Settlement agreed for failure to diagnose fatal subarachnoid haemorrhage

Our medical negligence team recently concluded a case for a person who sadly passed away due to a subarachnoid haemorrhage (a type of stroke caused by bleeding in the space between the brain and the surrounding membrane). Had the subarachnoid haemorrhage been diagnosed sooner, they would have survived and made a full recovery.

This person had a migraine for several days and sought advice from their GP. They then began vomiting, and their partner called an ambulance. Their blood pressure was very high and they were muddled, behaving in an unusual way, with a severe headache.

The patient was taken to hospital and observed in the emergency department over the course of that night. After seven hours they were seen by a doctor who recorded their history. However, due to Covid-19 restrictions in place at the time, their partner was not present to help provide a history. Therefore, the fact that they had collapsed twice at home the day before was not recorded.

The initial impression was recorded as a CVT (cerebral venous thrombosis – a type of stroke) or migraine. A CT head scan with contrast was performed. The CT scan was reported as suboptimal but the limited imaging looked unremarkable. It was not repeated. Throughout the admission, the patient’s blood pressure was checked regularly and varied between extremely high and moderately high.
The patient was discharged and advised to follow up with their GP regarding their blood pressure readings as soon as they left. The discharge summary described the blood pressure as high, but only provided an average reading and did not flag the very high readings taken earlier in the admission.

They had a telephone appointment with their GP around a week later. They were still suffering from headaches and were booked to come in later that afternoon to have their blood pressure checked with a nurse.

Tragically, later that day, before they could attend the appointment, they collapsed at home and, despite an ambulance being called and paramedics carrying out lifesaving attempts, they sadly passed away. The cause of death was a subarachnoid haemorrhage.

An inquest was held and the hospital undertook a serious untoward investigation report (SUI), which identified several failings in the patient’s care. Their partner and children then instructed us to investigate these failings.

Expert evidence was sought and the case was put forward to the defendant. The defendant admitted that a non-contrast CT scan should have been performed and that, if it had, the subarachnoid haemorrhage would have been diagnosed while the patient was still in hospital. They would have received treatment and likely survived, making a good recovery. The defendant apologised for the shortcomings in the care provided.

Further work was required to calculate the value of the claim and negotiations were held. A six-figure settlement was agreed upon, and approved by the court, as one of the patient’s family members was a protected party.

Victoria Johnson, senior associate in the medical negligence team who conducted the claim, said: “This was a tragic case where a much loved person lost their life avoidably. Nothing will ever come close to compensating their family for that loss. I hope that the settlement helps them to access some support, and that concluding the claim brings some sense of comfort or resolution.”

Grace Norris, associate, who handled the approval hearing following settlement of the claim, commented: “Though the hearing was understandably a difficult day for the family, I am pleased that this has now drawn the legal matter to an end for them.”