S v Barking, Havering & Redbridge NHS Trust
Out of Court Settlement - 13th April 2005
This case concerns allegedly negligent treatment by the medical staff at King George Hospital , Ilford.
The Claimant (DOB: 29.07.82) was, at the time, of the incident in the middle of taking her A level exams. She was predicted to get very high grades and had a place to read French and Business Administration at King's College in London .
At around midnight on the night of 22nd/23rd May 2000, the Claimant awoke from her sleep, shaking uncontrollably, feeling extremely hot, sweating profusely and with a fever.
The Claimant was given paracetamol by her mother but her condition did not improve and she continued to shake uncontrollably and to sweat profusely. Her mother then took her to the A & E Department of the King George Hospital arriving at 01.09 hours on 23 rd May 2000 . She was seen by an SHO, Dr. Bhandwaj who, after a brief examination, diagnosed exam stress. He discharged her with no further advice.
The Claimant's mother took the Claimant home but, on arrival back at the house, the Claimant was vomiting profusely. Her mother took her back to bed but was so concerned about her daughter that she sat in the doorway of her bedroom on a chair all night. The Claimant's condition got markedly worse overnight until, in the early hours of the morning, her mother thought she looked almost dead. She had been vomiting in the early hours but this had gradually stopped, she was pale, cold and lifeless.
As soon as the GP Surgery opened, the Claimant's mother telephoned the GP. Unfortunately, no GP was able to come out until later that day so the Claimant's mother tried to get her into the car but the Claimant was immobile and unable to stand. At this point, the Claimant's mother telephoned for an ambulance which arrived at 09.30 hours. The ambulance arrived at 09.30 and the Claimant was taken back to the A & E Department at King George Hospital . She was seen by a doctor at 10.30 hours. This doctor recorded a bacterial infection and referred the Claimant to the Hospital's Physicians for admission.
Unfortunately, the Claimant's condition was not further reviewed at the hospital until 14.00 hours when she was eventually seen by a Senior Medical House Officer who concluded that she was seriously ill with signs of meningitis.
The Claimant was immediately admitted to ITU and treated with intravenous broad spectrum antibiotics. Notwithstanding this, her condition deteriorated and it was anticipated that she would not survived.
The Claimant did survive but developed disseminated intra vascular coagulation (DIC) with severe ischaemic changes in her right hand and in both feet. Her right hand and both feet became gangrenous and were eventually amputated.
In addition to this, the Claimant underwent multiple operations, namely skin grafts and suffered the resultant body scarring from where the grafts were taken. She spent a prolong period in hospital undergoing strenuous physiotherapy and rehabilitation and was eventually discharged home in August 2000. Her father took 6 months leave from work in order to help the Claimant's mother look after her so that she could return home as, at that point, the Claimant required more or less 24 hour care.
In the intervening years, the Claimant made a miraculous recovery. After a great deal of negotiating, fundraising and donations, the Claimant was able to obtain prostheses from the Dorset Orthopaedic Clinic. These enabled her to resume some of the activities she had enjoyed prior to the meningitis, namely swimming and walking.
After deferring her place at King's College for one year, the Claimant did try to undertake the course at the college but it was not really suitable for someone with her level of disability. Therefore, she reapplied and gained a place at Queen Mary's College at the University of London which has better facilities for someone who is wheelchair bound for much of the time. She is studying Business Administration and French and is predicted to attain a First Class Honours Degree.
The Claimant is able to walk for approximately 50 yards after which she needs a wheelchair. She is able to manage most of the activities of daily living with some assistance. She anticipates one day living independently of her parents and hopefully attaining employment although the prospects are very much reduced given that she is a triple amputee and would rank on a scale of disability as very severely disabled. Her minimal voice compounds problems facing her in relation to future employment.
The Claimant's parents originally instructed Rosamund Rhodes-Kemp with a view to securing compensation for their daughter's ordeal. At the time, she was in the middle of a very difficult rehabilitation programme and they were still coming to terms with the fact that she could have died. More recently, however, the Claimant herself has voiced her own feelings about the claim and her main objective was to secure funding to pay for ongoing prostheses from the Dorset Orthopaedic Clinic which would enable her to restart more of the activities that she enjoyed prior to the meningitis, namely horse riding, skiing and scuba diving.
It has to be said that the bravery, fortitude, beauty and intelligence of the Claimant made an impact on everyone who met her throughout the case.
