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Case Studies

Cerebral palsy due to negligent delays

In March 2004 Frances consulted her GP who confirmed she was pregnant, and she was referred to North Middlesex University Hospital NHS Trust, Edmonton, for anti-natal care. Frances’s pregnancy was relatively uneventful and she went two weeks overdue.
By 15th December 2004, she was admitted to hospital for labour to be induced. There was soon signs of foetal distress, as the baby’s heart rate soared, but there were delays in delivery. On 16th December, Frances delivered with the aid of forceps after an attempt to deliver by ventouse had failed. The baby, Jonathan was in a poor condition after his birth and required special ventilation in intensive care for two days. Brain scans were taken and they showed damage to the brain caused by a lack of oxygen. Once his condition stabilised, he was discharged home.
Jonathan experienced a number of problems and a paediatrician diagnosed that he was suffering from quadriplegic (four-limb) cerebral palsy with global development delay.
Frances was concerned about how long it had taken to deliver Jonathan and she instructed Alsters Kelley to investigate a birth injury medical negligence claim. We obtained independent expert evidence, which criticised the standard of care and the delay in delivery. Following negotiations, the hospital admitted that Jonathan should have been delivered earlier (a full hour and six minutes before he was actually delivered) and that his brain injury would have been avoided if the negligent delay in delivery had not occurred.
Jonathan is now unable to walk or stand unaided, or sit unsupported. He has significant speech and communication problems.
Further investigations now need to be made to value Jonathan’s clinical negligence claim. Due to the severity of his injuries, requiring life-long care, therapy, equipment and accommodation, this will be a multi-million pound claim. We have already obtained an interim payment of £50,000 to help pay for care and equipment while the case is ongoing and a further 6-figure sum has been requested.

Child's brain injury caused by untreated infection

Charlie was 16 days old when he was admitted to Plymouth’s Derriford Hospital with signs and symptoms of an infection, caused by Group B Streptococcus. Charlie developed septicaemia and meningitis and there was a delay in treating him with antibiotics. Sadly, this resulted in a brain injury.
Charlie is now 9 years old and has severe behavioural problems, is clumsy and poorly co-ordinated. He has severe learning problems and is dependent on others for all elements of daily living. He also suffers from epilepsy and has a very poor sleep pattern.
After obtaining Public Funding (Legal Aid), detailed investigations and negotiations led to an admission of liability. Plymouth NHS Trust admitted negligence in not treating Charlie in time. An interim payment of damages was obtained in order to purchase a suitable property for Charlie, and to pay for adaptations and a care package. Once Charlie is old enough to assess his long-term needs, his claim will be settled in full.

Delay in diagnosis of wrist fracture

Whilst playing football John fell on to his outstretched right hand. The hand remained painful the following day so he attended A & E at the local hospital in Coventry. After being seen by a doctor, it was concluded that although his hand was tender, there was no bony injury. It was suggested tubigrip, painkillers and RICE (rest, ice, compression and elevation) should be used to ease the pain and promote healing. No x-rays were taken.
Approximately a year later, John returned to the GP with pain and ongoing problems. He was referred on to a physiotherapist, who suggested that John should undergo x-rays. Fifteen months after the accident, x-rays confirmed a fracture of the scaphoid (the largest bone beneath the thumb and above the wrist). An arthroscopy and MRI followed ten months later and revealed avascular necrosis (bone death through lack of blood supply) at the site of the injury, and displacement of the lunate - the bone next to the damaged scaphoid.
Nearly nine months after arthroscopy John underwent a partial fusion of the wrist. Although this did help him initially, pain and stiffness increased after 6 months. Nearly a year after surgery, John had to undergo a total wrist fusion. As a result he has no wrist motion and has reduced grip strength but is more comfortable.
Damages were sought on the basis that the initial diagnosis was wrong. The doctor at A & E failed to check the wrist for movement, pain and failed to request a series of x-rays. As a result a soft tissue injury was diagnosed and John was sent home with the fracture missed. The case settled for £50,000 which included a payment for John’s loss of earnings.

