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At present, it appears that dissatisfaction with the NHS is filling the headlines. As portrayed in the media, it is clear that patient safety is a current public concern. This concern will only be heightened by the Junior Doctors’ latest strike.

According to the BBC, The British Social Attitudes Survey, which has been tracking satisfaction since 1983, has recorded that last year (2015) there was the biggest ever rise in public dissatisfaction with the NHS. There seems to be a real public concern in relation to waiting times in A & E, staff shortages and a worry that the NHS will not be able to adequately care or treat them if they required their services. The full article can be read at

 

Further recent news reports have highlighted failings of the NHS, including the story of little William Mead who passed away in 2014 from blood poisoning following a chest infection. As reported by the BBC, a report by NHS England highlighted a number of failings and lessons to be learned from William’s death, including the fact that GPs had failed to diagnose him despite William’s mother having taken him to the GP on numerous occasions in the months leading up to his death. The report had suggested that if the NHS had acted differently it is likely that William would have survived.

 

Other news articles have appeared in response to the concerns highlighted by William’s tragic death. The Daily Mail have reported a further case of sepsis missed in the daughter of TV actor Jason Watkins, and highlighted The Daily Mail’s campaign against the ‘Sepsis Scandal’.

 

There is no doubt that our NHS is under pressure not only from a funding, staffing and performance point of view, but also from the glare of the media.

 

Sadly, lapses in patient safety continue to happen, sometimes having devastating consequences on the patient and their families. As a firm, Brindley Twist Tafft & James LLP are currently dealing with a number of claims in relation to sepsis.

 

If you have experienced poor medical treatment or have a Clinical Negligence enquiry, please do not hesitate to contact us for a free no obligation initial consultation.

 

Nicola Godfrey-Dunne

Medical Negligence Department

 

About the Author

Nicola Godfrey-Dunne is a Medical Negligence solicitor at Brindley Twist Tafft & James and works on a wide variety of clinical negligence claims.

 

On 18 April 2013 Brindley Twist Tafft and James Solicitors and Barrister Teresa Hargreaves of Number 5 Chambers, Birmingham, represented the family of Jessica Strong at the inquest touching her life at Stoke Coroner’s Court. The story of Jessica’s short life and tragic death received coverage in the national press and on local television.

 

Jessica was born prematurely in Nuneaton and transferred to a specialist baby unit in Stoke, as the local units either did not have space or did not have the facilities to meet her requirements. Initially Jessica thrived despite her prematurity but she then became acutely unwell and sadly passed away at just 11 days old.

 

A post mortem revealed that baby Jessica had contracted Serratia Marcesans, a common bacteria which thrives in moist conditions and can be found in many bathrooms. The bacteria is readily fought off by adults and children but is aggressive and difficult to treat in the very young. In this particular instance the bacteria was known to have colonised, but not infected, a different baby on the unit and the treating doctors had not considered a link. Jessica only received the correct antibiotics for the infection a matter of hours before her death, by which time the damage was too severe.

 

Serratia Marcesans was found to have colonised six babies on the unit with another baby dying several days later. The Coroner recorded a narrative verdict that Jessica had died from extreme prematurity and infection spread by human contact, most likely as a result of poor hand washing practice in the unit.

 

Although the hospital suggested that it could have been members of the public who did not use the hand gels, the family were strongly of the opinion that the spread of infection must have been by hospital staff given that six different babies were colonised by the bacteria. The hospital staff confirmed that hand washing and other hygiene procedures are amongst the best in the country following a review of their practices.

 

The NHS Litigation Authority which represents the hospital trust made an early admission of liability prior to the inquest and compensation negotiations remain ongoing.

 

Full story: http://www.dailymail.co.uk/health/article-2311636/Pair-newborn-babies-died-killer-bug-new-400m-University-Hospital-North-Staffordshire-hospital-people-neonatal-ward-failed-wash-hands.html

Richard Stanford

 

About the author

Richard Stanford is a Medical Negligence Solicitor at Brindley Twist Tafft & James and is very experienced in a wide range of clinical negligence cases.

A significant number of patients have been recalled as part of an investigation over the treatment given to cancer patients by urologist, and Channel 4’s Embarrassing Bodies’ doctor, Mr Arackal Manu Nair at Solihull Hospital (Heart of England NHS Trust) and the privately-run Spire Parkway Hospital. It is alleged Mr Nair operated on one man who did not have cancer, while leaving another incontinent and infertile.

 

Mr Arackal Manu Nair, otherwise known as Manu was suspended from his post as an NHS Consultant Urologist at Solihull Hospital when colleagues raised their suspicions about his surgery with hospital bosses and he was referred to the General Medical Council. He has subsequently resigned from his post at the Heart of England NHS Trust.

 

Concerns over Mr Nair’s operations have led to a recall of Mr Nair’s prostatectomy patients at Spire Parkway Hospital and BMI Priory Hospital, Birmingham. There are approximately 170 radical prostatectomy patients within the NHS who were treated at Solihull Hospital and Spire Healthcare group. A radical prostatectomy is a common surgical procedure to remove the prostate gland where patients are diagnosed with prostate cancer.

