seen within 30 minutes of arrival.
  • Following triage, he would have either been admitted or told to wait and if he was told to wait, he would have waited.
  • If he had waited, his collapse would have happened in a hospital setting and he would have had earlier surgery and a near full recovery.
  • Mr Darnley’s decision to leave was based partly on the inaccurate that he was given by the receptionist about waiting times.
  • It was reasonably foreseeable that a person told he would have to wait for 4 to 5 hours might leave without treatment and then might go on to suffer physical harm as a result.

The claim however failed as the Judge held that there was no duty of care owed by the receptionist to patients attending the Emergency Department.  This was upheld by the Court of Appeal.

However, the Supreme Court has taken a different view and has held that the question is not whether a receptionist owes a duty of care to a patient, it is the hospital that owes the duty of care and this duty is well established.  As soon as a patient arrives at the Emergency Department and is booked in, the hospital owes that patient a duty of care which includes a duty to ensure a patient is not provided with inaccurate and misleading information.  As it is the hospital that owes the duty of care, there is no distinction between advice given by clinical and administrative staff.

Although this case relates to the advice given by a receptionist at an Emergency Department, the same principle can apply to advice given by clerical staff in any healthcare setting such as at GP surgeries or transport services.  It is important to remember that whilst a number of claims for injuries are the result of treatment provided by doctors, dentists and nurses, this is not always the case.

Kathryn Watson, December 2019

Chambers & Partners UK Guide to Solicitors 2020 – Top Middlesbrough Clinical Negligence Firm

We are delighted to announce that Armstrong Foulkes LLP has once again been recognised in the “Chambers & Partners 2020 Guide to Solicitors” for its expertise in Clinical Negligence in Middlesbrough & surrounding area. Chambers & Partners annually research in detail legal firms and the solicitors who work there. They take the views of the firm’s clients and also of barristers who work with them. They then provide rankings/recommendations for firms in each legal and then geographical area. We are proud to have been ranked in this directory as the only Band 1 firm for Clinical Negligence in Teesside.

We are described as a “Stellar boutique firm with outstanding expertise in clinical negligence claims. Represents clients on a wide range of matters, including child brain injury, surgical negligence and delayed diagnosis cases. Further capabilities handling claims concerning neonatal injuries due to negligent care, as well as secondary victim claims.”

All 4 Partners also achieved impressive individual rankings as experts in this area of Law, Hilton Armstrong, Band 1, is praised by a client who asserts “He kept me well informed and provided good advice throughout.”. Joanne Davies “is very experienced and effective, with good judgement,” and Ashleigh Holt “is tenacious, good with clients and very perceptive”, both achieved again a Band 2 ranking. Kathryn Watson is, as suggested in this guide, indeed “one to watch” who according to a client “listens to everything I say and fights for my case.”

Our profile can be found at https://chambers.com/department/armstrong-foulkes-llp-clinical-negligence-mainly-claimant-uk-1:140:16346:1:162233

We are delighted and proud to be recognised again for the dedication and expertise shown by each and every one of our solicitors and would like to thank any past and current clients as well as barristers who have taken the time to speak to Chambers & Partners researchers on our behalf.

Joanne Davies – November 2019

Hospital’s failure to treat infection resulted in “flesh-eating disease”

H underwent a caesarean section to deliver her first baby.  Whilst in hospital afterwards, she felt very unwell, with a raised temperature, feeling hot and cold, shivery and had an increased heart rate.  She also suffered from a lot of pain in the caesarean section wound.  Her blood test results were abnormal indicating she had an infection but despite this, she was discharged home to look after her new born son.

The following day, she went to see her GP who diagnosed a wound infection and prescribed antibiotics.  The day after, she had deteriorated further so she returned to hospital where she was diagnosed with necrotising fasciitis, commonly known as the flesh-eating disease.  She required 4 surgeries to remove large amounts of dead tissue which were incredibly painful for her and left her with scarring to her stomach.  She was distressed both by her own illness and the separation it caused from her new born baby and she subsequently developed post-traumatic stress disorder.

It was the evidence of our expert that she had clear signs of infection throughout her admission to hospital and these simply were not acted upon.  Had she been prescribed antibiotics at any time before her discharge 5 days after the caesarean section, the infection would have resolved and it would not have progressed to necrotising fasciitis.

The hospital denied this and suggested that the disproportionate pain she experienced following the surgery was because she was overweight. We alleged this pain was, amongst other symptoms, a sign of infection.  H’s weight was a common theme throughout the claim and reflected disparaging comments about her weight that had been made to H whilst she was in hospital.

As the hospital was of the view their treatment was reasonable, as was the decision to discharge her, we proceeded to issue court proceedings and the claim settled shortly thereafter.

If you suspect you or a member of your family has received negligent treatment and would like some advice as to how best to proceed, please contact us on 01642 231110 and one of our solicitors will be happy to speak to you and advise you on the merits of a clinical negligence claim.

Kathryn Watson – August 2019

Bicep injury attracts compensation of over £60,000

In addition to his usual daily employment, Mr B worked as a bouncer a few evenings a week to supplement his income and support his large family.  It was on one of these evenings that he felt something snap in his left upper arm which immediately felt painful and weak.  The following day, his arm was still painful and a bruise had started to form just past his left elbow.  Within 48 hours there was heavy red bruising around the arm and his bicep muscle appeared to be moving under his arm.