Dispensing error at pharmacy

A dispensing error made by a pharmacist resulted in physical harm to a patient who had been given the wrong drug to treat blood pressure.
Brian suffers from a heart condition and high blood pressure, which had been treated over the course of 20 years with combination tablets. It was only in the last 18 months that his GP found an effective combination to minimise side effects. Brian regularly attended the pharmacy to collect repeat prescriptions. Instead of being dispensed Amiloride Hydrochloride, a blood pressure reducing medicine, the parmacist negligently dispensed Amlodipine. Brian did not notice the error and took the wrong drugs. After ten days he began to feel unwell with breathing problems and muscular aches. He developed chronic pain and inflammation in both feet.
He returned to the GP a month later where front of house staff did not recognise the error made by the pharmacist. Upon Brian’s return home he read the packaging note and realised the wrong medicine had been prescribed.
The head pharmacist sent a letter of apology, admitting the error.
Brian suffered unpleasant side effects as a direct result of the mistake made by the pharmacist in dispensing the wrong drug. Thankfully, the symptoms were not long-lasting and he made a complete recovery within a short period of time. He brought a clinical negligence claim against the pharmacist and his claim settled quickly for the sum of £1,500.

Failed sterilisation operation

In April 2008, Penny underwent a laparoscopic clip sterilisation to prevent pregnancy. The specialist registrar who performed the surgery documented that an uncomplicated procedure had been performed.

However, in October 2009 Penny found to her surprise that she was pregnant. A subsequent scan showed that she had conceived 17 months after the sterilisation procedure. After deciding to continue with the pregnancy, a further scan showed a missed miscarriage at 7 weeks and 4 days and so Penny underwent a suction evacuation of the uterus.

Following the failed sterilisation and the subsequent miscarriage, Penny was reviewed in January 2010. The consultant who then took over her care looked through the photographs of the original sterilisation procedure and noticed that there was a problem with the clip placement on the left fallopian tube, which had not been placed across the fallopian tube, but above it.

Penny opted to undergo another sterilisation, which was performed in June 2010.

Penny broughtaclinical negligence claim against Royal Devon & Exeter NHS Foundation Trust for the failure to correctly perform the operation in the first instance. As a result of the negligence, Penny became pregnant, suffered a miscarriage, underwent two unnecessary operations under general anaesthetic and suffered psychologically. Despite no admission of liability, the case was settled for £6,250.

Failure to diagnose brain tumour

Claire suffered from tinnitus and head pains and after a visit to her GP in 2006 she was referred to the ear, nose and throat(ENT) department. An MRI scan was conducted in 2007. The report confirmed the presence ofa schwannoma (tumour of the nerve which connects the ear to the brain)but then concluded thatthe scan was normal.The ENT consultant simply read the conclusion and not the rest of the report so Claire was discharged with no further follow-up.

Claire’s symptoms continued and a year later, she returned to her GP and was re-referred. Deterioration in her hearing was noted and the error on the reporting of the MRI scan was picked up.

A month later, Claire was referred to the hospital and underwent repeat scanning, which showed an increase in the size of the tumour of 4mm by 5mm. She subsequently underwent gamma knife radiosurgery to remove the tumour.

Aclinical negligence claim was brought againstUniversity Hospitals Coventry & Warwickshire NHS trustfor failing to diagnose the schwannoma on the MRI scan in 2007. The delay in diagnosis meant that the hearing loss was no longer amenable to treatment with a hearing aid andClaire also sufferedsymptoms of dizziness, head pains and balanceproblems, which prevented her from working.

The trust accepted the negligence but did not accept that the delay caused all of Claire's ongoing problems.The case was settled for £125,000.

Failure to diagnose foot fracture

On 14 February 2007, Julie was attempting to move a wardrobe down a set of stairs when it slipped and landed on her left foot and lower leg. The foot and lower leg became swollen, bruised and painful and did not improve over the next few days. She decided to attend A&E at George Eliot Hospital on 17 February 2007.
The doctor who saw her recommended anti-inflammatory medication and ‘RICE’- rest, ice, compression and elevation. He said to return if symptoms got worse or if she had any concerns. No x-rays were taken.
Julie attended her GP surgery on 23 February 2007 for a medical certificate and the doctor said that it was likely she had a sprain to her left ankle. The pain and loss of movement continued and Julie therefore returned to see her GP on 16 April 2007. He felt it was a soft tissue injury and that it would recover.
Throughout the summer, Julie continued to have problems with her foot and returned to her GP for a fourth time on 2 August 2007. He finally referred her for x-rays.
X-rays were taken on 3 August 2007 and confirmed the diagnosis of a fracture at the talo-navicular joint deep inside the foot. Julie was referred to orthopaedic outpatients and was seen on 26 September 2007. A CT of 3 December 2007 revealed secondary degeneration as well as the old fracture. To control the pain, Julie had to have a steroid injection on 8 January 2008, which brought temporary relief from pain but her symptoms returned and she continues to have persistent pain from her left hindfoot, which limits her mobility.
The failure to diagnose the fracture on 17 February 2007 was found to be negligent by an independent expert. As a result of the delay in diagnosis, Julie continues to suffer with pain and mobility problems. She was awarded £18,000 in damages.