 

We understand that the central issues concern whether patients were properly advised and surgery was undertaken unnecessarily and the degree of the need for surgery. A prostatectomy is a fairly common operation for prostate cancer. It is an extensive operation to remove the whole of the prostate gland, but other treatment options are usually available, all of which should be discussed with the patient.

 

The Independent hospitals and the Heart of England NHS Trust asked the Royal College of Surgeons to review Mr Manu Nair’s surgical practices both in the NHS and the private sector. It was in light of the result of this review from the Royal College of Surgeons that patients were subsequently recalled.

 

The investigation into Mr Manu Nair’s practice has echoes of the investigations into the cases of ‘cleavage-sparing mastectomy’ by disgraced Solihull breast surgeon Mr Ian Paterson who performed hundreds of unrecognised operations at Spire Hospital at the Heart of England NHS Trust that breached medical guidelines and left women at a greater risk of breast cancer returning. Mr Paterson also performed unnecessary mastectomies, telling some patients they had cancer when they did not. Victims of Mr Paterson are stepping up their battle for justice and compensation against the Spire Hospitals by launching a petition. See the link provided for more information.

 

If you are one of the patients who had been recalled you may wish to do the following:

  1. Review the letter you have received following your recall.
  2. Do you wish to take the matter further?
  3. If so would you like an apology and/or compensation?
  4. Have you already lodged a complaint/spoken to solicitors?
  5. Call us to talk through your concerns

 

We would like anybody who was a patient of Mr Manu Nair to be aware of the issues concerning his work and to have the opportunity, not only to be reassured medically, but to be able to make an informed decision on their rights and available actions.

 

If you have been treated by any doctor or clinician either as an NHS patient, or as a private patient, and have concerns relating to your treatment then do not hesitate to contact our Clinical Negligence team for a confidential, no-obligation discussion and free advice.

 

We are able to offer a Conditional Fee Agreement (i.e. no win, no fee) or act under Legal Aid in appropriate circumstances.

 

Roseanne Elkington & Richard Stanford

Clinical Negligence

November 2015

References:

http://www.birminghammail.co.uk/news/midlands-news/heartlands-doctor-who-starred-tvs-10172871

http://www.birminghammail.co.uk/news/midlands-news/ian-paterson-cancer-surgery-victims-10101785

http://solihullobserver.co.uk/news/second-solihull-doctor-suspended-and-under-investigation-for-cancer-operations-6894/

http://www.itv.com/news/central/2015-10-01/embarrassing-bodies-cancer-surgeon-suspended-after-investigation-launched-into-treatment-of-patients/

http://www.bbc.co.uk/news/uk-england-birmingham-34418228

Mr H of West Bromwich received £25,000 in compensation from Sandwell and West Birmingham Hospitals NHS Trust following their failure to correctly manage his broken wrist.

 

Mr H, aged 34, was messing about a work during a lunch break. He went to punch a foam block when his friend took a step backwards, altering the point of contact. Mr H’s right hand was forced downwards when contact was made. His hand became cold and numb and he was in considerable pain.

 

Mr H attended Accident and Emergency at Sandwell General Hospital that day. He received x-rays which did not reveal any break. He was put into a plaster cast as a precaution and an appointment was made for him to attend the fracture clinic two days later. At the clinic the Consultant was suspicious that Mr H had suffered a fracture to his scaphoid bone (http://www.patient.co.uk/health/Scaphoid-Fracture.htm) which is common with this mechanism of injury and, notoriously, is rarely revealed by x-rays.

 

The treatment plan was for Mr H to remain in cast for 6-8 weeks. Five days later Mr H reattended the fracture clinic at the hospital. He was seen by a Trust Doctor (i.e. less well qualified than the Consultant he had seen previously). No additional x-rays were taken and the Trust Doctor decided there was no break. He decided to keep Mr H out of cast and provided a splint for him to use at night. Mr H was encouraged to mobilise the hand and returned to work at a factory, which involved manual work.

 

One month later Mr H returned to Accident and Emergency as he was in increasing pain in his wrist. Further x-rays and a CT scan were carried out which, by that time, revealed a minimally displaced scaphoid fracture. He was put back into a cast for five weeks.

 

One month later Mr H was seen again by the initial consultant who noted “I have seen him about two months ago with a suspected scaphoid fracture. He was put into plaster. Unfortunately following this he was taken out of plaster and mobilised. His fracture has now gone on to non-union.”

 

Mr H was referred to an expert wrist surgeon at Birmingham City Hospital. He underwent surgery three months later to fix the bone in the correct position. There was a threat he would need further surgery to include a bone graft which looks to have subsided.

 

Mr H recovered reasonable use in his hand although it will never be as good as the left hand. He instructed Brindley Twist Tafft and James to investigate the treatment that he received.

