Abstract
Background
The Claimant claimed damages for clinical negligence arising out of her visit to and discharge from the A&E Department of the Royal Hampshire County Hospital where she attended after a fall on 16 February 2008.
The claim related to a negligent failure to diagnose and treat an L3 compression fracture at an A&E attendance. When the Claimant attended A&E at the Defendant's hospital she was informed she had not suffered a fracture but a soft tissue injury only; she was discharged with analgesics and muscle relaxants and told to mobilize.
When the pain did not subside, she was X-rayed at the Wessex Nuffield Hospital in Chandler's Ford and it was revealed that she had a burst L3 fracture and anterior vertebral collapse.
It was the Claimant's case that the L3 fracture had been negligently overlooked in A&E on the 13 February 2008 and the Claimant endured significant pain until diagnosis was made and treatment commenced. Fortunately the Claimant's long-term prognosis was unaffected.
Allegations of negligence
The Claimant obtained persuasive expert evidence that the L3 fracture and collapse was clearly visible on the X-rays taken in A&E, and that in conjunction with her history and the mechanism of injury (having fallen backwards and struck her back hard against a car suffering immediate pain) the Claimant's fracture should have been picked up.
It was also the Claimant's case that a second opportunity to treat the fracture was also missed. A few days later the X-ray was reported upon by a radiologist as showing the L3 fracture. The Claimant should then have been called back and treated but due to an administrative error in A&E, this did not happen. The Claimant's medical expert advised that on both occasions, the Claimant had received unsatisfactory care.
The Claimant's expert advised that the Claimant's vertebrae had lost 25% of its anterior height at the time of her initial presentation to A&E, and that when diagnosed this had increased to a total 40% loss of anterior height.
Accordingly, it was the Claimant's case on causation that had her fracture been correctly diagnosed at her initial presentation and treated appropriately that she would not have suffered the additional 15% loss of vertebral height, nor would she have had to endure over five weeks of pain and suffering, attempting to mobilize a broken and acutely painful back.
Settlement
The claim was dealt with by the NHS Litigation Authority on behalf of the Defendant Trust. The Trust had apologised for what it described as a ‘systems failure’ within A&E following its internal investigation in response to the Claimant's complaint. Following independent investigations by the Claimant, a Letter of Claim was duly served along with a settlement offer. In the Letter of Response it was argued that the evidence of fracture on the X-ray taken in A&E was subtle such that it was not negligent for the A&E doctor to have missed the fracture. However, liability for the failure to call the Claimant back for follow-up after the X-ray had been correctly reported by the radiologist was conceded.
Following settlement negotiations the claim was concluded with the Claimant accepted the Defendant's offer of £3000 plus costs.
The Claim was funded under a Conditional Fee Agreement.