Failure to intervene in pregnancy

This was Sam’s first pregnancy. At her 34-week scan, she was told that her baby was in the breech position. She was told to return for another scan at 36 weeks. At the 36-week scan, it was confirmed that the baby was still in the breech position. It also showed a reduction in amniotic fluid, which led to a Doppler scan being undertaken. This showed a change in blood flow around the placenta. Sam should have been immediately referred to the consultant obstetrician, as these findings were a real concern.
Sam soon developed abdominal pains and went in to hospital where it was confirmed that her baby had died. The failure to ensure that Sam was referred to an obstetrician after the findings of the 36-weeks scan was considered to be negligent. The pregnancy should have been closely monitored, so that an earlier delivery could have been carried out, before the baby died. As a result of the failure to provide an appropriate standard of care both Sam and her partner suffered psychologically. They pursued a claim against University Hospital in Coventry, which settled out of court for £55,000.

Failure to treat baby's eye condition

Sara was born on 6 April at 28 weeks and two days gestation and was admitted to the Neonatal Unit at Ealing Hospital. She had some initial problems as a result of her prematurity but was discharged home on 6 June 2005.
In babies who are born prematurely, there is a known risk of sight problems, so they must be monitored carefully and treated. This condition is known as retinopathy of prematurity or ROP. Unfortunately, no system of monitoring Sara was put in place.
Sarah was brought back to the outpatient clinic on 4 July and a referral was made to a consultant ophthalmologist. The referral asked for an appointment in the near future but by the next outpatient review on 2 August, an appointment still had not been fixed. She wasn’t seen by the ophthalmologist until 10 August 2005 where he found that there was a poor visual response. Retinal detachments were diagnosed and Sara underwent treatment at Moorfields eye hospital. Sadly she has been left with a significant visual impairment, and is registered blind.
Following investigations into the case, Ealing Hospital and Great Ormond Street Children’s Hospital accepted there had been a failure to provide ROP screening for Sara, which should have been undertaken 6-7 weeks after birth. This would have picked the problem up early enough to save Sara’s sight. Sara’s case will be settled once she is old enough to have her sight fully tested and the impact on her life assessed.

Failure to treat high blood pressure

Andrew had suffered with polycystic kidney disease (PKD) for a number of years. A consequence of suffering from this disease is high blood pressure, which needs to be carefully monitored and controlled.
Andrew was employed by the Ministry of Defence (MOD) in the Royal Navy as a weapons engineer. The MOD was aware of his diagnosis of PKD. From 1990 onwards, Andrew was seen regularly by different medical professionals at the Royal Navy Hospital, Haslar. Consistently high blood pressure readings were noted, but his blood pressure was not adequately controlled and there was a failure to refer him to the nephrologists (doctors with expertise in PKD). He was eventually referred in February 2002 to the Plymouth Hospital NHS Trust, but was not given an appointment until December 2002.
As a result of failing to treat the hypertension, Andrew suffered a massive stroke on 11 September 2003, which left him with severe and permanent disabilities. It was admitted by the MOD and two hospital trusts that treatment was negligent and that the devastating consequences of the stroke would have been avoided with appropriate care.
A claim was made for the huge financial impact of the negligence, as well as for the catastrophic injuries suffered by Andrew. Claims were made for loss of earnings, care and therapy costs, single-storey accommodation, aids and equipment. The case settled out of court for a lump sum payment of £1,100,000; plus an annual payment for life at an average of £122,000 per year, which will be used to pay for Andrew’s care.