 

Expert evidence obtained suggested that had Mr H remained continuously in a plaster cast for an appropriate duration (6-8 weeks) on the balance of probabilities the fracture would have healed without further treatment and the surgery would have been unnecessary. His recovery period would have been shorter and he would not be left with a pin in his wrist which may later require surgery to remove.

 

The Defendant trust admitted the allegations made in that the original consultant’s treatment plan should not have been overturned by a more junior doctor. Settlement of £25,000 was negotiated which included the above factors under general damages. In addition Mr H had missed considerable time off work, been restricted on a family holiday and had been unable to assist his wife in caring for their baby.

Richard Stanford

Medical Negligence

The work of our Clinical Negligence team is wide and varied, ranging from low value claims for insignificant but unacceptable delays in treatment, to catastrophic brain injury caused by inappropriate medical treatment.

 

The most common cases we encounter include delays in diagnosing cancer, failure to diagnose fractures, falls in hospital and pressure sores. This article aims to provide more information on the last of those issues.

 

Pressure sores (or pressure ulcers) are caused when a person remains stationary for too long. The weight of the body prevents normal blood flow to the area which bears the weight, causing the skin and surrounding tissue to be starved of the necessary oxygen, and other components within the blood, to maintain and regenerate the tissue cells.

 

Pressure sores generally occur on the back of the heels, on the buttocks and on the sacrum (the base of the spine). The heels are especially at risk because the blood flow to the feet is less than elsewhere, there is little tissue between the skin and the bone and, crucially, the area does not usually bear any weight so is poorly adapted to do so.

 

Pressure sores are graded from 1 to 4 depending upon their severity. Higher graded sores can easily become infected and take years to treat. If infection takes hold (which is not uncommon if they occur in a hospital environment) it can lead to blood poisoning and, all too often, the amputation of affected limbs.

 

Some people are more at risk of developing pressure sores than others. Factors increasing risk and vulnerability include:

    • Immobility/reduced mobility (which can be through lifestyle or medical issues) will lead to the person spending too long with weight on “at risk” areas – the longer the pressure is applied, the greater the risk.
    • Circulatory problems such as those seen in diabetics or those with cardiac issues. The blood flow is already poor and it will take less pressure for the supply to be affected.
    • Blood disorders such as liver disease which will mean that the “quality” of the blood is below average, and any disruption to the usual supply will have negative effects more quickly.
    • Dermatological issues: If the person’s skin is already compromised through age, disease or long term use of steroids or steroidal cream (as often prescribed for psoriasis and severe eczema) then it will be more susceptible to damage.
    • Mental Health issues can mean that an individual is unable to comprehend or follow instructions in respect of their own care. They may be entirely oblivious to any risks and may move around less than others.
    • Incontinence and Hygiene issues can leave the skin in a compromised state. Exposure to urine especially causes problems due to its proximity to the sacrum and buttocks; aside from the acid content of urine the prolonged dampness can also make the skin more vulnerable.

 

The risk is multiplied many times for individuals with a combination of the above factors. Because such risk factors are more commonly found in older patients, it is often they who are at the greatest risk, although the problem does not exclusively occur in old age.

 

Pressure Sores are a well-known challenge and a problem for treating clinicians. Extensive research has been carried out and the general view is that their occurrence (at some grade) may be as high as 10% of all hospital admissions. The costs of treating the same are far in excess of the necessary expenditure to prevent them, not to mention the distress and pain caused to the patient.

 

The management of patients in hospital who are deemed to be at risk of developing pressure sores is primarily a nursing issue with accurate assessment (initially and ongoing) and appropriate treatment being key to their prevention. The Royal College of Nursing provides the following Quick Reference Guide which is in use in many hospitals throughout the country – please click on the linkl below.

http://www.rcn.org.uk/__data/assets/pdf_file/0003/78501/001252.pdf

 

Although primarily a nursing issue all treating clinicians need to be aware of the risks of pressure sores. A particular problem is that some patients who require surgery may be kept stationary on an operating table under general anaesthetic for substantial periods of time. Operating tables are not generally designed with pressure relieving methods in mind, and patients are already at increased risk whilst under anaesthetic as blood flow is already compromised.

 

A quote from such circumstances appears in the opening pages of the Royal College of Nursing “Pressure Ulcer risk assessment and prevention guidelines” handbook, referenced above:

 

I had an operation on my gallbladder. I told the staff I was prone to getting pressure sores. They assured me I would not get any while in their care. Low and behold when I came around from the anaesthetic, they found a beauty…it is now six and a half years old

 

That situation is all too common.

 

Generally with appropriate care pressure sores should never develop in a modern hospital, even in individuals with a multitude of risk factors.

 

If you or a friend or relative has developed pressure sores, particularly whilst in hospital, there is a strong possibility that you or they will be entitled to compensation for the same. Should that be the case we invite you to contact our experienced team for free advice, in confidence and without obligation.

 

Richard Stanford

If you require more general advice or information concerning pressure sores it can be found here: http://www.nhs.uk/Conditions/Pressure-ulcers/Pages/Introduction.aspx