Nicholas was admitted to Ealing Hospital on 5 October 1998,
having suffered an alcohol related fit. While he was in the
accident and emergency department, he fell
from the trolley injuring his right eye.
Nicholas was admitted to a general medical ward and at
approximately 08:30 on 6 October 1998. He suffered a further fall
injuring the left side of his head. He underwent a CT Scan within
approximately 20 minutes of the accident. The scan was reported as
showing no abnormality.
Between 7 October and the morning of 13 October, Nicholas'
condition deteriorated. He remained confused (despite the
withdrawal of sedatives to prevent further fits), became doubly
incontinent and spent most of the time asleep.
A further fall was recorded on the fluid balance chart of 10
October 1998 but no accident report was filed. Neurological
observations were not performed on a regular basis and were
terminated on 10 October 1998. No neurological assessments were
undertaken by the medical staff after 6 October 1998.
At approximately 09:00 on 13 October 1998 Nicholas' wife
complained to the nursing staff that her husband was
unrousable.
When Nicholas was seen on a ward round a couple of hours later,
he was discovered to be unconscious.
A CT Scan confirmed that Nicholas had suffered extensive
intra-cranial bleeding and there was a fracture of the skull in the
left temporo-parietal area.
Following consultation with the Regional Neurosurgical Centre,
it was advised that no treatment could be offered and Nicholas
suffered a respiratory arrest and died later that day.
Expert evidence was obtained from a consultant in general
medicine who confirmed that the management of Nicholas on the ward
had fallen below the required standard.
There had been a failure to investigate Nicholas' ongoing
confusional state after 6 October by means of regular neurological
observations, examinations and repeat scanning.
However, both the expert in general medicine and an expert in
nursing care agreed that no criticism could be made of the failure
to prevent Nicholas suffering the falls both in the accident and
emergency department and on the ward.
Neurosurgical evidence confirmed that if appropriate reviews had
been undertaken, Nicholas' deterioration would have been determined
and scanning would have revealed raised intra-cranial pressure.
Nicholas would have been referred to a Regional Neurosurgical
Centre where action could have been taken to relieve the raised
intra-cranial pressure thereby preventing Nicholas' final
deterioration.
That being said, Nicholas would have suffered permanent serious
neurological deficit as a result of injuries sustained following
the second fall.
We advised the family of the difficulties on the issue of
causation. A Part 36 Offer was made and following negotiations,
Nicholas' widow accepted £12,000 in full and final settlement of
the claim.
For further information or if you have an accident and emergency claim please call
Paul McNeil
on
020 7861 4019 or email paul.mcneil@ffw.com
You can discuss your accident and emergency claim with any member
of our medical negligence team on
freephone 0800 358 3848, email personalinjury@ffw.com or
complete our short enquiry form.