Failure to treat wrist fracture effectively

On 26 January 2006, Elizabeth fell down the stairs at home. She was taken by ambulance to Hereford Hospital A&E, where she was x-rayed. She was diagnosed with fractures in her left wrist and right thumb. The wrist was manipulated and plastered in a back-slab and she also had the thumb on the right hand plastered.
On 2, 9 and 16 February 2006 Elizabeth attended the outpatients fracture clinic when x-rays were taken. These showed a gradual deterioration, with the fracture starting to displace. No further treatment was recommended. On 16 February the plaster on the right hand was removed and on 2 March the left plaster was removed. X-rays were taken and she re-attended on 4 May 2006 when she was advised her recovery was reasonable and she was discharged.
Attending physiotherapy for 4 weeks, Elizabeth’s condition didn’t seem to be improving, with the wrist remaining painful, stiff and weak. Her rheumatologist referred her for more physiotherapy much later, in July 2008. X-rays were taken again and it was advised physio would not help due to the position her wrist was in. She was referred on to an orthopaedic consultant in Hereford.
Elizabeth saw the consultant on 23 September 2008. He advised that the wrist was displaced and that she would need further surgery, which would involve fusing and plating the wrist.
The Hereford Hospitals NHS Trust admitted negligence in failing to recognise that the fracture was displacing on 16 February, 2 March and 4 May 2006. Our expert advised that remedial action should have been taken in the form of a manipulation and stabilisation by the insertion of k-wires. If this had been carried out, the wrist would have healed normally. As a result of the failure to treat the displacement, Elizabeth is left with a painful and weak wrist, but has decided not to proceed with the wrist fusion for now. The case settled for £40,000.

Foot drop following hip operation

In October 2002 Julie was referred to the orthopaedic department of Coventry Hospital with osteoarthritis in both hips, worse on the left. She was advised that she would require a total hip replacement on the left side.
On 24 March 2003 Julie underwent the procedure on her left hip and made a full recovery.
Due to a deterioration in the right hip, Julie was advised to have a hip replacement on that side and the operation went ahead on 14 October 2003. Immediately after the operation, Julie noticed problems moving her right foot upwards (towards her shin), otherwise known as ‘foot drop’.
The foot drop continued after she was discharged and Julie was diagnosed with sciatic nerve palsy. She was referred to a physiotherapist but when no improvement was made, she underwent a tendon transfer operation on 14 October 2005. This did not improve matters and as a result, Julie was left severely disabled. She continues to suffer from pain in her right leg, muscle wasting, altered sensation, curling of her right toes and foot drop. Her mobility is poor as a result.
Foot drop can be a recognised complication of hip surgery, as the nerves around the hip can be damaged non-negligently during the operation. However, the evidence seemed to show that the nerves were damaged lower down, around the knee, which the experts felt must have been caused negligently by positioning or gripping during the operation.
A clinical negligence claim was pursued on behalf of Julie. The case was strongly contested but eventually settled for a five-figure sum.

Negligence in causing damage to sperm

We have acted for a number of individuals who have suffered damage to sperm in storage at University Hospital’s Centre for Reproductive Medicine.
Males who are diagnosed with cancer and are to be treated with chemotherapy and radiotherapy are given the option to produce sperm samples prior to treatment, to enable them to have the opportunity of having children in the future if the treatment makes them infertile. The sperm samples are frozen and stored in specialist freezers at the Centre for Reproductive Medicine.
Storage of sperm is governed by the Human Fertilisation and Embryology Authority (HFEA) and for those patients who have sperm stored for medical reasons there are strict guidelines on how the sperm should be stored. The samples should be split across two storage vessels and all vessels should be alarmed to ensure they cannot be switched off and suffer a drop in temperature without it being noticed.
University Hospital contacted a number of patients to advise that there had been a critical incident and that one of the freezers containing sperm samples had been inadvertently switched off. The fluctuations in temperature meant the samples were no longer viable. A number of individuals have brought cases against University Hospitals Coventry and Warwickshire NHS Trust for failing to have a system in place to prevent freezers being switched off and samples damaged. Some people have now lost the opportunity to father their own children and have suffered psychological damage as a result.
Cases vary in value but generally settle for 5-figure sums.

Severe burns due to extravasation

James was diagnosed with leukaemia aged six. As a result he attended Walsgrave Hospital, Coventry for chemotherapy. He was scheduled to undergo intravenous (IV) administration of vinicristine, a chemotherapy drug, and also to have a blood transfusion.
James complained of pain as soon as the IV cannula and the vinicristine was inserted but the administration of the chemotherapy drug was still completed. A blood transfusion at the site was, however, terminated and the cannula removed. James was sent home.
At home, his condition deteriorated and he returned to Walsgrave Hospital with a high temperature, swollen hand and a black mark where the cannula had been inserted. A plastic surgeon was consulted who confirmed that ‘extravasation’ had occurred. This is where the cannula is misplaced and the drug is inserted into the tissues rather than the blood stream, which is highly toxic and can cause severe burns.
James was transferred to Birmingham Children’s Hospital for further treatment of the hand. Necrosis (death of the tissues) was noted and he had to undergo surgery on 16 July. He went back on 24 August for a further operation to remove dead tissue from the back of his hand and three days later had a skin graft. Due to the severity of the injury, James had physiotherapy and occupational therapy and splints to help him flex his hand.
We obtained legal aid for James to bring a claim for clinical negligence, alleging that the hospital staff were negligent in misplacing the cannula and for not noticing it was misplaced and continuing with the drug administration. Liability has been admitted but settlement has been delayed as James required further surgery to try and improve the appearance and function of the hand.

