Medical Negligence

HOSPITAL NEGLIGENCE / NHS NEGLIGENCE

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We see many medical negligence cases against hospitals. Cases we have worked on with our partner law firms are outlined below. For more information simply click on the case type or contact us now to start your claim

Fracture – a break in the bone – usually results from trauma. Typically there is pain, bony tenderness, inability to use the affected part, and sometimes deformity; there may be multiple fractures, and associated injury to nerve or blood supply. A fracture may be suspected on clinical examination, but is usually confirmed by x-ray.

The assessment of an injury may or may not include x-ray.

Fractures may be missed at medical assessment; this may be for a number of reasons including: failure to suspect fracture and so failure to x-ray; not seeing the fracture on x-ray; failing to recall the patient where an initially missed fracture is identified.

A missed fracture may result in persisting pain and reduced movement, deformity and non-union. It may require surgery when eventually diagnosed.

The scaphoid is one of the bones of the wrist. It is typically caused by a fall onto the outstretched hand. It may also occur in sport.

Clinical assessment may reveal tenderness at points in the wrist and reduced movement. Conventional x-rays may not reveal a scaphoid fracture; special scaphoid views may be required. Even if the x-ray is normal, if there is tenderness of the wrist so that scaphoid fracture is suspected the injury is treated presumptively as fracture by immobilisation; the patient is recalled for review.

A missed scaphoid fracture may lead to poor healing (mal-union) or to the bone dying from loss of it blood supply. Surgery may be required.

The cauda equina (Latin for “horse’s tail”) consists of the nerve roots that originate from the lower end of the spinal cord within the lower part spinal canal. These nerve roots emerge from the spinal column.

The cauda equina may be compressed by a central prolapsed disc – it may occur where there is already a history of degenerative back disease and prolapsed disc. Typical features include back pain, bladder and bowel disturbance, numbness over the bottom, back of thighs and between the legs (“saddle anaesthesia” the contact points when riding), numbness in the ano-genital area, and leg weakness.

Recognising the condition in good time is crucial so that emergency decompression surgery can be performed. Surgery may result in complete or partial recovery where there are persisting problems of leg weakness, incontinence, sexual dysfunction, saddle and perineal anaesthesia.

Claims in respect of cauda equina syndrome may concern allegations of delayed or missed diagnosis resulting in delayed surgical decompression leading to irreversible nervous injury.

Subarachnoid haemorrhage describes a bleed on the brain.

The characteristic feature is sudden onset of very severe headache. Other associated features include seizure, confusion, neck and back pain, vomiting, neurological disturbance, visual disturbance and light sensitivity.

There may be small warning bleeds in the few weeks preceding a major bleed.

Diagnosis is by imaging. Treatment involves preventing further bleeding by controlling the source, and supportive measures.

Negligence claims may involve failure to diagnose a warning bleed so that an avoidable major bleed occurs, and delay in diagnosis of a major bleed.

The brain and spinal cord are lined by the coverings called meninges. These can become inflamed causing meningitis. Meningitis can be caused by various agents including infection. Infection includes bacterial and viral.

The most sinister form of meningitis is bacterial meningitis. The features include headache, fever, neck stiffness, and aversion to light. The features vary depending on whether the patient is adult, child, or infant. The younger the patient, the less specific the features. The earlier the onset of the illness the less specific the features.

Meningococcal meningitis is very serious form which can have a rapid onset; it typically has a non-blanching rash. It can lead to complications including death, brain damage, deafness, and septicaemia resulting in limb amputation. The earlier the condition is diagnosed and treated the better the outlook.

Negligence claims may concern failure to diagnose meningitis; however, early diagnosis may be difficult since the clinical features are undeveloped and non-specific.

Chest pain is a significant symptom which can be caused by conditions including: heart disease, clot in the lung, chest disease, and indigestion. It may also be caused by less serious disease such as muscle strain. It requires careful assessment and appropriate investigation.

Negligence claims may arise where a serious cause of chest pain has been missed and attributed to a trivial cause because of inadequate assessment and investigation.

Cerebral palsy is the general term for a number of neurological conditions that affect movement and co-ordination. It is usually due to injury to the baby’s brain that can occur before, during or after birth. There are many causes and varying degrees of severity. The condition may only become apparent when the baby fails to achieve development milestones.

Some cases of cerebral palsy may be due to mismanagement of pregnancy and labour – the baby may be starved of oxygen so as to cause brain damage. Such cases may give rise to a negligence claim; the compensation level may run into millions to fund the future needs of the child.

Some degree of tearing during vaginal birth is common. Such tears vary in extent; they originate from the vagina and can extend to involve the anus, and through the anus to the rectum.

It is essential that the more serious tears are recognised and repaired. Failure to recognise a tear involving the anus or failure to repair such a tear adequately can result in problems of anal incontinence. It can give rise to a negligence claim.

Anaesthesia for caesarean includes general anaesthetic and regional anaesthesia (spinal and epidural). Caesarean section may be planned or emergency. Inadequate pain relief during caesarean section suggests negligent care.
Cholecystectomy (removal of the gall bladder) is usually performed laparoscopically but may be by open surgery. Damage to the bile duct may occur and is often due to surgical error – failure to identify the structures. It is crucial that the structures have been correctly identified as there are anatomical variants. Damage to the bile duct results in biliary leak; this may be apparent at the time of operation or in the post-operative period. Negligence claims may concern the occurrence to the bile duct damage itself, failure to recognise such damage, and delay in diagnosis of the biliary leak in the post-operative period.
If you have fallen pregnant within 12 months of having a sterilisation procedure then you should contact Medical Negligence Team.