Mr B attended his local Accident and Emergency Department and was seen by an Emergency Care Practitioner.  She examined his arm and diagnosed a partial rupture of his left bicep.  She discussed the diagnosis with a doctor and then discharged Mr B with advise to rest the arm.  Mr B accepted the advice but became concerned after a few months that his arm was just not improving so he consulted his GP who referred him to an Orthopaedic Surgeon.  He was eventually seen by a specialist 9 months after the original injury and was diagnosed with a complete rupture of his bicep however secondary reconstruction at this late stage carried a 40 – 50% risk of nerve injury resulting in further permanent disability seriously affecting the function of his arm.  Mr B was strongly advised against any surgical intervention and a subsequent ultrasound scan confirmed the diagnosis.

As a result of the continued weakness and discomfort in his arm, and the lack of treatment options, Mr B was unable to continue working as doorman and he continues to be at a disadvantage on the open labour market.

Initially Mr B made a complaint to the Trust about the standard of treatment he had received.  The Trust’s first response was to advise that they had referred him to physiotherapy and had therefore discharged their duty of care.  Mr B objected to this and following a meeting with the Trust, they conceded they could not confirm that a physiotherapy referral had been made.  Mr B sought our help at this point and we agreed to investigate his case and offered him a “no win, no fee” agreement.

With the assistance of independent expert witnesses in the fields of Nursing and Orthopaedic Surgery, we discovered that there is a duty on examining clinicians to confirm or refute if a patient has suffered a total rupture.  This would usually be by way of a scan or a referral to the fracture clinic so that the patient can be examined by an Orthopaedic Surgeon.  There is some urgency in getting the diagnosis in an injury like this as repairs are easiest and most successful if carried out within 3 weeks in which case the patient will usually recover 95% of their original strength.  A referral to physiotherapy would be inadequate when the nature of the injury has not been confirmed.

A formal Letter of Claim setting out our allegations was sent to the Trust and a full admission of breach of duty and causation was admitted within the 4 month pre action protocol period in which the Defendants have to respond.  An initial offer of settlement was made in the sum of £10,000 however this was rejected because of the loss of earnings he had suffered in being unable to continue his door work.

Negotiations commenced and just before court proceedings were to be started the Defendants made a reasonable offer in full and final settlement of the claim.

The injury Mr B suffered is considered relatively minor.  He had a good degree of function remaining in his arm.  He was able to continue in his main employment and while being a doorman was no longer suitable for him, he was able to undertake other types of evening jobs if he wanted to in order to minimise his loss.  Therefore the element of the compensation he received for the actual injury was assessed at around £12,500 meaning that he recovered over £50,000 in past and future loss of earnings.

It is not uncommon for injuries considered less serious than others to attract higher awards of compensation because of the impact the injury can have on other areas of a person’s life.  Someone can have limited pain but they may suffer other restrictions in their life that they can be compensated for.

If you have suffered a similar injury, it is worth taking the time to get some from a specialist solicitor before dismissing it as being “not worth it”.  Our solicitors are more than happy to discuss this with you.

Ashleigh Holt, June 2019

Best Medical Claims Law Firm – Northern UK & Leading Specialist in Clinical Negligence Law 2019

I am delighted to announce that we have achieved another award recognising our achievements and specialism in Clinical Negligence in the North East of England. Armstrong Foulkes LLP were successful in being named the “Best Medical Claims Law Firm – Northern UK & Leading Specialist in Clinical Negligence Law 2019” in the inaugural SME Legal Awards. Confirmation of our award can be found at the SME News Website where the press release states

“The legal industry plays a significant role in the UK economy, not only in terms of employment numbers but their overall contribution to the national economy, exports and the UK’s trade. As such, SME News is proud to introduce the inaugural UK Legal Awards to its roster, with the intention to recognise and spotlight the very best that this innovative and competitive industry has to offer.

 As an independent awarding body, business size or reach are not the only deciding factors for our nominations. Rather we focus more on the quality of dedication and innovation within the work done and in forming positive relations with clients.

 Kaven Cooper, Award Coordinator discusses the success of this year’s programme: “It is with great pride that I present the winners of this prestigous awards programme. Congratulations to all my winners, and best of luck for the future.”  

SME News prides itself on the validity of its awards and winners. The awards are given solely on merit and are awarded to commend those most deserving for their ingenuity and hard work, distinguishing them from their competitors and proving them worthy of recognition.”

We pride ourselves on offering a “personal service” where you case is handled by experienced Solicitors practising only in this area of law and with our practice handling cases largely in the local area we can offer availability by in person to speak to your solicitor when required reinforcing our company motto of “personal care for medical claims”. We are honoured to be recognised as a leading firm in Clinical Negligence Law in our area.

Please do visit the SME Legal website for more details at https://www.sme-news.co.uk/2019-the-2019-sme-legal-awards-press-release for the press release and https://www.sme-news.co.uk/2019-armstrong-foulkes-llp for our award page.

