Damages recovered from Hospital Trust following death of patient

Settlement Report

Name of case: RE  v St Ashford and St Peters Hospitals NHS Foundation Trust

This settlement case was covered in the Daily Mail. To read the article click here, or to download as a pdf, please click here.

Facts of the case

The Deceased died whilst under the care of the Defendant Trust.

Prior to her death the medical records stated that she was aged 90 and was very good for her age, was independent and fully mobile. She had however developed an ulcer on her right foot which was painful. She was diagnosed as having a superficial femoral artery occlusion and was to have a duplex scan.

The duplex scan was performed and sometime later she was seen again and it was recorded that she still had ulcers on the shin and dorsum of the right foot which were clean and healing well. Arrangements were made to see her in three months’ time.

At a further consultation she was advised that if the ulcers failed to heal she may need to proceed to an angioplasty. The Deceased was not keen on surgery and therefore conservative treatment was to be resumed and she was to be reviewed in a month’s time.

When reviewed again she agreed she would undergo an angioplasty and she was to be admitted to St Peter’s Hospital.

The surgery was performed at St Peter’s Hospital and she was discharged the next day with the suggestion that the angioplasty had been successful. The surgeon requested a 1 week review be arranged.

No review appointment at all was arranged and it was not until approximately 6 weeks later that the deceased was re-admitted because of her worsening leg ulcer. The notes state that there had been an episode of bleeding from the ulcer and on examination there was an extremely extensive and dirty ulcer on the right leg which required cleaning in theatre. After discussion with the Microbiologist she was given flucloxacillin and metronidazole.

The ulcer was to be debrided. An angiogram confirmed extensive calcification and what looked like an occlusion of the superficial femoral artery on the right and on the left what looks like a narrowing of the superficial femoral artery.

She was put on the emergency list for surgery.

The Surgical Registrar wrote that she was to have an operation tomorrow and was therefore to starve from midnight.

Surgery was however delayed and whilst the ulcers were debrided on the lateral and medial sides of the leg nothing else was done by way of bypass grafting or attempts to save the leg. The ulcers were merely dressed and AVAC dressing applied.

She remained in hospital and was seen by the Tissue Viability Nurse as the ulcer was now the full circumference of the leg and very sloughy and various dressings were applied.

Whilst in hospital her condition deteriorated and it was felt that her condition was due to sepsis and she needed an above knee amputation to try and arrest the process.

The Consultant Vascular Surgeon raised concern that the sepsis was being driven by the infection in her leg and stated the need for an urgent lifesaving amputation. Instructions were left by the surgeon that this needed to be performed on the emergency list and if for any reason the On Call Team were not available he himself would perform the emergency amputation despite the fact he was not on call.

The urgent potentially lifesaving procedure was however delayed.  

Following the delayed procedure the deceased spent time overnight in a recovery area where she had impending renal failure and multiple organ failure with severe acidosis.  She regained conscious post operatively but then became unresponsive. She was treated with noradrenaline infusion to try and improve blood pressure and kidney function. Her condition was rapidly deteriorating and it was felt that no further action could be taken following which she was declared dead.

Procedural history

Following her death, the Deceased’s family complained about their mother’s treatment via the NHS Complaints Procedure. This was met with a denial. They then took their complaint to the Healthcare ombudsman without success.

After many years the family instructed Gregory Abrams Davidson Solicitors.

We obtained independent medical evidence from a Consultant Vascular Surgeon. This evidence confirmed to us that the original procedure to treat the ulcer was reported as successful but in fact, the Radiologist only managed to dilate the artery above the blockage but did not actually negotiate the blockage at all. Therefore the condition was always going to deteriorate further if left untreated. This was then compounded by the fact that whilst her Treating consultant requested a review 1 week no review was arranged.

The Deceased’s condition therefore deteriorated unchecked eventually resulting in the need for an urgent life-saving amputation, which was unsuccessful.

Following our investigations a Letter of Claim was sent to the Trust who denied liability. They argued that the original angioplasty procedure to treat the ulcer had been a good result and argued that it was the deceased who had failed to attend a follow up procedure and this was not due to any failures by the Trust. Our clients were invited to discontinue their claim.

Consequently formal documents were drafted and Court Proceedings were commenced. A short time the later the Trust engaged in settlement negotiations and a negotiated settlement for substantial damages was reached together with a written apology from the Trust.

GAD Solicitors specialise in obtaining compensation for clients who have sustained injuries as a result of Medical Negligence. We deal with claims for compensation against hospitals (both NHS and Private), dentists, general practitioners, pharmacists and opticians. We have offices in Liverpool City Centre, Allerton, Garston Village and Golders Green, London. We offer a free initial case assessment and No Win No Fee Funding is available. To enquire contact a member of our Medical Negligence new enquiries team on 0151 733 3353, email This email address is being protected from spambots. You need JavaScript enabled to view it.