Sight problems due to delays in treatment

Sam was diagnosed with type 2 diabetes in 1996, which was initially managed by his GP. Some years later he was referred to the Machen Eye Unit at Warwick Hospital. Diabetes can cause eye problems, known as diabetic retinopathy, which can lead to blindness if not monitored and treated. He was reviewed by the ophthalmologists who confirmed no treatment was required initially.
By July 2007 it was found that the left eye had some retinopathy but treatment was not commenced. Sam was not reviewed again until July 2008 and tests indicated that he had sight-threatening retinopathy. Still treatment was not started and in June 2009 his condition had deteriorated. He was advised that he would require some laser treatment to correct this and that an appointment letter would be sent out to him. There were some problems with the appointment letters and he did not re-attend until 15 July 2009. At this appointment further investigations were ordered, instead of starting the treatment, which was by now urgent.
Sam was finally seen for his first laser treatment on 24 March 2010, some 9 months after being advised that he had diabetic retinopathy and that he would require laser surgery by way of corrective treatment. He was told he would require further treatment in two week’s time but again, no appointment was received.
As a result of the delays to his treatment, on 14 June 2010, Sam suffered a haemorrhage (bleed) in his left eye. He attended the clinic for urgent laser treatment. By August/September Sam had two clots in his left eye and was given injections into the eye. He then suffered a bleed in his right eye in December 2010 and also a further bleed in his left eye in January 2011.
Sam had severely affected vision for many months but treatment has been fairly successful in restoring most of his vision. He lost earnings as a result of having time off work. Sam’s case was settled out of court following negotiations for £13,000.

Chemotherapy drug administered incorrectly

In June 2004, our client who was 5 years old was diagnosed with acute Lymphoblastic Leukaemia and chemotherapy was required as part of his treatment.
On 7th July 2004 our client was administered a particularly potent drug called Vincristine into his left hand and forearm. Unfortunately, instead of the drug being injected into the vein it went into the tissue, resulting in sustained, severe and extensive tissue loss to the hand and lower arm.
Since the injury, our client has undergone numerous procedures and operations to try to improve the functionality and appearance of the hand and arm.
However, although there has been some improvement, our client’s forearm remains shorter and thinner on the left side.
Overall, there is a 33% reduction in function of the hand and forearm, 20 – 30% reduction in grip power and continuing numbness and stiffness in the arm.
In addition to the physical injury, our client has been diagnosed as suffering from mild depressive episodes as they struggle to come to terms with the disability and Cognitive Behavioural Therapy (CBT) has been recommended.
Liability was admitted and the case was settled for £170,000.

7 Figure payout for birth mistakes

Our client was born at the North Middlesex Hospital in Edmonton, London in December 2004. He was delivered with the aid of forceps after an attempt to deliver by ventouse had failed.
He was in a poor condition at birth and required intubation and ventilation and was subsequently transferred and treated in the neonatal unit of the hospital.
Following his admission to the neonatal unit, our client suffered from seizures and required intensive care and ventilation for two days. His condition gradually stabilised and he was discharged home from hospital but he subsequently had feeding difficulties and showed early signs of cerebral palsy.
In April 2006, our client was assessed by a consultant paediatrician. The diagnosis made at that time was of quadriplegic cerebral palsy with global development delay.
Investigations into the circumstances surrounding our client’s birth began in February 2007. In June 2009, the Trust admitted that there was a negligent failure to deliver our client an hour and six minutes earlier than he was actually delivered and if delivery had occurred at the earlier time the resulting brain injury would have been avoided.
In July 2013, a joint settlement meeting took place and has been approved in a hearing in the Royal Courts of Justice. Settlement was a £3 million lump sum plus annual payments which increase with age, (although life expectancy is reduced due to his injuries) which equates to just under £6.5 million in total.

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Kiran Jalota
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Kiran's role is to recover necessary compensation for victims of negligence who have suffered physical and/or psychological injury & other consequential loss. Read more

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