Clinical Negligence Case Study
In or about 2004, our Client experienced respiratory difficulties. These included a chest infection and wheeze, and were treated as a chest infection with underlying asthma. Our Client’s GP prescribed an inhaler, the use of which made no difference to the symptoms.
In July 2008, respiratory function tests indicated non-reversible airway obstruction. This made a diagnosis of asthma less likely.
In August 2009, our Client was unable to cope with work due to his symptoms and his GP certified that he was unfit to work.
In November 2009, our Client was examined by a Professor at hospital, who diagnosed asthma or chronic obstructive pulmonary disease, or a mixture of the two.
In February 2010, our Client was seen again in the same clinic, and the same diagnosis was made.
In August 2010, our Client’s GP identified stridor on inhalation (a high pitched breath sound) and referred him to his local ENT Department.
A letter from an ENT specialist detailed symptoms of hoarseness but made no reference to the history of stridor and our Client was referred for speech therapy and an ultrasound.
The ENT department advised that an ultrasound scan had revealed a right sided neck swelling due to a “multi-nodular goitre”.
In March 2011, our Client was discharged from the care of the ENT department, having been advised that the thyroid goitre had not enlarged significantly and surgery was not appropriate. September 2011, he was discharged from speech and language therapy.
He continued to report symptoms and was seen by nurses at his GP’s surgery in December 2011 and January 2012.
At the request of his asthma nurse, our Client underwent a chest x-ray in January 2012 which revealed a “large mediastinal mass, compressing and displacing trachea within the thorax” (i.e. a large retrosternal goitre).
He underwent surgery in April 2012 to remove the goitre. The surgery involved fracturing his sternum to locate and remove the goitre, this immediately improved his symptoms.
Our Client pursued a claim against the hospital trust on the basis that the medical treatment provided was sub-standard and negligent because there was a failure to make the correct diagnosis in 2009. The diagnosis of asthma was not only wrong, but unlikely. Further, he alleged that there was a failure to recommend or arrange further investigations, including a chest x-ray, and there was a failure to consider the possible cause of the stridor, at which point further investigations should have been arranged, including a chest x-ray.
It was also alleged that medical staff failed on numerous occasions between 2009 and 2012 to recommend or arrange the appropriate investigations and failed to recommend surgery at any time prior to January 2012.
In fact, the medical staff continued incorrectly to diagnose asthma when the clinical signs made such a diagnosis unlikely. The hospital trust admitted liability but denied causation, stating that the diagnosis of asthma/COPD was not unreasonable.
Our client received damages totalling £15,000 which included compensation for his loss of earnings and the unnecessary pain and suffering experienced in relation to the delay in diagnosing his condition.
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