Sterilisation involves interrupting the Fallopian tubes by various surgical techniques; it can involve occlusion by clips, rings or implant, and excision of the tubes.

There is a small risk of failure – post sterilisation pregnancy. This can be for a number of reasons including natural recanalization the interrupted tube – reforming its continuity – or technical failure of the operation. It may be difficult to distinguish between these mechanisms of failed sterilization. The interval between the operation and the conception may provide a clue – the shorter the period the more likely the failure is due to technical failure.

Human error may occur so that the surgery is performed “wrongly”: wrong site, wrong side or wrong operation. Such cases are often human error or down to system failures. Such cases are often referred to as never events as they simply should not occur.
All sorts of items are used in the course of procedures including instruments, swabs, needles, drains, catheters, and so on. There are procedures to ensure that items are accounted for at the end of a procedure. The inadvertent retention of such items in the operative field suggests unacceptable negligent care.
The bowel may be injured in the course of an abdominal procedure. There may be fault associated with: (1) causing the bowel injury; (2) failing to detect the bowel injury at the time of the procedure; (3) delay in diagnosing the bowel injury in the post-operative period.
The bladder and/or ureters (the tubes from the kidney to the bladder) may be injured in the course of surgery. There may be fault associated with: (1) causing the injury; (2) failing to detect the injury at the time of the procedure; (3) delay in diagnosing the injury in the post-operative period. Failing to deal with a ureteric injury can have catastrophic consequences such as the loss of a kidney.
Damage to teeth during an elective (non-emergency) procedure may represent unacceptable care. The teeth at greatest risk are the upper front teeth and canines. If you teeth were healthy then the care may in particular be negligent if teeth were lost.

Claims may arise in respect of surgery from the performance of the surgery itself and /or from the consent for such surgery (see above). For example:

  • Damaging the bowel in abdominal surgery
  • Stitching structures such as the bowel, bladder or appendix into the wound
  • Damaging the bladder or ureters (the tubes which run from the kidney to the bowels)
  • Cutting the wrong structures during a gall bladder operation
  • Leaving a patient with a leg length discrepancy following a hip replacement
  • Causing permanent nerve damage which a competent surgeon would not have caused
  • Operating in the wrong place altogether
  • Leaving items inside such as swabs, needles or drains which should have been removed
Nerves may be injured in the course of surgery. These include the accessory nerve in neck surgery; the sciatic nerve in hip surgery; the recurrent and superior laryngeal nerves and thyroid surgery.
The purpose of general anaesthetic is to render the patient unconscious for the duration of surgery. Awareness is the explicit recall of events during general anaesthesia; it includes experiencing pain and of being conscious while paralysed. If the patient has clear recall of their surgery it suggests substandard care. It may be the result of insufficient anaesthetic agent being delivered, equipment failure, and inadequate monitoring.
Anaesthesia is to enable a patient to undergo surgical procedure without experiencing pain and if necessary to provide muscle relaxation to enable the surgeon to operate whilst maintaining the vital functions of the body as close as possible. The patient is completely dependent for the support of vital functions. Where there has been insufficient provision of oxygen this can result in death or brain damage.
All medical treatment to adult patients of sound mind requires consent: this is the principle of patient having the right to refuse treatment. Consent is usually implied for most treatments. For surgical treatments consent is expressed; there is a consent form.

Consent has a number of elements. It requires that the patient has capacity – is able to make a decision and understand relevant information. The decision is voluntary. The decision is based on sufficient information.

Claims may be made on failure of consent; it may concern any aspect of consent. Commonly it is the failure to warn; to impart sufficient information so that the patient’s decision is properly informed. The claim may arise where if the patient had been properly informed, the patient’s decision would have been different, and a poor outcome avoided.

Administrative errors can have catastrophic consequences.

There may be fault associated with: (1) losing a patient in the system meaning treatment is delayed; (2) failing to arrange an appointment; (3) failing to act on a suspicious finding on x-ray, CT or histology meaning the correct treatment is delayed or does not take place at all. Such administrative
mistakes can lead to negligence claims.

Such errors can have catastrophic implications in cancer treatment. Cancer can affect any organ of the body. Different cancers typically present with different symptoms; some symptoms are considered “red flag” for certain cancers and require urgent referral. For example, blood in urine is a red flag for urinary tract cancer; a breast lump is a red flag for breast cancer.

Delay in diagnosing cancer can result in: loss of cure so the cancer is incurable; worse symptoms and more extensive treatment; reduction in life expectation.

Nursing errors can lead to negligence claims.

There may be fault associated with: (1) giving incorrect medication; (2) failure to notice a deterioration in patient observations which should have triggered a review by a doctor; (3) allowing a patient to develop serious pressure

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MEET YOUR TEAM

ANTHONY BARTON
ANTHONY BARTONDoctor & Solicitor
Dr Anthony Barton is joint editor of the book “Clinical Negligence” and is one of the leading medical negligence experts in the UK. He is a founder member of the Society of Doctors in Law and will work on your case.
LIZ DURANT
LIZ DURANTExperienced Nurse
Liz Durrant is a qualified nurse with ward based and district nursing experience. Liz’s experience is invaluable in nursing and residential home cases such as pressure sores.
ANDY HOGAN
ANDY HOGANMedical Negligence Expert
Andy Hogan manages Medical Negligence Team and if you call us you will most likely speak to Andy, Sue or Liz. Andy has over 10 years’ medical negligence experience working alongside Anthony.

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