Archive for March 2016

Parents to Receive Compensation for Failings in Community Psychiatric Care

The parents of a woman, who died from complications related to malnourishment, is to receive £7,500 compensation for failings in community psychiatric care.

In September 2012, Ruth Mitchell (40) was found dead on the floor of her flat in Plymouth due to complications related to malnourishment. The single mother had been under the care of Livewell Southwest (formerly Plymouth Community Healthcare) at the time, and was discovered in “squalid and impoverished conditions” with no furniture, curtains or floor coverings.

An investigation into Ruth´s death found that there had been a failure to formally review her situation in 2011 despite concerns about her “deteriorating self-care”, that Plymouth Community Healthcare had failed to assess Ruth for vulnerable adult status, and that a community psychiatric nurse´s response to Ruth´s deteriorating condition “did not go far enough”.

Ruth´s parents – Russell and Anne – complained to the Parliamentary and Health Service Ombudsman about the standard of care that had been provided for their daughter. The Ombudsman partially upheld their complaints – its report concluding: “There is not enough evidence for us to say whether Ruth’s death could have been avoided if she had received appropriate care, but opportunities to prevent her deterioration and death were completely lost.”

As a consequence of the report, Russell and Anne will receive £7,500 compensation for failings in community psychiatric care, while the nurse responsible for Ruth´s wellbeing – Joanne Campbell – faces a disciplinary hearing for the failure to maintain adequate records over a four year period and the failure to escalate safeguarding concerns, causing an “unwarranted risk” to a patient.

Speaking with the BBC after his claim for compensation for failings in community psychiatric care had been resolved, Russell Mitchell said: “Nothing can compensate for the loss of a child. We only really started this because we wanted someone to say sorry. My wife was particularly moved because she felt that Ruth couldn’t be the only one. We know it won’t bring our daughter back but it might help someone else’s daughter.”

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Claim for a Vasectomy on the Wrong Patient Likely after Errors Admitted

A claim for a vasectomy on the wrong patient is likely to be made against the Broadgreen Hospital in Liverpool following the admission of procedural errors.

In February 2014, the man – identified only as Patient A – was due to undergo surgery to have scar tissue removed, when he was brought into the operating theatre out of sequence and underwent a vasectomy procedure instead.

The error occurred initially due to changes being made to the operating theatre running order. The nurse responsible for the changes – Rosemary Tollitt – failed to advise colleagues of the changes or check Patient A´s identity as he was being taken into theatre.

However, the doctor in charge of the surgery – Dr Nanikram Vaswani – has admitted misconduct charges for failing to confirm the patient´s identity, not reviewing the patient´s medical notes and not following surgical checklists before commencing surgery.

Dr Vaswani has also admitted failing to inform the hospital authorities immediately after realising his error, and failing to keep notes of his conversation with Patient A after the operation – a conversation that led to an unsuccessful vasectomy reversal operation being attempted later in the day.

In addition to the procedural errors likely to be included in a claim for a vasectomy on the wrong patient, it is also the opinion of the General Medical Council that Patient A would not have been in an appropriate emotional state to give his informed consent for the vasectomy reversal procedure.

It is understood that Patient A has sought legal advice about making a claim for a vasectomy on the wrong patient against the Royal Liverpool and Broadgreen University Hospitals NHS Trust. A spokesman from the General Medical Council said that the man had been “physically and emotionally traumatised” by the experience.

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Settlement Agreed in Savita Halappanavar Medical Negligence Claim

An undisclosed six-figure settlement of compensation has been agreed in the high-profile Savita Halappanavar medical negligence claim in Ireland.

Savita Halappanavar died on October 28th 2012 at the Galway University Hospital – one week after attending the hospital´s Accident and Emergency department complaining of back pain. Savita (31) was seventeen weeks pregnant with her first child at the time, but doctors failed to consider she was suffering contractions prior to a miscarriage and sent her home.

Savita returned to the hospital later that day and was admitted following a correct diagnosis of her condition. Blood tests were taken that indicated she was about to lose her baby but, despite repeated requests, Savita was denied a termination due to the presence of a foetal heartbeat. Savita subsequently developed septicaemia due to E.coli ESBL – a strain highly resistant to antibiotics.

By Wednesday October 24th, Savita´s condition had deteriorated significantly. She was prescribed stronger anti-biotics and the decision was made to abort the pregnancy to save the mother as allowed by Irish law. Prior to surgery, it was found that the foetus´ heart had stopped beating and, during the operation to remove the foetus, Savita spontaneously delivered her dead child.

Savita suffered septic shock and was transferred to the hospital´s intensive care unit. Over the next few days she became critically ill as her organs started to fail and, on Sunday October 28th 2012, Savita suffered a cardiac arrest and died.

Savita´s husband – Praveen – made a claim against Ireland´s Health Service Executive for the death of his wife due to medical negligence. Ireland´s abortion laws forbid terminating a pregnancy unless the mother´s life is at risk. Praveen alleged that doctors at Galway University Hospital should have realised sooner that Savita´s life was at risk, and conducted the termination when it was originally requested.

Due to the complex nature of Ireland´s abortion laws, the Savita Halappanavar medical negligence claim attracted worldwide interest. Two investigations into the circumstances surrounding Savita´s death both found significant failings in the care provided by the hospital and, in April 2013, the inquest into Savita´s death returned a verdict of death by medical misadventure.

The date of March 10th 2016 was set for a High Court hearing into the Savita Halappanavar medical negligence claim, but the day before the hearing was scheduled to commence, the news broke that the claim had been resolved for an undisclosed six-figure settlement of compensation. It was also reported that both the Health Service Executive and Galway University Hospital had apologised for the failings in Savita´s care.

