We have achieved significant compensation for our client who underwent privately performed eye surgery at the Shelburne Hospital (previously run and administered by BMI Healthcare, now Circle Health Group), and suffered a retinal detachment and complete loss of functional vision from her dominant left eye.
Our client attended for private surgery at the Shelburne Hospital in July 2017. The procedure – known as an epiretinal membrane peel – was performed without complication. Post-operatively, at around 5pm, our client was managed in the recovery room before being transferred to the ward at around 6pm.
It was around this time that our client began to feel unwell, feeling nauseous and sick. Her symptoms gradually worsened and, at just before 9pm, she experienced a wave of nausea and told the nurse that she needed to be sick. The nurse spoke with a doctor who was working in the hospital – known as a ‘resident medical officer’ (RMO). The RMO was not employed by the hospital; she had been provided by an agency – NES Healthcare – which provides private hospitals with locum doctors to enable them to function as hospitals.
The RMO attended our client’s hospital room but did not examine our client. She prescribed a weak anti-sickness drug, which is usually used to treat patients who suffer movement induced nausea (such as car sickness). It was inappropriate to treat nausea and sickness induced by anaesthetic drugs.
Our client’s symptoms of nausea were not resolved with the anti-sickness tablet that the RMO prescribed, and her nausea continued. Our client informed the hospital nurse of her ongoing symptoms but was not re-examined. She was prepared for discharge. At around this time our client’s husband arrived to collect her and take her home. He complained to the nursing staff that our client was clearly not well enough for discharge, but his concerns were rebuffed.
At the time of our client’s discharge, she was prescribed another anti-sickness tablet, which she was advised to take before going to bed that evening. The RMO then discharged our client from hospital, without ensuring that she was actually well enough to go home.
Our client was so unwell that she was not able to stand and walk independently. A nurse had to fetch a wheelchair and wheeled her out of the hospital with a sick-bowl on her lap, into which she vomited. She was then driven home by her husband. When our client arrived home, she continued to experience nausea and sickness. During one episode of nausea and retching, she felt something change in her eye, which was confirmed the following day to have been an intra-ocular haemorrhage, causing a retinal detachment.
Our client’s eye surgeon did his best to treat her injury but was ultimately unable to reattach the retina. By February 2018, our client was informed that the sight from her left eye was permanently impaired, and she would be unlikely ever to recover her sight from this eye.
Quite soon after our client learned of her intra-ocular haemorrhage, she approached Penningtons Manches Cooper to enquire about a negligence claim against the Shelburne Hospital and the medical staff for permitting her discharge when she was so unwell, and without properly treating her symptoms of nausea and vomiting.
We investigated the claim and obtained evidence from independent experts in anaesthesia, nursing and ophthalmology. It was the opinion of those experts that our client’s symptoms of nausea and vomiting were negligently managed. She should not have been discharged from hospital with severe ongoing symptoms of nausea.
The RMO, when informed of our client’s anaesthetic induced nausea, should have contacted and informed the consultant anaesthetist of our client’s symptoms. Had she done that, the anaesthetist would likely have advised treating our client with IV anti-sickness medication.
The expert evidence was that, had our client been treated with an appropriate anti-sickness medication, and had she been managed in hospital until her symptoms resolved, it was likely that she would have avoided the retching episode that caused the intra-ocular haemorrhage. The ophthalmic expert was of the opinion that, had our client avoided the haemorrhage in her left eye, she would not have suffered retinal detachment, on the balance of probabilities, and she would have retained the sight from her left eye.
The allegations were presented initially against BMI Healthcare, which informed us that the RMO was an agency member of staff and not under the direct employment of the hospital group. Accordingly, it denied liability for that RMO’s actions and/or omissions. The allegations were then presented to the RMO’s agency provider, NES Healthcare.
The allegations of negligence were denied, and court proceedings were ultimately issued and served against NES Healthcare. Failures were also identified against the private anaesthetist and the hospital nursing staff, and the claim was also served against those parties.
NES denied the claim, but our experts remained firmly critical of the RMO’s management of our client and maintained that, but for those failures, she would have avoided injury to her sight. On our assessment, there were aspects of her claim that had been ignored by the defendant in its defence, and so further questions were put to the defendant to clarify its case. This elicited further information which strengthened our client’s claim against the RMO.
We investigated the value of our client’s claim with evidence from an expert who assessed the increased amount of care, support and assistance our client would likely need in the future as a result of the injury to the sight from her left eye.
NES, whilst continuing to deny the claim, agreed to enter into discussions about settlement, and subsequently settled the claim for £100,000. NES made no formal admission of liability in this case, but our client was content to have reached a resolution to her claim.
We were very pleased to have achieved a successful outcome for our client and to have obtained compensation for her injury.
This case demonstrates the risk of obtaining treatment in a private hospital. Many staff in the hospital are ‘independent’, part-time, or locum staff; they are not employed by the hospital and may not be completely familiar with hospital processes and protocols; and record keeping appears to be poor. While there will inevitably be positive reasons for pursuing healthcare in a private setting, we are concerned by the limited continuity of care that seems to be provided in private hospital settings (compared to that which is provided in an NHS hospital). This may lead to key reviews, assessments or examinations being missed and putting patient safety at risk, as was the case here.
Should you have concerns over the management of any ophthalmic surgeries, either in an NHS or private setting, please do not hesitate to contact a member of the clinical negligence team.