Negotiated settlement for delayed diagnosis and treatment of subarachnoid haemorrhage

We have settled a complex clinical negligence claim brought by a woman in her thirties, relating to a delayed diagnosis and treatment of subarachnoid haemorrhage. The claim proceeded against GPs at an NHS walk-in-centre and an NHS trust in respect of treatment provided by NHS Direct.

The subarachnoid haemorrhage caused damage to the frontal lobes of the claimant’s brain, leaving her with permanent neurological impairments, affecting her cognitive and intellectual functioning, her information processing, her memory and her capacity to absorb and retain information. The brain injury has had a significant impact on the claimant’s ability to work and to manage activities of daily living.

Breach of duty was robustly denied on behalf of all defendants. In essence, it was argued that the claimant presented with symptoms that were consistent with a diagnosis of sinusitis and that no further investigation or referral to hospital for neurosurgical review was required. In terms of causation, it was denied that the claimant would have received an earlier diagnosis of subarachnoid haemorrhage with an earlier referral. It was argued that, in any event, there would have been some irreversible cerebral ischaemia arising from the primary haemorrhage, leading to cognitive and behavioural problems.

We were instructed only weeks before limitation was due to expire, at a stage where the claimant’s capacity to litigate was unclear. We took urgent steps to identify all potential claimants and to issue protective proceedings. The court ordered a split trial and the case on liability was defended throughout a court timetable, proceeding past the joint statements of experts of like discipline.

Liability for the case settled at a joint settlement meeting several weeks prior to trial, in the proportion 90:10 in the claimant’s favour. Following resolution of liability, the matter proceeded in respect of quantum and reached a negotiated settlement.