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NHS Litigation Authority Settles Claim for the Missed Diagnosis of Cancer

A woman from Swindon has received £50,000 compensation from the NHS Litigation Authority in settlement of her claim for the missed diagnosis of cancer.

In March 2009, the unnamed mother of two attended her GP complaining of a lump on the left side of her neck and a persistent dry cough. The woman was referred to the Ear, Nose and Throat Department of the Royal United Hospital in Bath, where she underwent a CT scan.

The scan suggested that the woman may have cancer of the lymph nodes, but the biopsy sample taken to confirm the result of the CT scan was insufficient for a full assessment to be conducted. A review of the scan concluded that there was no need to conduct another biopsy and instead the hospital carried out an MRI scan on her neck.

Following the MRI scan, the woman was diagnosed with “idiopathic vocal chord palsy” – a weakness of the vocal chords that manifests in a persistent dry cough and a hoarse voice. However, in July 2011, the woman returned to her GP with an increase in size of her left cervical lymph nodes, and pins and needles in her left arm.

The GP sent his patient for an urgent chest X-ray and ultrasound scan of her neck. This time the woman was diagnosed with metastatic breast cancer that had spread into her neck and left shoulder and had to undergo six courses of chemotherapy. Fortunately the treatment managed to halt the spread of the cancer and the pins and needles disappeared.

Due to the distress she had experienced, the woman made a complaint to the Royal University Hospital. The hospital denied any failings in the standard of care she had received, so she sought legal advice and made a claim for the missed diagnosis of cancer after an investigation commissioned by her solicitor detected a number of abnormalities on the 2009 scan.

In her claim for the missed diagnosis of cancer it was alleged that, if the cancer had been correctly identified in 2009, the disease could have been treated with hormone therapy and the woman would not have required chemotherapy. It was also alleged that the appropriate treatment in a timely manner would have cured the vocal chord palsy from which she still suffers.

The Royal United Hospital continued to deny its liability for the woman´s experience but, after issuing court proceedings, her solicitor was able to negotiate a £50,000 settlement of the claim for the missed diagnosis of cancer with the NHS Litigation Authority. Speaking after the claim for the missed diagnosis of cancer had been settled, the woman´s solicitor said:

“Despite our client’s experience, the defendant continued to deny that the failure of the radiologist to report the abnormalities in the MRI scan fell below an acceptable standard of care. This is disappointing but sadly, has become par for the course in clinical negligence cases, where the NHS Litigation Authority and its defendant solicitors refuse point blank to accept liability. However, we are delighted that we achieved a very good settlement for our client”.

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Increase in Claims against Primary Care Nurses for Medical Negligence

The Medical Defence Union (MDU) has reported a steep rise in claims against primary care nurses for medical negligence over the past decade.

The MDU is one of the largest organisations providing medical practitioners in the UK with insurance against medical negligence claims. In 2005, the organisation recorded just two claims against primary care nurses for medical negligence. In 2015, that number had risen to twenty-five.

Much of the increase is attributed to the changing role of primary care nurses in the past decade. An analysis of the claims against primary care nurses for medical negligence shows that nurses are seeing patients with more acute conditions – patients who historically would have been seen by a GP.

The report by the MDU mirrors one produced in 2012 by the Medical Protection Society that attributed the increase in claims against primary care nurses for medical negligence to an expansion of the nursing role and a greater awareness of patients´ rights.

The figures produced by the Medical Protection Society showed the majority of claims against primary care nurses for medical negligence related to missed diagnoses, while the second most common cause was a failure to properly manage chronic diseases such as diabetes, asthma, coronary heart disease and hypertension. Three contributing factors were identified by both organisations:

  • The failure to refer (or a delaying in referring) a patient to a GP or specialist.
  • An inadequate assessment of a patient´s condition.
  • Inadequate monitoring of how a disease is progressing.

The MDU´s medico-legal advisor – Dr Beverley Ward – said: “Many practices have devolved more responsibility to nurse practitioners in their team to cope with the increasing demand. However, in taking on roles such as assessing and diagnosing patients, prescribing medicines, and running minor injury clinics, nurse practitioners are also at an increased risk of patients holding them individually accountable if something goes wrong.”

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Value of Claim for the Failure to Remove an Appendix Contested by NHS

The NHS is contesting the value of a claim for the failure to remove an appendix, made by a woman who was left infertile when her appendix burst.

In 2008, Sarah Marquis visited her GP complaining of severe abdominal pain. Sarah was admitted to Homerton Hospital in East London, where doctors treated her with painkillers for three days and overlooked that Sarah needed an emergency operation to remove her appendix. When the appendix was eventually removed, it was “gangrenous and perforated” and had burst – causing a severe abdominal infection that left Sarah infertile.

Due to her illness, Sarah took the next three-and-a-half years off from her £65,000 per year job with top London lawyer firm DLA Piper. She made a claim for the failure to remove an appendix in a timely manner against the Homerton University Hospital NHS Foundation Trust. The NHS Trust admitted liability for her injuries, but disputed the £1.5 million compensation Sarah was claiming – arguing that the value of her claim for the failure to remove an appendix was closer to £300,000.

The case is currently being heard at the High Court in London, where Judge Robert Owen QC was told that Sarah had to forgo opportunities to live and work in the USA because of the consequences of the hospital´s negligence. It was claimed that her earnings would have been considerably higher in the States, and that her dream of naturally conceiving a child with her partner had been taken away from her.

The NHS Trust´s barrister – Bradley Martin – read out an apology to Sarah in which it was acknowledged that hospital negligence had been responsible for her injuries. However, Mr Martin then questioned whether Sarah´s “burning desire” to have children would have overridden her desire to progress her career in the USA – or vice versa – and contested that she would have had one or the other of her desires come true – but not both.

The hearing into the contested claim for the failure to remove an appendix continues.

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