Penningtons Manches specialist cardiology team recently settled a claim against University College London Hospitals NHS Foundation Trust for the wife of a patient who died as a result of the care he received at The Harley Street Clinic.
The husband’s medical history, prior to the development of heart valve disease, was largely unremarkable. He was very fit and healthy throughout his life, with no particular medical problems. In February 2014, he was identified as suitable for a mitral valve replacement and tricuspid valve repair. He sought medical advice in June 2014 and the NHS placed him on the waiting list for the procedure.
The husband did not receive an admission date for some time and, on contacting University College Hospital, he was offered surgery at a private practice, The Harley Street Clinic, due to the long waiting list at the NHS hospital.
In December 2014, the husband attended The Harley Street Clinic and was taken to theatre. During the procedure, a peri-operative injury was sustained to the back wall of his heart. This injury has been attributed to the tip of the catheter, attached to the syringe, which was used to fill the left ventricle with saline in order to test the mitral valve repair. The perforation caused a bleed but the surgeons could not locate where this was coming from. They attempted to repair the posterior left ventricular muscle injury, but this was unsuccessful.
The husband was transferred to the Intensive Care Unit but his condition worsened and, tragically, the decision was made to turn off the life support machine the next day.
Following the surgery, the family asked the surgeon what had happened during the operation. He told them that the back of the heart was ‘mushy’ and that he had ‘not seen this before’. However, he did not provide any further information at stage.
Understandably, the death came as a huge shock and the patient’s family were left with a number of questions about what had happened.
The Harley Street Clinic carried out an investigation in early 2015 following the incident. However, they did not inform the family of this, or the outcome of the investigation at the time. There were also errors in the report. However, this investigation identified that the root cause of the incident was the peri-operative injury.
Ultimately, after a conversation with the treating consultant three months later, the family were told that it was the catheter that caused the damage/hole to the back wall of the heart. They made a complaint and instructed Penningtons Manches given their concerns over the treatment provided and the fact the duty of candour had not been complied with.
Penningtons Manches carried out an independent clinical negligence investigation and obtained supportive expert evidence from a consultant cardiologist.
The expert we instructed was highly critical of the care received and identified numerous failings during and following the surgery. The expert confirmed that disruption of the left ventricular muscle with a stiff catheter is not an acceptable consequence of mitral valve surgery and that the injury was caused either by the tip of the extension catheter being pushed into the ventricular muscle or by the force of the injected saline disrupting the muscle fibers. Both of these actions are the result of a poor technique and resulted in the patient’s death. Concerns were also raised about the myocardial protection during surgery.
Investigations took place into the identity of the Defendant given this was NHS treatment at a private hospital.
NHS Resolution, on behalf of the Trust, initially said they would take responsibility, but after receiving a Letter of Claim from Penningtons Manches, they attempted to resile from the position and suggested the private hospital was liable. This resulted in a significant delay in responding to our Letter of Claim.
Ultimately, liability was admitted by the Defendant Trust and the claim settled for a six figure sum.
Georgina Blackwell, Associate in Penningtons Manches’ Clinical Negligence Team and member of the cardiology specialist team, who advised on the claim said:
“This is an extremely tragic case that has had a devastating impact on our client and her family.
The fact that the surgery was performed at a private hospital but was arranged by the NHS unearthed a number of issues as initially neither entity were prepared to take responsibility. This led to substantive delays responding to our Letter of Claim adding more distress to an already difficult situation for our client. It was nearly a year before we received a response to our Letter of Claim.
This case clearly highlights a number of concerns, particularly about the indemnity arrangements in place between the NHS and private hospitals. Further, although many NHS patients are sent to private hospitals for surgery, often such hospitals are not as well regulated and do not have the resources to deal with unforeseen complications or errors. It is also worth mentioning that, in such instances, the NHS has to bear the costs of errors that occurred as a result of private treatment.
We are pleased that the Trust admitted liability and we were able to reach a good settlement for our client. We hope this has now bought the family some closure.”