Matthew Brown, our senior Chartered Legal Executive, acted for a 72-year old female claimant (“C”) who received £400,000 compensation, after agreeing an out of court settlement. Whilst under observation on an Acute Stroke Ward, staff delayed in recognising signs and symptoms of a stroke, C was therefore denied administration of thrombolysis (a clot-busting drug) and suffered permanent right-sided paralysis.
The £400,000 settlement included general damages (for pain, suffering and loss of amenity) and past and future financial losses.
On 18 November 2013, “C” felt a sudden aching sensation in her right arm whilst at home and believed she was suffering a stroke. Upon examination by paramedics, C was said to be Face, Arm and Speech Test (FAST) positive. The symptoms appeared to improve during the blue light transfer to hospital. C was assessed in the Medical Assessment Unit of Solihull Hospital and the working diagnosis was of a possible transient ischaemic attack. A CT scan was unremarkable. C was admitted to the Acute Stroke Ward for observation and with a plan for inpatient carotid Doppler the next day.
At around 3 a.m. on 19 November, C reported increasing weakness in her right hand to a Healthcare Assistant but was reassured and encouraged to sleep. When she awoke, C was paralysed down her right side. Examination revealed reduced power in the right upper limb (3/5) and lower limb (4/5) in comparison to normal power on the left side. An untimed entry in the records that day by a Consultant Physician, noted that it was “disappointing not considered for thrombolysis.” On 20 November C experienced a dense weakness in her right arm and right leg and her power in each of the upper and lower right limbs was recorded as 1/5.
After physiotherapy treatment, C was assessed on 09 December as beginning to mobilise, taking a few steps with the assistance two people. Her power remained 0/5 in the right upper limb and 2/5 in the right lower limb. The next day, C was assessed as being medically stable and ready for discharge home having been treated with anti-platelets at a therapeutic dose, statins and hypertensives.
On 17 April 2014, at review in the Stroke Clinic, C was discharged from further follow-up. A subsequent MRI scan of the head performed on 27 February 2017 showed appearances consistent with the stroke on 19 November 2013, being one involving the anterior choroidal artery territory.
Having pursued a complaint about the treatment provided, a letter drafted by C’s husband dated 16 November 2015, was treated as a letter of claim. In March 2016, it was met with a response which admitted breach of duty on behalf of the Defendant Trust (“D”) but denied causation of injury. C instructed Medical Solicitors after another practice had rejected the potential claim having obtained an unsupportive opinion from a barrister. However, at Medical Solicitors, our team disagreed with the other firm and their barrister’s pessimistic view of the case.
It was common ground that D was in breach of its duty of care in relation to the lack of a rapid review by a nurse at, or shortly after, 3 a.m. on 19 November 2013. However, in terms of causing injury to C (‘factual causation’), it was not admitted that such a review would probably have resulted in:
an urgent call by the nurse to the on-call doctor, and;
clinical diagnosis of stroke being made by the on-call doctor and thrombolysis being offered had he been summoned.
In relation to medical causation, C alleged that with the benefit of prompt administration of thrombolysis, she would have enjoyed an excellent recovery from the stroke. However, D asserted that the administration of thrombolysis would not, on the balance of probabilities, have altered C’s outcome.
The Parties relied on expert evidence in the fields of stroke medicine, stroke rehabilitation and care/occupational therapy. There was extensive pre-action correspondence between our firm and D’s representatives. There was a mediation meeting in October 2018, but a resolution could not be found at that stage. Court proceedings were, therefore, served in March 2019 and, less than two weeks before trial, agreement for payment of compensation was reached in January 2021. However, this was without D every admitting factual causation.
This was a high value claim. On our client’s behalf, Matthew put forward a claim for pain, injury and suffering (‘general damages’) valued at £232,791, as well as and past and future financial loss in the region of £1.15m to £1.25m. D’s Counter-Schedule of Loss allowed for £60,000 in general damages and between £290,411 and £363,615 for special damages and future loss, subject to liability.
The settlement reflected a reduction in figures (of more than one half) during settlement negotiations to take account of the risks of going to trial. Matthew Brown had all evidence ready to proceed to the Trial and advised his client that she could recover a much higher sum at Trial (assuming the Judge found in her favour) and that he could negotiate at least £100K higher for her if she allowed him to continue negotiations pre-Trial. However, our client had been through a lot with her illness and was adamant she wished to accept the reduced figure of £400,000 to bring an immediate end to the litigation at that stage.