Settlement for bereaved family following failure to administer anticoagulant medication

Case Studies

Settlement for bereaved family following failure to administer anticoagulant medication

We settled a claim against Epsom and St Helier University Hospitals NHS Trust on behalf of the estate of an elderly lady who suffered a stroke after her anticoagulant treatment was not recommenced following surgery.

The claim was brought by the deceased’s children as executors of her estate. The claim arose from the care that the deceased received during a hospital admission to treat a fractured neck of femur. She underwent surgery at St Helier Hospital which was a success. Her anticoagulation was consciously withheld when her haemoglobin was reduced following the surgery, as the risk of bleeding was felt to be greater than the risk of thrombosis. This was standard practice. Her anticoagulant was prescribed again in the evening of the day after surgery, and was thereafter to be administered twice daily. However, it was not given until the evening two days later. Thereafter, of a further eight prescribed doses, seven were missed. The deceased subsequently suffered a stroke which left her with significant neurological disability.

Prior to her hospital admission she had lived in her own home with her husband and adult son. Following the stroke, however, she required an extended hospital admission and thereafter transfer to a care home. Her mobility and speech were compromised, and she suffered numerous falls and seizures over the 18 months between the stroke and her death.

NHS Resolution were cooperative in dealing with this matter. We submitted an early invitation to admit liability, in light of the failings identified within the trust’s internal investigation report, to avoid incurring the costs of investigating breach of duty. An early admission of liability was received, which allowed the claim to proceed purely on the issues of causation and quantum.

An expert consultant in elderly medicine, or geriatrician, was instructed to comment on the deceased’s likely trajectory if there had been no negligence. It was established that, on the balance of probabilities, but for the failings identified, the deceased would not have suffered the stroke nor the subsequent deterioration in her cognitive and physical abilities. She would not therefore have required such a lengthy hospital stay, nor a prolonged care home admission for the remainder of her life. It was further established that the stroke made a more than minimal contribution to the deceased suffering seizures and, on balance, reduced her life expectancy by 12-18 months.

Following the without prejudice service of the claimant’s schedule of loss and medical evidence, the parties were able to agree an extension to the expiry of the limitation period, and a settlement, before the need to issue proceedings arose. The settlement represented a good recovery of the sums claimed for the deceased’s pain, suffering and loss of amenity, as well as financial losses including funeral expenses, family travel expenses, treatment costs and care home fees that would otherwise not have been incurred.

Laura Hanvey, who specialises in elderly care claims within the clinical negligence team at Penningtons Manches Cooper, comments: “This was a very sad case where an oversight in medication administration had catastrophic consequences for the patient and her family. No amount of money was ever going to compensate this family for the injuries their mother sustained or her early death, however, the family were pleased to receive an early admission of liability from NHS Resolution and, subsequently, a fair financial settlement of the claim. This claim was a good example of early admissions saving the costs of obtaining expert evidence on breach of duty and avoiding any unnecessary upset that reviewing such evidence might have caused the family.”

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