As always do not hesitate to contact us and speak to one of our qualified solicitors on 01642 231110 on a no obligation basis if you have suffered medical negligence or have concerns about treatment you have received.

Joanne Davies – May 2019

Delay in diagnosis of ruptured oesophagus

In December 2015, Mr H underwent surgery to his left hand.  Afterwards, he vomited as a result of the anaesthetic he had been given, experienced a lot of pain and then began to vomit blood.  He was given an anti-emetic (to stop him being sick) and pain relief.

Over the next few days his condition deteriorated and he was in a lot more pain.  An x-ray and CT scan were performed which showed he had ruptured his oesophagus.  Unfortunately, due to the delay in diagnosis, it was no longer possible to surgically repair his oesophagus and it had to be left to heal by itself.  However, Mr H required open surgery to insert a tube into his stomach through which he was fed for 4 weeks.  He then had to gradually reintroduce drinking and eating, firstly with water, then juice, followed by soup and finally a soft diet.

A few weeks after his discharge from hospital, Mr H had to be readmitted to hospital as his oesophagus had re-ruptured.  Once again, he had to be fed through a tube into his stomach.

The hospital admitted very early on that they should have diagnosed the ruptured oesophagus much earlier when, on the balance of probabilities, Mr H would have undergone surgical repair and avoided all the subsequent problems.  After negotiation between the parties, the case was settled for £45,000.

If you or a family member think you may have received substandard medical treatment and would like advice on bringing a medical negligence claim, please telephone us on 01642 231110 and one of our solicitors will be happy to advise you.

Kathryn Watson – May 2019

LIMITED TIME TO CLAIM- DON’T DELAY IN SEEKING ADVICE

A lot of people are aware, mainly from television and radio advertisements, that you have 3 years to bring a personal injury/clinical negligence claim.  This is what is known as the limitation period.  If you do not start court proceedings within 3 years of the allegedly negligent treatment, or within 3 years of when you suspected or ought to have suspected you may have received negligent treatment if that is later, you may be barred from bringing a claim.

What these adverts often do not make clear is what needs to be done before you will be in a position to issue court proceedings.  These adverts often relate to simple personal injury or road traffic claims.  Clinical negligence claims are by their very nature much more complex and the following steps need to be taken before we can issue court proceedings:

  • We need to obtain all of the relevant medical records.  Under the Data Protection Act 2018 (for living patients) and the Access to Health Records Act 1990 (for deceased patients), the holder of these records, such as the hospital or GP, has one month to disclose them to us.  Frequently the records are not disclosed to us within this time and we have to threaten or, in some cases issue, proceedings purely for a court order for disclosure.  If we need a court order, this can take several months to obtain.
  • We then need to obtain expert evidence on breach of duty (what if anything was done wrongly) and causation (whether this caused any injury).  The experts we use are at the very top of their field and so are usually very busy with NHS work, their private practice and other medico-legal work.  It is therefore not unusual to have to wait several months for a report but as cases stand or fall on the expert evidence, it is important we go to the right expert even if this results in some delay.  In a lot of cases, we need more than one expert to assist us in proving the claim.
  • Once we know what our allegations are, we need to put these to the Defendant under the pre-action protocol.  The Defendant then has 4 months to investigate and respond.
  • During this time, we need to investigate the long term effect the injury has caused and the value of the case.  This is frequently far from straight forward, particularly when someone’s prognosis is not yet known, often because they are still receiving treatment for their injury.
  • Should the Defendant make a reasonable offer of settlement once they have investigated the claim, court proceedings will not be necessary.  However, if they deny they did anything wrong or even if they admit it but make too low an offer, we will then need to issue proceedings.

People frequently contact us regarding a potential medical negligence claim only a few weeks or months before the limitation period expires.  This is completely understandable; they have often had a life changing injury which has monopolised their time and attention, lost a loved one which has taken some time to come to terms with, or sometimes they simply hope they will make a full recovery and so will not take matters any further.  Whatever the reason, these people have been through an awful time and 3 years can pass by very quickly.

Whilst these people have our utmost sympathy, we are unable to take on a clinical negligence claim if we do not have enough time to investigate.  Whilst there is the possibility of the Defendant agreeing to give us extra time to investigate or a Judge allowing the claim to be brought out of time, there is no guarantee we would be able to secure either option and ultimately the claim may fail, not because of the merits of the claim, but simply because it has been brought too late.

If you think you or a family member has been injured as a result of medical treatment, please seek advice as soon as possible.  Whilst the limitation period may not start as soon as the negligence occurred if you were unaware of it and had no reason to suspect otherwise, the 3 year period will start to run as soon as you suspected, or ought to have suspected, you may have received negligent treatment.  This is known as your “date of knowledge”.  You have 3 years from your date of knowledge to bring a claim, and this can range from the time the negligence occurred, if you were aware of it straight away, to several years later.

We appreciate that should you have been injured as a result of medical treatment, you and your family will have a lot to deal with without the added stress of a legal claim.  However, by the time you feel able to investigate the claim, it may be too late and you may be unable to secure compensation for your injuries.

Our solicitors try to make bringing a claim as easy and stress-free as possible as we understand that you will no doubt be going through a very difficult time.  If you would like advice about treatment you or a family member has received, please telephone us on 01642 231110 for some free, no obligation advice from one of our solicitors.

