Tag Archives: Lexcel

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

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

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

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

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

Dan Richardson in the Red Bull Soapbox Race 2017

For the second time in two years a team of my friends and I were lucky enough to take part in the Red Bull Soapbox race held at Alexandra Palace in London.

Out of the over 4,000 teams that applied 70 were chosen to take part in the day. On the race weekend we lined up next to some fantastic soapboxes, including a Harry Potter inspired motorcycle and sidecar, a giant Donald Trump in a bathtub and my personal favourite, a pair of raptors from Jurassic Park! The quality of design and construction of some of these soapboxes was outstanding.

Our soapbox was built from scratch and inspired by the Mad Max films. While we were all very happy with how the soapbox tuned out, in hindsight our heavy and thick costumes may have been a little warm for a hot summer day spent out in the sun!

Although we took part in the race back in 2015 we are sure that the track must have somehow gotten steeper, and the jumps bigger, in the last 2 years. Particularly daunting this year was a water jump, the first jump on the course and for many teams the only one they got to.

Despite the obstacles both my co-driver and I got to the end of the track in one piece, although unfortunately the same can’t be said for our soapbox, which chose to disintegrate spectacularly on the way down, I am sure adding to the thrill for the spectators!

Now it’s back to the drawing board for 2019’s idea……..

Dan Richardson, August 2017

[“All Dan’s colleagues here at Armstrong Foulkes were very proud, thrilled and a little scared as we watched video of him fly down the course, dodging obstacles in a disintegrating soapbox! However, like the trooper he is, despite being a little bruised and banged up he was straight back in the office and is already planning for next race! Well done Dan” – Editor]

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Pressure sores whilst in intensive care

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

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

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

Kathryn Watson, August 2017

Wrongful removal of a testicle

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

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

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

Hilton Armstrong – June 2017

How to complain about the medical treatment you have received

Many people contact us because they would like to complain about the medical treatment they have received but are unsure how to go about it.  Alternatively, they may not wish to complain but would like more information or answers to questions they have not had the opportunity of asking or have done so and have not received adequate answers.

You are entitled to complain/ask questions about the treatment you have received.  We advise you send a letter to the Chief Executive of the Trust if the treatment was provided by a hospital or district nurse and to the Practice Manager of your GP practice if it was provided by a GP or practice nurse.  Complaints should normally be made within 12 months of an incident or of the matter coming to your attention.  However, sometimes people understandably don’t feel up to making a complaint so soon after, particularly following a bereavement or serious injury.  If more than 12 months have passed since the subject of your complaint, it may be useful to explain in your letter why you are only able to write the letter now and this may encourage the provider of the treatment to investigate your complaint in any event.

The letter of complaint should set out briefly the background to your complaint and then we recommend you make a list of numbered questions that you would like answering.  This will then enable the investigator of your complaint to respond to each question in turn.  Upon receipt of the complaint, the provider should acknowledge and initiate an investigation.  Once their investigation is complete, which may take some time if it is a complex matter, they will either provide you with a written response or invite you to attend a meeting to discuss the matter further.  Whether you choose to attend the meeting or not is entirely up to you and what you feel comfortable with.  If you do go to a meeting, we advise you to ask for minutes or a recording of the meeting.

Once you have the provider’s response to your complaint, you are entitled to ask further questions if you think the response fails to address all the issues.  If you are not happy with the way the complaint has been dealt with, you can take your complaint to the Parliamentary and Health Service Ombudsman, which is independent of the NHS.  They will then look into the matter further for you.

Solicitors are unable to get involved with the complaints process as it is separate from a legal claim.  However, if you suspect you or a family member has been injured as a result of medical negligence and you have made a complaint and would like to know what to do next, or if you would like advice before making a complaint, please do not hesitate to contact us on 01642 231110 and one of our solicitors will be happy to talk to you and provide advice on how best to proceed.

Kathryn Watson – May 2017

Increase in the value of claims with future losses – An explanation for our clients

There are several elements to calculating the right level of compensation. It is usually made up of awards for:

  • Pain, suffering and loss of amenity

Your injuries and their effect on you

  • Financial expenses incurred.

Anything you have bought or paid for as a direct result of the negligence, for example prescription or medication charges, travel expenses and loss of earnings.

  • Future anticipated losses.

These are any losses you will likely suffer in future as a result of the negligence such as ongoing medication charges, regular private treatment, annual fees for something you require or ongoing loss of earnings. They can also be one off future losses or losses recurring every 10 years in the future.

To calculate the future losses there are set formulas that all lawyers use. For future losses you take the likely future expense and multiply it by a figure known as the “multiplier”.  All lawyers use actuarial tables known as the “Ogden Tables” to work out the “multiplier” as you cannot simply use the amount of years the loss is expected. There are many different types of tables and of future loss but if we look below in general terms at a recurring loss for a set period you will see how the situation has changed in March in favour of the person claiming compensation.

When compensation is paid at trial you would receive “in your hand” the future financial cost of the expense, therefore if you were to suffer, for example, an annual medication cost of £100 for the next 34 years the calculation should not be £100 x 34 years = £3,400. The reason for this is that if you were to get £3,400 now you could in theory invest this and end up with more than the loss would have been at the end of the 34 years. The purpose of compensation is to put you back to where you would have been had it not been for the accident/incident/negligence therefore having more than your loss at the end of 34 years would be considered a windfall and against this principle. For this reason the figure of 34 is discounted to allow for the fact you could invest it and it could grow.

As mentioned above these discounted figures are set out in the Ogden Tables used by solicitors to calculate the position correctly. From 2001 until 19th March 2017 all “years of loss”,for example, were discounted by 2.5% to provide the correct “multiplier” or figure to times the ongoing or future loss by.

From 20th March 2017 the figure to use to discount the future loss has changed. Now instead of discounting by 2.5% in the above 34 year example it will be discounted by -0.75%. This is an incredible change and significantly increases the total figure. 34 years annual loss in this situation which at 2.5% discount was 23.01 years totalled £2,301. This becomes 38.75 years at -0.75% discount totalling £3,875. This is more than the anticipated loss at £100 per year for 34 years. Any claim with future losses has now increased in value. In some claims the increase is dramatic by hundreds of thousands of pounds.

Understandably this has not been popular with Defendants and we all accept that this is likely to alter again. The likelihood is that it will change to something which will still potentially mean a discount to the years claimed but one more likely to be balanced by investing the money and returning you to the position you would have been in, had the negligence never occurred.

This is a complicated issue but our solicitors always aim to explain in detail why and how they are claiming losses for you. If you think you may have a claim for compensation and in particular for future loss do not hesitate to call us and speak to one of our specialist clinical negligence solicitors on a free, no obligation, basis.

Joanne Dennison – March 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

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

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

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 www.middlesbroughtherapy.org and www.teessideblind.co.uk

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 www.middlesbroughmstherapy.org

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 www.teessideblind.co.uk

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