Our clinical negligence team has settled a compensation claim for a young woman who experienced a ruptured aneurysm which caused her to suffer a brain haemorrhage four years later. It was our client’s case that if the NHS trust responsible for her care had followed up her intracranial aneurysm, which was detected incidentally on a CT scan, it would have been monitored and treated with endovascular surgery, and would not have ruptured.
When first detected, our client’s aneurysm was small, but nevertheless required follow up. We obtained independent expert evidence in the fields of neurology, interventional neuroradiology and neurosurgery, which established that no reasonably competent consultant neurologist would have simply noted that the aneurysm was below a threshold requiring further intervention.
The expert evidence concluded that the neurologist should have discussed the patient’s aneurysm with her and explained the diagnosis. A further brain scan should have been recommended to monitor the aneurysm for growth after around 12 months and then repeated annually, or biennially, the latter if deemed safe to do so.
It was our client’s evidence that she would have chosen to have a further scan if it had been offered to her. As a young adult who was concerned about headaches and her overall health, she would have wanted to do everything in her power to be as well as possible. A hypothetical scan 12 months later would probably have shown that the aneurysm had grown and a repeat scan 12 months after that was highly likely to have demonstrated significant growth. While the aneurysm was only 2 mm in diameter when first detected, it was 6 mm larger when it ruptured four years on.
If our client had been referred to a neurovascular MDT after 12 months, she is likely to have been offered treatment with embolisation. Again it was her evidence that she would have agreed to this procedure, and indeed the experts agreed that the clear majority of young adult patients with enlarging aneurysms would opt for treatment.
With successful embolisation treatment, our client would have avoided suffering a ruptured aneurysm and a sub-arachnoid haemorrhage. As it turned out, our client required an emergency hospital admission which was followed by a lengthy rehabilitation from her brain haemorrhage both in hospital and at home. The ongoing physical, cognitive and psychiatric effects of her brain haemorrhage were life-changing.
After liability was initially denied by NHS Resolution, we commenced court proceedings. However, it subsequently proved possible to achieve a settlement through negotiation.