Kathryn Watson – April 2019

Amputation of the arm

Bill is a charming 78 year old retired seaman.  He fell at home and dislocated his left shoulder.  He went to hospital but didn’t receive the proper treatment.  The doctors failed to diagnose what is known as a false aneurysm.  This is where blood is left and then clots in an area where it shouldn’t be. In Bill’s case, the internal bleed was from his left shoulder into his left upper arm.

Over the following weeks/months his left arm became very swollen and painful.  When he was eventually referred to the Orthopaedic Surgeons, action was taken.  Unfortunately this was too late to save his left arm which had to be amputated at the shoulder.

His Consultant at the hospital was very honest with him and said that had he seen him sooner he probably could have sorted out the problem without the arm being lost.  We took the case on and secured an admission of blame from the hospital.  We settled the claim shortly after starting court proceedings.

Bill, whilst delighted with the settlement, like all injured patients, would have preferred to be fully able rather than have the compensation.

Hilton Armstrong – March 2019

Coronary disease misdiagnosed as tennis elbow

During the Christmas holidays Mrs A developed pain going down her left arm and pain from her right ear travelling down into her jaw, neck and top of her chest.  The pains would come and go in waves and would wake her from her sleep so when things did not resolve after a few days she attended a Walk in centre to see a GP.

The GP carried out an examination and diagnosed her as suffering from gastro-oesophageal reflux due to over indulgence in the festive period and tennis elbow for which she should take Paracetamol.

Mrs A’s symptoms continued and she began to feel worse.  She planned to make an appointment at her own GP practice when it re-opened but she was not afforded this opportunity and suffered a cardiac arrest at home in the meantime.  Her collapse was witnessed by her youngest child whose screams alerted Mrs A’s husband.  A 999 call was made and Mr A performed CPR until the Paramedics arrived.  Mrs A was taken to hospital but died a few days later.

Mr A approached us to investigate the standard of care that his wife had received from the GP who had seen his wife.  With the assistance of an independent GP expert witness and an independent expert witness in Cardiology we were able to establish that the GP had failed in his duty of care to Mrs A in not identifying that her symptoms could have a cardiac cause and to refer her urgently to hospital for investigations.  We were able to say that on the balance of probabilities, the results of these investigations would have been abnormal and lead to Mrs A being commenced on an acute coronary syndrome pathway including medication and stenting of blocked arteries.

With this treatment, she would have avoided the cardiac arrest and importantly she would have survived and lived to an old age.

Solicitors for the GP initially admitted breach of duty but denied that that the failure to refer Mrs A to hospital had made any difference to the outcome.  Formal Court proceedings then had to be started and the Defendants quickly made a full admission of liability for Mrs A’s death.

Mrs A had been the primary carer for her children while her husband worked and as a result the majority of the compensation claimed was for the loss of care and services Mrs A had provided to her family.  A 6 figure settlement was agreed between the parties and was  approved by the Court.

Acute coronary syndrome can be misdiagnosed as the symptoms, particularly in women, can mimic other conditions and can be atypical.  The consequences of failing to pick up on early signs can be catastrophic and as illustrated in this case, it can be fatal.  Early diagnosis and treatment is essential.

If you have suffered as a result of a missed or delayed diagnosis, we would be happy to discuss this further with you.

Ashleigh Holt – February 2019

Favourable changes in claims for surrogacy

As a firm we have previously acted for clients who have lost the ability to conceive and carry a child naturally as a result of medical negligence.  Until very recently our hands have been tied as to what our clients could claim for.  We have been able to recover as compensation the costs of IVF treatment and in some cases for our clients to engage a surrogate in the UK to carry a child on their behalf and the expenses associated with this but there are strict limits which reflect the current law in the UK which in turn have meant a limit on compensation levels.

Despite surrogacy becoming increasingly popular and accepted, the law in the UK has not quite kept up with this so while surrogacy is legal, it is also restricted, particularly when compared to the laws in other countries such as the USA.  Notably:

  1. In the UK no one can profit from surrogacy.  Therefore the surrogate can only claim her expenses.
  2. In the UK, once the child is born, the surrogate is regarded as the legal mother.  This is even the case where the surrogate has carried someone else’s biological child.  A court order is required to give the intended parents the correct legal status and it is possible for the birth mother to refuse to part with the child.
  3. In the UK, the surrogate will chose the parent/parents she wants to assist.  This is often done at “parties” which can be intimidating and frightening for couples who have already been dealt a vicious blow.

In the recent case of XX and Whittington Hospital NHS Trust (2017) EWHC 2318 QB, a High Court Judge held that XX’s claim for the expenses of using a surrogate in California where commercial surrogacy is widely accepted and legal were not recoverable because commercial arrangements in the UK were illegal and it was against public policy.  He therefore limited XX’s claim to using her own egg’s and a surrogate in the UK and the associated costs of that.  The total compensation he allowed for this was £74,000 which was intend to produce two children.

Despite the damning judgement, the Judge did suggest that the Supreme Court which is the final court of appeal in the UK may see things differently.  XX was therefore allowed to appeal this decision and the matter was heard at the Court of Appeal in November 2018.  The outcome was that her appeal was successful and it was held that she should not be barred from recovering reasonable compensation for her loss which would include the costs or entering into a lawful commercial surrogacy contract in California.  She would not be breaking any laws.

