Penningtons Manches LLP has settled a claim for a client whose mother died following a fall in a Care UK home in Surrey.
The elderly woman was suffering from dementia and took warfarin for a heart condition. She walked with a frame due to her frailty and instability and had a history of falls. In the five days leading up to the incident, she suffered four falls while she was unattended in the home. It should have become clear that she was at high risk of falling and particular care should have been taken since patients who are on warfarin are at risk of severe bleeding from their injuries.
The fall which led to the mother’s death occurred on an evening when she was showing severe confusion and difficult behaviour, partly due to delirium caused by a urinary tract infection. It was very late at night and she was standing in the kitchen/dining area several metres away from a care assistant. She fell backwards, hitting her head on the hard flooring. Although she was conscious after the fall, she was found to be bleeding from the back of her head. However, no one called the emergency services for medical advice.
Over 12 hours later, when the district nurse visited for her mid-morning rounds and checked the residents’ medication, she identified that the woman was difficult to rouse. A GP, who was also visiting the care home, examined her and immediately advised that an ambulance be called due to signs of neurological deficit. She was taken to East Surrey Hospital where a CT scan of her head revealed a subdural haematoma and intracerebral haemorrhage. Tests also showed that her blood clotting levels (INR) were significantly raised due to warfarin. A neurosurgical specialist confirmed that this was a terminal head injury and there was no prospect of surgery to save her life. She died approximately two weeks later.
Care UK compiled a report accepting that its care team failed to call an ambulance, contravening its policy guidelines for residents who have sustained a head injury and are taking anticoagulant medication, such as warfarin. Penningtons Manches investigated the case prior to the inquest and instructed a barrister to represent the family at the hearing.
The coroner concluded that by not following its own guidelines, Care UK caused an opportunity to be lost to treat the blood clotting levels earlier with appropriate clotting agents. He found that the woman “died from an intracranial bleed following a fall which was more than minimally contributed by a combination of a high INR and a delay in being taken to hospital on a background of frailty and old age”.
Following the inquest, a letter of claim was submitted to Care UK and the claim was settled after Part 36 negotiations.
Lucie Prothero, a senior associate in Penningtons Manches’ clinical negligence team, who specialises in elderly care and falls cases, comments: “We are seeing a significant increase in the number of enquiries relating to falls among the elderly, involving both hospital and community-based care. In many instances, these falls have very serious consequences, leading to disabling fractures, brain injury and sadly, as in this case, death. There is a large amount of publicity at the moment about the UK’s ageing population and the devastating effect that falls can have on the elderly. This case highlights the importance of ensuring that older patients are properly assessed for their risk of falls and receive appropriate medical care when an incident occurs. Often, simple safeguards are all it takes to prevent falls and avoid the devastating loss that our client suffered.”