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Case Study

Late diagnosis of subarachnoid haemorrhage causes vasospasm and stroke

Late diagnosis of subarachnoid haemorrhage causes vasospasm and stroke

I received a fantastic service from Stamp Jackson and Procter, they kept me informed at all times and explained every detail clearly so that I knew exactly what was being done to help me.

I have been really happy with the service, support and guidance provided and would recommend them 100% to anyone who needs their service.

Ms B

Stamp, Jackson and Procter were able to secure £275,000 in damages for their Claimant due to breach of duty and delay in diagnosis.

Our Claimant suffered a sudden and dramatic pain in her head, like an 'explosion'. She felt sick and weak and was aware of 'flashing lights'.

Over the next few days the Claimants severe headache continued and decided to go to the Walk-in Centre where she was seen by two nurses.  She recounted how she had been in bed with her partner when she felt a sudden severe pain in her head 'like it had exploded' and thought she might have banged her head on the headboard but was unsure, that she had 'seen' flashing lights and lost vision for around 20 minutes and had vomited, which she put down to drinking alcohol the night before.

The first nurse made a note which was accurate save that it omitted to describe the sudden severe pain as the Claimant had described. However, the second nurse, in contrast, did not record accurately what the Claimant told her. The second nurse subsequently made an assumption or interpretation of lower back pain, following which she diagnosed a muscular sprain. The inaccuracy of note recording became the main issue as the claim proceeded.

In the following days after attending the Walk-in Centre, the Claimant continued to suffer from increasingly severe headaches and vomiting. Our Claimant then attended the Accident and Emergency Department with a 5 day history of headache. She had been unable to get out of bed for 2 days.

A CT scan was arranged followed by a lumbar puncture which confirmed a diagnosis of subarachnoid haemorrhage. Onward referral to the Neurological Centre was arranged.

The Claimant was diagnosed with a 5mm MCA aneurysm and subsequently underwent a procedure to coil the aneurysm. 2 days later our Claimant suffered from vasospasm and developed right facial weakness and right-sided pronator drift. She was readmitted to the HDU for triple H therapy and discharged home 6 days later.

Just over a year later our Claimant underwent further coiling treatment for a small 2mm right MCA aneurysm. Follow up MRI/MRA later in the year showed that all aneurysms were adequately occluded.

The allegations were that the Defendant Trust was negligent in that they failed to suspect subarachnoid haemorrhage and to refer her on to hospital for further investigation and treatment, despite her presenting with classic symptoms of subarachnoid haemorrhage. 

Further, the delay in diagnosis deprived the Claimant from having access to immediate therapies to prevent vasospasm.

As Stamp Jackson & Procter had been instructed only 8 weeks before the limitation period was due to expire, they first had to obtain agreement from the Defendant Trust to extend the limitation period.

Protective proceedings had to be issued due to lack of response from the Defendant Trust.

The Claimant sustained severe vasospasm and stoke caused by vasospasm as a result of the negligent delay in diagnosis of her condition. Had she been referred to hospital when she attended the Walk-in Centre for treatment of the aneurysm, with coil embolisation, then her outcome would have been good and she would have avoided both vasospasm and the subsequent stroke caused by the severe vasospasm.

The Claimant has been left with permanent neurological symptoms. She now has poor memory and concentration, and has difficulty multi-tasking especially in a noisy environment. She rapidly fatigues mentally and physically on a daily basis. She also experiences pins and needles in her right arm, again mainly when she is tired.

Stamp, Jackson and Procter received medical records in January 2014 and approached a Consultant Neurosurgeon to prepare a report. He then sought the opinion of a Neuroradiologist to interpret the CT scans. Following this he was able to conclude his report on breach of duty and causation supporting the Claimant's claim.

Further investigations were undertaken into causation, in particular, what treatment the Claimant would have received had she been referred, in order to assess the merits of the case. A preliminary opinion was received supporting the claim.

Proceedings were served in December 2015, The Defence was received in March 2016.

A Costs Case Management Conference took place in October 2016 and the Master approved a set of Directions and a costs budget was also put in place. The trial was listed for 7 days in a 5 day window.

The Defendant made a Part 36 Offer in the sum of £75,000.00.

Breach of Duty and causation evidence was exchanged in February 2017.

The Claimant made a Part 36 Offer in the sum of £275,000.00 in a letter, which was accepted by the Defendant.

This was a fully defended case where no admissions were made by the Defendant Trust. No attempt was made by the Defendant to settle the claim until after exchange of witness and expert evidence.

Mark Slade

Please contact Mark Slade on 01482 316726

Neil Holland

Please contact Neil Holland on 01482 316742

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