This is an exciting development in this area of the law.  Claimants from the UK who need to engage a surrogate can now claim the costs entering into a contract with a surrogate in the USA who essentially carries and gives birth to other people’s children for a living.  Claimant’s will now no longer be restricted to having to use their own eggs but will be able to use donor eggs from a surrogate of their choice or another donor and they will be able to return to the UK with the child legally theirs.

The obvious downside to this in terms of the “public purse” is the difference in cost.  In the USA, to produce two live births via a surrogate the associated costs will run into perhaps hundreds of thousands but to someone who has been told they will not be able to have a child, no amount of compensation can restore them to how they would have been but for the negligence.

If you have been affected by infertility as a result of failed or unacceptable medical treatment, please contact us to discuss this further.

Ashleigh Holt – January 2019

Court allows patient to seek further compensation should she develop progressive lung condition

LH suffers from asthma.  In 2006, when she was 13 during a PE lesson at school, she used her inhaler which had been in her pocket along with 2 earrings.  She felt a sharp scratch in her throat and began to cough badly.  She then discovered one of her earrings was missing and assumed she had inhaled it when she had used her inhaler.  She immediately went to A&E when she explained what she thought had happened.  The doctor treating her thought she had instead swallowed the earring.  No x-ray was performed, she was reassured and sent home.

Over the next few years her asthma worsened and in 2014, she underwent a chest x-ray as a result of her increasing problems which included shortness of breath and a persistent cough.  This x-ray showed the earring in her lung which had collapsed as a result.  Fortunately, the earring was successfully removed and LH’s symptoms improved.

The hospital very quickly admitted that a chest x-ray should have been performed when she attended A&E in 2006 and this would have revealed the presence of the earring in her lung.  They admitted it would have been removed and she would have avoided the deterioration in her asthma from 2006 to 2014, along with the collapse of her lung.

However, they denied the long term effects this incident has had on LH.  It was the evidence of our expert respiratory physician that as a result of this incident, LH now has a 25% risk of developing bronchiectasis, a progressive life altering lung condition which may affect her ability to work and care for herself.

LH had 2 options to compensate her for this risk.  Firstly, she could settle on a full and final basis for 25% of what she would receive if she did develop the condition (to reflect the fact there is a 75% chance she will be fine).  Secondly, she could settle the case on the basis that she will not develop the condition but reserve the right to return to court for further compensation should she go on to develop bronchiectasis.  This is known as provisional damages.  It was our advice that this latter option provided far greater security and ensured she would receive full compensation if the worst happened.

LH followed our advice and sought provisional damages.  This was resisted by the hospital for a long time but they eventually conceded and the claim settled shortly before trial for £20,000 and the right to seek further damages should she be diagnosed with bronchiectasis at any point in the next 25 years.

This case highlights that when a mistake has been made, the long term consequences are often unknown until a thorough investigation has been completed.  Here, LH was unaware there was any risk to her future health as a result of what had happened until we obtained evidence from an expert in respiratory medicine.

If you or a family member are concerned by medical treatment you have received and the potential effect it has had on you, please do not hesitate to contact us and one of our solicitors will be happy to advise you.

Kathryn Watson – January 2019

Top rankings again for Armstrong Foulkes LLP!

We are delighted that once again, we have received the top ranking in 2 prestigious guides to UK solicitors; Chambers & Partners and The Legal 500.  These rankings, which we have held for many years, are reviewed each year following interviews from clients and legal professionals with whom we work.

We are the only firm in the Teesside area to be awarded a Band 1 ranking for Claimant clinical negligence work by Chambers & Partners and we have also been awarded a Tier 1 ranking in The Legal 500.  We are described as a top-quality boutique with a superb reputation for complex clinical negligence claims and expertise in a wide range of matters”.  Our solicitors are praised for being “friendly, prompt when communicating and have really good specialist knowledge of their subject” and that “nothing fazes them and they obtain good results for their clients, who they place at the centre of each case.”

In these publications, Hilton Armstrong is described as “a tough and determined litigator” with “excellent judgement” who always explains matters clearly, is always approachable and keeps us informed as to what is happening and why.”

Joanne Davies is hailed for being “extremely meticulous” with clients reportedly being particularly impressed by the “very proactive, clear and understanding” way she handles claims.

Ashleigh Holt, who is described as being “experienced and intuitive” is applauded for conducting litigation “with exemplary vision and skill”. Interviewees report her to be “very organised, engaged with the issues and understanding of the situation.”

Kathryn Watson is also recommended with sources admiring “her knowledge and client service” with one client reporting “you can tell that she cares.”

We are proud to continue to hold top rankings in these two reputable publications and are gratified to receive such positive feedback, particularly from our clients as their opinions are what matter to us most.

If you or a family member have concerns about any aspect of medical treatment and would like no obligation advice from one of our solicitors, please do not hesitate to contact us on 01642 231110.

Kathryn Watson – December 2018

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 for the Husband and adult children in cases such as this can never reflect the true value of the loss.

