Adrian was born on the 19 April 1987
at Guy’s Hospital. On the 22 April at about 15:00 hours, his
mother found blood, mucus and grainy material in his nappy.
By this time, Adrian was off his
feeds, and was drowsy and unresponsive. A midwife attended at home
and advised that he should be taken immediately to the
casualty department to see a paediatrician.
Adrian arrived at the A&E Department at 17:05 hours.
The admitting nurse noted a high temperature and recorded his
complaints as “drowsy, blood in stools”.
No clinician saw Adrian between 17:05
and 19:00 hours. When he was seen by a doctor, his mother showed
the doctor the nappy containing the blood stained stools.
The doctor did not heed the mother’s
history of blood stained stools and threw the nappy in the bin. He
made a diagnosis of urinary tract infection and Adrian was admitted
to hospital for observation and treatment with antibiotics.
Adrian continued to vomit and was very
poorly. His parents spent a very anxious three hours with him in
casualty.
Eventually, Adrian was admitted to a
ward at 22:15 hours. Shortly afterwards, he began to vomit bilious
material, but was not seen by a doctor until about 03:00 hours.
Adrian was immediately referred
for a surgical opinion and a laparotomy was performed at about
06:00 hours. The surgeons found a volvulus (a twisting of the
bowel). This had caused necrosis to most of Adrian's small
bowel.
As a result in the delay in treatment,
Adrian suffered a severe long-term injury to his gastrointestinal
tract. He has been to theatre over 75 times and spent the first
four years of his life as an inpatient in hospital.
Adrian has suffered recurring
infections and is still unable to feed normally. He is fed by
a tube every night for 12 hours. As a consequence, he has
failed to thrive and remains on a barrage of powerful drugs,
including steroids and antibiotics.
As a result, he has permanent loss of
high frequency hearing and his education has been constantly
interrupted with admissions to hospital.
The action was fixed for trial for 29
November 2004. The principle allegations of negligence were that
the doctors had failed to give sufficient weight to the history
given by the mother and failed to investigate for the presence of
blood in the stool and/or failed to refer Adrian to a paediatric
surgeon in time.
Liability was difficult. The hospital
denied responsibility on the grounds that the stool was normal and
that in any event the development of volvulus may occur
rapidly.
It was asserted by the defendant that
Adrian had no obvious features of volvulus and that it was
appropriate to treat conservatively until about 02:00 hours.
The defendant argued that treatment at
that stage would not have made any difference to the outcome. The
defendants also argued if an abdominal x-ray had been performed
early in the evening (as contended by us) it would not have been
diagnostic.
Assessing the value of the claim was
also difficult because the defendant also stated that Adrian would
soon be able to feed by mouth and would soon be able to lead a
normal life.
The day before trial the defendant
offered to settle the claim in the sum of £1 million. This
offer was accepted by the claimant and approved by the court taking
into account the undoubted risks of litigation.
The case was conducted by Paul McNeil with the benefit of Public Funding.
For further information or if you have
an accident and emergency negligence
claim call Paul
McNeil on
020 7861 4019 or email paul.mcneil@ffw.com
You can discuss your accident and emergency
negligence claim with any member of our
medical negligence team on
freephone 0800 358 3848, email personalinjury@ffw.com
or complete our short enquiry form.