Instructions were received in August 2000 and the first Funding Certificate was granted on 7 th September 2000 . Thereafter, an investigation was carried out into liability and causation.
An expert in A & E medicine, a Specialist in Infectious Diseases and a Microbiologist were all instructed. Their reports were obtained.
Dr. Roger Evans - A & E Expert - was supportive of the claim on liability.
Dr. Martin Wood (Deceased) on Infectious Diseases was supportive on causation.
Professor Susie Eykyn, Consultant Microbiologist was equivocal and felt the timing was very tight.
A conference was arranged and the experts at which, following Professor Eykyn's input, Dr. Evans changed his opinion and said he could no longer support the case. Dr. Wood remained supportive but was concerned that the timings for causation were tight.
Counsel was concerned about the continued funding of the case unless Dr. Evans could be persuaded to reconsider his view.
Faced with this situation, Dr. Evans was asked if he would reconsider but was not happy to do so.
Therefore, a further liability expert was instructed, namely an A & E Specialist from Nottingham . She turned the case down but had discussed causation with a colleague, Dr. Martin Culshaw. Dr. Culshaw was so appalled at the sequence of events that he said he would prepare a positive report on liability and deal with causation which he did.
Sadly, meanwhile, Dr. Martin Wood, died so the entirety of the Claimant's evidence on liability and causation was focused on Dr. Martin Culshaw.
One further expert on liability and causation was instructed on behalf of the Claimant, namely Dr. Graham Westmore, Consultant ENT Surgeon, who dealt with her loss of voice.
After this marathon investigation which had not been without its ups and downs, proceedings were issued on 13th May 2003 and Particulars of Claim were served on 8th September 2003 . A Defence was received on 15th December 2003 and the first Case Management Conference took place on 9th February 2004 with the second Case Management Conference taking place on 1 st July 2004.
The Trial was listed for 18 April 2005.
Tragedy amongst the experts struck again but, this time, on the Defendant's side and they asked for an extension of time to consider the Part 36 offer because their expert on causation, Dr Thurston had suffered a stroke and it was unclear as to whether he would be able to continue in his role as expert on the case, report on documentation and give evidence at Trial. Fortunately, that expert made a recovery sufficient to go on advising on the case because, otherwise, it would have necessitated a complete revisiting of all of the documentation including the Defence, expert reports, meetings of experts and witness statements.
Quantum experts were instructed with perhaps the key experts being accommodation, care and prosthetics. Further problems with the experts were encountered with the prosthetic expert who flatly refused to endorse any of the prosthetics provided by Dorset Orthopaedic or the costs thereof. Therefore, a further prosthetic report had to be obtained - this time from a Specialist at Dorset Orthopaedic to confirm the reasonable expectations of the Claimant to have prosthetics which enabled her to regain some of the function that she had lost through the alleged negligence.
Armed with these reports, a Schedule was prepared and served with documentation in support.
This was served and the Defendant's Counter Schedule and supporting documentation followed a few weeks later.
The Defendants made an offer of £100,000 on 9 th March 2005 .
The Claimant made a Part 36 offer in excess of £2 million.
Rather strangely, in the run up to Trial, the only offer ever made by the Defendants was £100,000 (until the settlement meeting) and it was not on a Part 36 basis and would not put the Claimant at risk as to costs.
Very belatedly, the Defendants agreed to a settlement meeting but, unfortunately, the Claimant's Counsel was away on holiday as it was, by now, the Easter vacation.
The first opportunity for a settlement meeting was 13 th April 2005.
Both sides evaluated the litigation risks which, for the Claimant, were considerable given the history of the medical evidence and the difficulties that had been experienced throughout the course of the investigation.
Nonetheless, the Defendants also faced risks especially as they had not made a Part 36 offer in the run up to Trial.
After much discussion, the Defendants offered £850,000.00 which was accepted by the Claimant who had not wanted to go to Trial, very aware of the risks, was glad that the matter was finished and could look forward to investing her award to enable her to purchase the prosthetics that she so desperately needs from Dorset Orthopaedic Clinic and which, with further investment, could provide for her long term care needs.
The Claimant was represented by Mr. Derek Holwill of Hailsham Chambers and Rosamund Rhodes-Kemp of Bolt Burdon Kemp.
The Defendants were represented by Counsel - Fiona Neal, 3 Serjeants Inn and Miriam Farley, Solicitor for the Trust, Messrs. Kennedys.