Hilton Armstrong – November 2018

Hospitals are responsible for the advice given by receptionists! – Darnley v Croydon Health Services NHS Trust

The Supreme Court have this month ruled that incorrect information on waiting times at A&E given by a  receptionist at the Mayday Hospital, Croydon resulting in permanent brain damage could be considered negligent. The Court decided that it justified an award of compensation in the same way as incorrect doctor’s advice or treatment would.

Mr Darnley attended A&E with a head injury and feeling very unwell, only to be told by the receptionist that there was a 4 or 5 hour waiting time before he could be seen by a doctor. After waiting for 19 minutes and feeling very unwell he left unable to face the prospect of several hours wait. He was returned to hospital later that night as an emergency. He was diagnosed as suffering a large bleed on the brain and despite surgery he suffered permanent brain damage. He and his legal team argued that he been treated sooner or immediately on collapse he would have made a nearly full recovery.  He made a claim for compensation against the NHS Trust who run the hospital for the brain damage suffered and its effect on his life.

The A&E receptionists working there agreed that in this situation they would usually advise a patient would seen by a Triage Nurse in 30 minutes and/or would consider priority Triage but neither admitted to giving the mistaken advice. Mr Darnley argues that if he had been told this he would never have left hospital after 19 minutes and the bleed would have been diagnosed and treated sooner. When this was first heard by a Judge the claim was unsuccessful. It was appealed and the Court of Appeal ruled that it was not negligent for incorrect advice on waiting times to be given by the receptionist and that the injury was not caused by this in any event.

Mr Darnley then appealed this further to the Supreme Court who have this month ruled that a receptionist giving waiting time advice in an A&E department like this has a duty of care to the patients to act appropriately. They are responsible for the advice given in the same way any medical professional is. These receptionists/non-medical staff were given the role by the Trust as the first point of contact and owed a duty to the patients. They also stated that there was a direct link between this advice on waiting times and the injury he suffered as a result and that earlier diagnosis would have resulted in admission and earlier treatment with a nearly full recovery.

This is an important case as it establishes that incorrect advice from non-medical staff working for NHS Trusts, in particular an A&E receptionist, which results in an injury to a person could justify a claim for damages like any other compensation claim arising out of negligence by medical professionals. The circumstances of each case and whether the  advice caused an injury will need to be considered but if you feel you have been in a situation like this please do not hesitate to speak to one of our solicitors on 01642 231110 for a free no obligation chat.

Joanne Davies – November 2018

Failing to act on abnormal Echocardiogram leads to heart failure

Mr P was referred to a Consultant Respiratory Physician at James Cook University Hospital after developing shortness of breath and a cough in 2014.  Over the next 3 months the Consultant arranged a series of investigations including an Echocardiogram (Echo).  This showed Mr P had a mild left ventricular systolic impairment.

Mr P was told the Echo was normal and 3 months later he was referred to another hospital for a second opinion.  The referral letter requesting the second opinion advised that the  Echo was “normal”.

Mr P’s condition continued to deteriorate.  By March 2016 he was struggling with day to day activities.  He was unable to sleep as he was struggling to breathe when he lay down.  He could not make it upstairs to bed.  In May 2016 he attended a review appointment and his condition prompted his Consultant to admit him to hospital there and then for further investigation.  A second echocardiogram now showed significant left ventricular dysfunction and Mr P was told he was in severe heart failure.  His left ventricle was narrowed and his aorta was only working 15 – 20%.

Mr P’s care was transferred to a Cardiologist and he was started on a number of anti-heart failure medications.  He was initially unable to return to work as a HGV driver as his condition had to be reported to the DVLA and his driving licence.  It was later returned when a further echocardiogram showed that he was responding to the medication and his condition had improved.

We investigated the standard of care Mr P had received with an independent Respiratory Physician and Cardiologist.  They confirmed that he should have been referred to a Cardiologist following his first Echo and he would have been commenced on treatment 2 years earlier.  Had this occurred, the progression of his condition would have been slower and he would not have developed heart failure in 2016.

These allegations were put to the Trust and were admitted.  A financial settlement was achieved quite quickly for a 5 figure sum.  However, Mr P had lost 2 years of his and his young son’s life and his heart condition had been accelerated.

If you have suffered an injury as a result of a test or investigation being wrongly reported or interpreted and you would like to discuss this please contact us for free no obligation advice.

Ashleigh Holt – September 2018

Avoidable pressure injuries admitted by hospital as part of their duty of candour

Mrs P, an 80 year old lady at the time of treatment, developed severe pressure injuries to her heels and buttock whilst an inpatient at the James Cook University Hospital.  The pressure sore to her right heel was particularly serious, requiring multiple courses of antibiotics due to infection of the bone, hospitalisation, surgical debridement and taking 9 months to heal.

Initially, she did not consider that these sores may have developed as a result of substandard treatment.  However, the hospital adhered to their duty of candour which stipulates that medical professionals should be open and honest with patients and admit when something has gone wrong.  It was only after they told her they thought the sores were avoidable did she decide to contact us for advice.

