Young London father wins substantial settlement against GP for failure to spot liver disease

Posted: 01/03/2012

Penningtons Solicitors LLP has settled a claim for Krasanakant Nanji, 33, a young father from Plumstead, SE London who sued his GP for failure to diagnose and treat his symptoms of kidney failure which have resulted in him being on dialysis three times a week while he waits for a kidney transplant.

In February 2005, Mr Nanji registered with the defendant, Dr Lakshminarayana, as a new patient. His assessment indicated high blood pressure and traces of protein in his urine while blood tests revealed high liver function and cholesterol as well as significantly high creatinine levels. No action was taken on these test results at the time or in subsequent attendances.

By the end of 2007, the claimant visited Dr Lakshminarayana suffering from headaches. An increase in blood pressure was noted and medication prescribed over the ensuing months but there was no cohesive management or further investigation. Further blood test results revealed increasingly high creatinine levels but were ignored.

In September 2008, Mr Nanji visited the GP Surgery because his headaches were worse and he was feeling dizzy. He was seen by a different GP who noted high blood pressure and immediately referred him to hospital where tests revealed extremely high creatinine levels. On 3 October 2008 he was diagnosed with acute on chronic renal failure. Renal replacement therapy commenced immediately and he was placed on the transplant list. Mr Nanji still requires dialysis three times a week while he waits for a transplant and has been unable to return to work.

Mr Nanji instructed Philippa Luscombe of Penningtons Solicitors LLP to make a claim for damages and losses following the delay in diagnosis of chronic renal failure. A GP expert instructed by Penningtons was extremely critical of the defendant's repeated failures between February 2005 and February 2008 to act appropriately in light of the elevated blood pressure readings, abnormal test results and subsequent symptoms of headaches and to refer Mr Nanji to a kidney specialist.

The expert opinion of a Consultant Physician specialising in Nephrology concluded that an earlier referral for specialist opinion by the defendant would have resulted in an earlier diagnosis of the renal problems and that the defendant’s failures resulted in accelerating the onset of end stage chronic kidney disease by eight to ten years. An earlier diagnosis and appropriate management would have significantly reduced the rate of decline in renal function by approximately ten to 12 years.

On the basis of the expert evidence, a letter of claim was submitted to Dr Lakshminarayana who, after a considerable delay, instigated negotiations to settle the claim although he did not provide a letter of response or make any admissions.

Commenting on the settlement, Mr Nanji said: "The last few years have been a very difficult time for me and my family. Recovering compensation will help make life easier financially as I have been unable to work but it will not make up for the significant loss of my quality of life or the uncertainty of my future. I feel very let down by Dr Lakshminarayana's failure to spot the signs of kidney failure or to properly investigate the cause of my symptoms. Had he done so, I could have had the specialist help and treatment that I needed at a stage when it would really have made a difference."

Philippa Luscombe of Penningtons Solicitors said: "We were pleased to achieve a good settlement for Mr Nanji but it was frustrating that, despite having acknowledged errors in his response to Mr Nanji's complaint, Dr Lakshminarayana did not respond to the letter of claim or admit the errors. It is very hard for Mr Nanji to cope with the fact that relatively simple steps could have made a big difference to his condition in the short to medium term.

"This is an example of a GP failing to look into the cause of symptoms and assess the information available to him. Mr Nanji had the benefit of Legal Aid to bring his case – those costs were recovered in full which has meant that there was no overall cost to the Legal Services Commission - but the recovery of compensation has made a big difference to him and is an example of the sort of case where public funding can make a real difference." 

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