A woman from Dartford in Kent, Clare Wadey, has settled a clinical negligence compensation claim against Gravesham Community Hospital (part of Kent Community Health NHS Foundation Trust) for the negligent medical care she received while suffering from a urinary tract infection which developed into a life-threatening case of sepsis. She became so alarmed by the standard of treatment that she was receiving at the community hospital that she insisted on an ambulance being called from her hospital bed to secure the urgent care she required to treat her condition. Her case is an example of basic and unacceptable failings in NHS care which are sadly occurring too frequently.
Statistics released by the UK Sepsis Trust estimate that there are around 150,000 instances of sepsis in the UK every year and that it kills around 44,000 people each year. In light of these figures, it has recently been stressed by the National Institute for Health and Care Excellence (NICE) that healthcare professionals should consider the possibility of sepsis in all patients who may have an infection, and new guidelines have been released to help them recognise and deal with patients displaying symptoms of this condition. Basic awareness of the signs of sepsis and the importance of its prevention have not been consistent and are often not acceptable.
Miss Wadey instructed the clinical negligence team at Penningtons Manches LLP to investigate her concerns over the management of her urinary tract infection during her stay in the nurse-led rehabilitation unit at the local community hospital. She had a particularly complex medical history, including a neurogenic bladder, for which she requires a long-term catheter and is therefore particularly susceptible to developing complications with urinary tract infections. When she was admitted to hospital in August 2012, Miss Wadey was well known to the nurses within the rehabilitation unit and they should have been aware of her susceptibility to urinary infections.
Shortly after her admission, Miss Wadey, who was aged 37 at the time, started to experience increased fatigue and higher levels of loin pain and became increasingly reliant on a strong from of analgesia, Oxynorm. Despite repeatedly informing nurses of her symptoms, staff failed to keep clear and accurate records of her case and any treatment provided. This was alleged to be in breach of the NMC Guidelines 2005. As part of the investigation into her claim, independent experts reviewed her case and echoed her concerns about the quality of record keeping as well as staff failure to monitor her at regular intervals. This negligence compounded the problems that later ensued.
A week after the start of her stay in hospital, Miss Wadey became very unwell and her infection progressed to sepsis. Sepsis can start when the immune system overreacts to an infection and begins to damage the body itself. It can ultimately result in organ failure. Despite showing symptoms of the condition overnight, the nursing staff decided simply to throw an extra blanket on her and close the window. The next morning, she continued to be very unwell and it was clear from the records that the nursing staff failed to consider the possibility of sepsis or recognise that her condition required urgent attention. A GP from the community who was visiting another patient that afternoon was asked to see her but he failed to examine her, despite the fact that she was clearly unwell with a raging infection, and merely prescribed oral antibiotics before leaving the unit.
A couple of hours later, Miss Wadey’s condition deteriorated further. By this time she knew that something was very wrong and as she had lost all confidence in the nursing care, she asked that an ambulance be called. By the time the paramedics arrived, her temperature was recorded to be 40.5° and her pulse was 128. The paramedics immediately raised a suspicion of sepsis and Miss Wadey was “blue lighted” to the nearby acute hospital, where she was taken into intensive care. Thankfully, due to the prompt action taken by the doctors at the acute hospital, she recovered from the ordeal, although it was a slow and difficult process and the events caused her and her family much distress and anxiety.
Without emergency care, Miss Wadey may not have survived. She decided to lodge a formal complaint with Gravesham Community Hospital under the NHS complaints procedure. The hospital subsequently performed an internal investigation and compiled a root cause analysis report, which identified a number of failings in her care as well as knowledge gaps. Miss Wadey also liaised with the General Medical Council (GMC) over the conduct of the GP who visited her that afternoon. Fitness for practice proceedings were brought by the GMC and then dropped when the GP elected to remove himself from the roll of practising physicians.
At this point Miss Wadey approached Penningtons Manches so that her concerns could be investigated further. After obtaining supportive evidence from a number of specialist independent experts, a case was presented to the hospital trust. Within its first response, the NHS Litigation Authority (NHSLA) admitted that there were a number of failings in her care and indicated that it would be prepared to reach a settlement. Miss Wadey duly made a reasonable offer to settle the claim in full in early 2016. However, some weeks later, the NHSLA informed her that it now believed that the admitted failings in her care had had no adverse causative effect on her condition and that therefore no damages were payable.
Miss Wadey was understandably upset by this change of stance and apparent complete disregard for the traumatic experience that she had been through. Penningtons Manches subsequently highlighted to the NHSLA that there were significant issues with its conduct and revised position and that if it did not take a sensible approach, court proceedings would be issued. After negotiations, the claim was then settled.
Commenting on her case, Miss Wadey said: “My experience at Gravesham Community Hospital was both frustrating and traumatic. To be in hospital but to end up insisting on an ambulance being called yourself because you recognise you are seriously ill and those caring for you do not, is a position that no patient should be in. I felt sufficiently strongly about the basic failings in care that I wanted to draw attention to what had happened to me so lessons were learned. Having been initially reassured that things were taken seriously, it did rather add insult to injury to have the NHSLA offer to settle my claim and then try to deny I had suffered any adverse impact from its failings. I have seen many comments recently regarding claimants’ legal costs but there is no doubt that in my case additional delay and cost was caused by the conduct of the NHSLA. I am, however, pleased to see the recent campaigns regarding awareness of sepsis and hope that the staff at Gravesham Community Hospital have learned something from my experience.”
Naomi Holland, an associate in the clinical negligence team at Penningtons Manches who represented Miss Wadey, added: “This is an example of a case where a patient became extremely unwell with a life-threatening condition which could have been avoided. Since these events, she has made every effort to highlight the issues in her care so as to improve standards and avoid future incidents. Sadly, despite acknowledging that there were failings in our client’s care, the NHSLA’s conduct has been poor, in breach of the pre action protocol in place for these claims and without any sensitivity to what our client has been through.”