We took her case on to investigate the standard of the nursing care whilst she was an inpatient.  Our nursing expert was critical of the nurses who had been responsible for Mrs P and identified a number of failings in their care, in particular failing to ensure adequate pressure relief by the use of repositioning and pressure relieving devices.  We then obtained expert evidence from a vascular surgeon on the effects of the injuries Mrs P sustained and he was also critical of the treatment she received from her treating doctors – she was suffering from leg ischaemia which required revascularisation surgery.  Had this been performed earlier, the injuries to her heels would have been avoided.

The hospital was slow to respond to our allegations of negligence and only did so once we were about to issue court proceedings.  They admitted liability and the claim was settled shortly thereafter for £25,000.

In this case, the hospital followed the duty of candour policy and informed Mrs P that, in their opinion, the injuries she sustained were avoidable.  Often, hospitals and doctors are not so forthcoming.  If you think you have suffered an injury as a result of negligent treatment, please contact us on 01642 231110 and one of our solicitors will be happy to advise you.  There is no obligation on you to pursue a claim and the initial discussion is free of charge.

Kathryn Watson – September 2018

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

Surveillance and Fundamental Dishonesty

Defendants in clinical negligence cases often challenge the claims we put forward on behalf of our clients, and in particular, assert that the injury has had a more minimal effect than we have alleged.  They can do this on the basis of their medical evidence (from the expert doctors they have instructed to assist them with the case) but also by surveillance.

A Defendant is entitled to investigate whether what a Claimant says about of the effect of their injuries upon their lifestyle is genuine.  Whilst they are entitled to do this in any case, in practice, they mainly tend to do it only when a person is severely disabled and their day to day activities are limited as a result.

In our experience there are 2 main ways in which they do this:

  1. Looking at a person’s social media presence, i.e. Facebook, Instagram, Twitter etc. A Defendant can ask a Judge to order a Claimant to provide copies of their posts, photographs etc. for them to consider.
  1. If we claim that a person is housebound, has problems walking, getting in and out of cars or needs help with shopping or doing things outside of the home, the Defendant may check to see if this is genuine. This could involve filming that person, for example, driving, attending the supermarket or at public events to see if the injuries and limitations are consistent what we have claimed.

The benefit to a Defendant if they can show a Claimant is not as badly affected as alleged is twofold.  Firstly, it will help them prove that the level of damages the Claimant is due is less.  Secondly, and more importantly, the Court has power to dismiss the entirety of a claim if it is satisfied on the balance of probabilities that the Claimant has been “fundamentally dishonest” in relation to any aspect of the claim.

This is nothing to worry about and certainly not a reason to avoid looking into bringing a medical negligence claim if you think you may have received substandard treatment.  The vast majority of Claimants are honest and accurately report their symptoms and the effect any injury has had on them.  However, it is something to bear in mind if you are bringing a claim, especially if you are thinking of trying things you previously thought impossible.  In this situation, we would ask that you keep us informed so we can make sure that the Defendant and our experts are aware of it. If you find these changes last for just a short period of time, it will prevent a situation where the Defendant believes they have evidence that you are more able than we have previously stated.

If you would like to discuss this further or think you may have a claim for medical negligence and would like some advice from one of our solicitors, please contact us on 01642 231110.

Kathryn Watson – April 2018

Another excellent rating for the Firm – Band 1 in Chambers & Partners!

I am delighted to announce that following on from our Tier 1 rating in Legal 500 (see article 01/11/2017) we have been again awarded the highest rating (Band 1) for excellence in clinical negligence work in the Teesside area. This rating is given by a prestigious guide to UK Lawyers entitled “Chambers & Partners” where we are described as a “Specialist boutique with a superb reputation for handling complex clinical negligence claims”. These ratings are reviewed annually and based on interviews with our clients and barristers with whom we work and the feedback they give on our solicitors and the firm in general.

Our 3 partners were singled out for praise for their work, Hilton Armstrong is described as “very friendly, very approachable; he’s lovely to deal with”, Joanne Davies (neé Dennison) is “very reliable, very bright and always gives me the information I need” and Ashleigh Holt is praised for the way she handles a range of complex clinical negligence matters.

One client stated “They have made it very easy for me, and have taken a lot of stress away”. This alone makes us feel we are doing our job well as our priority is always our clients and ensuring that what can be a difficult experience is as stress free as possible. We are, however, equally proud when recognised for the hard work we do on our clients’ behalf and this ranking is a reflection of the dedication of the entire team from our admin staff to the Partners. If you would like any information on this please do not hesitate to contact us or read the review for yourself using the link below.

https://www.chambersandpartners.com/16346/140/editorial/1/1

Joanne Davies (neé Dennison) – March 2018

Bereavement Damages – a long overdue change on its way?

There is a fixed amount of money that is awarded to certain close relatives when someone dies in an accident.  It applies to medical claims and other accidents when someone else is proved to be at fault.  The sum is fixed by Parliament and is currently £12,980 and is called a ‘bereavement award’.  It is Parliament’s financial assessment of the amount of money needed to compensate you for your grief and suffering from losing a loved one.

However, injustices have arisen (not only because the amount is small) but also because the people who are entitled to claim is limited by Parliament in the Fatal Accidents Act 1976.  Surviving spouses (or civil partners) and the parents of children under 18 years of age are the only two groups who are eligible.  If you are cohabitees or a parent of a child over the age of 18 you are not entitled.  As about 17% of couples now living together are either not married or in a civil partnership it affects a lot of people.

