If you or your family have been affected by poor NHS or private care (in any medical field – for example, childbirth), then you have to read the following cases attentively.

The Claimant, a 63 year old man, received £850,000 plus periodical payments of £130,000 per annum, in respect of injuries suffered following a failure to diagnose and treat a subarachnoid haemorrhage which resulted in him suffering irreversible brain damage, leaving him with significant cognitive and non-cognitive deficits.

On 1 September 2005 X developed a severe headache of sudden onset. He was pale, sweating profoundly and had an extremely high blood pressure. He was admitted by ambulance to the Accident and Emergency department at a local hospital at 1230 hours. On admission his blood pressure was 210/115 and a history of onset of headache during the morning with slight photophobia (sensitivity to light) but an absence of nausea, vomiting or blurring, was noted.

At 1700 hours Y was seen in the Medical Admissions Unit by which time his wife was present. Y reported that there had been a sudden onset of severe headaches, the likes of which he had never experienced before. He was advised that a CT would be performed in order to rule out the possibility of a subarachnoid haemorrhage. This was noted in Y’s medical records.

Y was seen again at 1800 hours by a Senior Registrar who noted the sudden onset of pain and noted that there was an impression of either sinusitis or subarachnoid haemorrhage. The plan was for Y to undergo a CT.

On the morning of 2 September 2005 Y was reviewed during the ward round. This time the impression was of a vascular headache and that his condition did not sound like a subarachnoid haemorrhage. Y was to be discharged.

Later, on 2 September 2005, Y was informed that he would be discharged. During preparations for his discharge he was violently sick and his blood pressure was found to be 210/100. He continued to complain of front headaches; his blood pressure remained elevated with some evidence of neck stiffness. The examining doctor noted the history of sudden onset of severe headaches, vomiting and persistent increase in blood pressure. It was noted that a subarachnoid haemorrhage needed to be ruled out. The plan was to discuss the possibility of a CT scan with senior doctors or send Y home. Y was reviewed again later that day but discharged without a CT scan being performed, and the plan was to review his blood pressure in 7 days.

On arrival at home Y was violently sick. Throughout the weekend he remained confined to a bed in a darkened room as he became increasingly intolerant of light. His headache remained.

On the morning of 5 September 2005 he was visited by the GP who noted his history and advised that he was acutely ill. Y was readmitted to the hospital by emergency ambulance.

On admission his blood pressure was 236/106 and his neck was rigid. It was noted that he was still complaining of the same headaches. Y was admitted to the ward and the plan was for him to undergo a CT scan the following day with a lumbar puncture to follow if the CT scan proved negative.

In the early hours of 6 September 2005 Y suffered a severe re-bleed. On examination he was found to be disorientated in time, place and person. Positive neurological signs were noted including lower limb weakness and a decrease in reflexes. An intracranial bleed was suspected and a CT scan was performed around 0530 hours as a matter of urgency. The CT revealed the presence of a subarachnoid haemorrhage, a small left front haematoma, blood in the anterior hemisphere fissure and early hydrocephalus.

Y was transferred to a different hospital on 9 September 2005 where he underwent a coiling of the anterior communicating artery aneurysm on 12 September 2005.

Liability was admitted by the first hospital.

Y suffered irreversible neurological damage to the brain and has been left with significant cognitive and non-cognitive deficits.

He has no current memory and is virtually amnesic. He has retained intellect but has severe word finding difficulties inhibiting comprehension. Y is disinhibited in behaviour and presentation. He is unable to manage his affairs or make decisions that involve complex thought reasoning or retention of information.

Immediately after the injury, he exhibited signs of gross motor disability involving use of his limbs. He has made a good recovery from this, but still exhibits an ataxic gait, stiffness and weakness of the right arm and he is at risk of falling.

Y suffers right sided hemiparesis, he tires very easily, has problems negotiating stairs and requires the use of a wheelchair for anything other than short journeys.

His disabilities are such that he will always require 24 hour supervision, a high level of care, will never work, drive or perform for himself the usual activities of daily living. He is at an increased risk of epilepsy and his life expectancy is reduced by 12 years.

Out of Court Settlement: £850,000 awarded after submission of evidence on the case through medical experts and clinical negligence expertise.

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