Some of this injustice may be remedied shortly.  A recent Court of Appeal case (Smith –v- Lancashire Teaching Hospitals) has declared that to exclude cohabitees is not compatible with the Human Rights Act 1998.  What does this mean?  Sadly nothing for Miss Smith but there is now a hope that Parliament will look again at its definition of who can claim and extend it to cohabitees.  However, with all things Brexit preoccupying the Government I am not hopeful this will be sorted any time soon.

Hilton Armstrong – December 2017

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

Fixing the amount of Costs in Clinical Negligence Claims

Our solicitors and indeed the profession have awaited with some dread Lord Justice Jackson’s review of costs in civil matters which includes clinical negligence claims. It was suggested that there should be a fixed amount of costs allowed for claims up to a certain value, whether it is a contract dispute, a neighbour dispute or a complex clinical negligence claim. This was worrying because this took no account of the very individual nature of clinical negligence claims, where each claim, like each person is very different. Two people could, for example, have suffered the same mistake or be misdiagnosed with the same condition but the reasons for this, the investigation and the effect on them can be completely different needing an individual approach to each claim. It was always our view that a “one size fits all” system would only lead to people being denied the thorough investigation they deserve.

The costs paid by the defendant that the media and the NHS repeatedly complain are too high and who portray solicitors as “bleeding the NHS dry” are not a “windfall” for solicitors as has been claimed. They include the costs of multiple medical experts whose involvement can in large value cases cost tens of thousands of pounds and the fees for specialist barristers to advise on the case and represent the Claimant at Court. Cases proceeding to Trial involve solicitors’ costs for work over generally 3-6 years, some even longer. Limiting costs available to pursue a claim can, in our opinion, only result eventually in being unable to properly investigate a claim. Being denied the opportunity to fully investigate and subsequently being denied justice could result in the loss of the much needed compensation that allows those injured to live with the effects of the negligence and improve their life.

Lord Justice Jackson’s review, published in July, has recommended many changes and has thankfully rejected a “one size fits all” system. However the most significant proposal for the work we do is to suggest limiting the level of costs for Clinical Negligence work in cases with a value of up to £25,000. At each stage in the case there will be a fixed amount of costs available. This is not ideal and will include cases which are very complex and emotional to investigate but lower in value such as errors causing the deaths of children. It remains to be seen how or when this process will be finalised and there is a lot more work to be done before then but it is clear there will be implementation in the future of a fixed amount of costs to some clinical negligence cases.

Here at Armstrong Foulkes our solicitors are always available to discuss a potential case and advise you of your options irrespective of the value or level of injury. Please do not hesitate to contact us for a free no-obligation chat on 01642 231110.

Joanne Davies – September 2017

Why choose a specialist?

If you are looking for a Solicitor to handle your medical claim, then you will probably do the following:

  1. Search the internet.
  2. See an advert in your local paper or on TV.
  3. Listen to a friend, relation or colleague.
  4. Contact your family Solicitor.

Nowadays, lots of Solicitors are doing Clinical Negligence work but that does not mean they are specialists.  They are turning their hand to it because they are short of work.  Their adverts are very good and they will promise you the world: e.g. “we expect to settle your claim within 6 to 12 months” or “we have successfully recovered compensation for thousands of injured people” and so on.  This is all rubbish.

So, why should you go to a specialist like us?  There is only one reason:

Would you be happy if a Neurosurgeon was going to remove your appendix, or if an Orthopaedic Surgeon operated on your brain?  Both are very competent in their own field but you would be a fool to trust them if they strayed out of their area of expertise – so why do it with your medical claim?

We only deal with medical claims for injured people on Teesside and in the North East.  We have years of experience which enable us to get you the best result for you, both in terms of compensation and answers.

We have national recognition and are listed in Chambers and The Legal 500:

Ring us today at 01642 231110 and we will tell you if you have a claim worth pursuing.  You will speak to an experienced Solicitor who will give you straightforward answers.

Hilton Armstrong – February 2017

Chambers & Partners 2016 – Highest Band 1 ranking retained

We are proud to announce that Armstrong Foulkes LLP has retained its status as the only Band 1 recommended firm dealing with clinical negligence for injured patients in Middlesbrough and surrounds in the 2016 edition of Chambers and Partners which was published at the end of last year.  The ranking, which is the highest accolade awarded by Chambers and Partners assessed things which matter to our clients such as our technical legal ability, our professional conduct, our client service, our diligence and our commitment among other qualities most valued by clients.  Comments included:

“They specialise in clinical negligence work. They know what they are about and get good results for their clients.”

“They are very compassionate, the communication is excellent and they are extremely efficient and in-depth in their research.”

In addition, all three of our Partners – Hilton Armstrong, Joanne Dennison and Ashleigh Holt – were also ranked in the prestigious guide which identifies and ranks the most outstanding law firms and lawyers around the world.

Ashleigh Holt of Armstrong Foulkes LLP said “By achieving this ranking we feel very proud to be able to represent injured patients in the Tees Valley and surrounding areas and to continue to do our very best for them.”

Ashleigh Holt – January 2017