A boy from Hertfordshire who suffered brain damage after heart surgery in 1999 is to receive £7.3m compensation.
Robbie Crane, who is now 13, won an out-of-court settlement for a claim of alleged medical negligence against Harefield Hospital in Middlesex.
The Royal Brompton and Harefield NHS Trust denied liability.
Robbie's parents said the settlement, which was given final approval on Wednesday, would allow the family to "plan for the future with confidence".
We were repeatedly told that there was no chance of securing compensation”
Catherine and Barrie Crane
Their son was born with transposition of the great arteries.
He was admitted to Harefield Hospital for the defect to be corrected in October 1999, when he was a few days old.
The surgery was successful but a legal claim was brought relating to alleged negligent treatment during a period of ventilation afterwards.
Robbie, who now has cerebral palsy, learning difficulties, limited speech and behavioural problems including no sense of danger, will need specially-adapted accommodation and round-the-clock care for the rest of his life.
In 2011, the High Court heard that settlement in the case had been reached with the Royal Brompton and Harefield NHS Trust on the basis that it would pay 70% of the full value of the claim.
On Wednesday, Mr Justice Tugendhat, approving the settlement, paid tribute to the devotion shown by Robbie's parents, Catherine and Barrie.
Neil Block QC, for the trust, said that although no admission was made as to breach of duty, he wished to apologise to the family and hoped that one huge worry had been lifted from their shoulders now Robbie was financially secure.
After the hearing in London, Mr and Mrs Crane said: "This brings to an end a long and challenging legal process but the daily care that Robbie requires will continue for the rest of his life.
"We were repeatedly told that there was no chance of securing compensation but our legal team urged us on and so it is a great relief to finally have it decided."
This article is courtesy of BBC News.
When Libby Zion, an 18-year old college freshman was rushed to New
York Hospital on the night of October 4, 1984, she had a fever, chills
and mysterious jerking symptoms. Following admission to the hospital,
she was evaluated by two medical residents, who were unsure what exactly
was wrong with her. They prescribed her meperidine, a sedative, and
left to take care of the other 40 patients that they were assigned to.
Later that night, Libby's temperature shot up to 107 degrees. Despite
her deteriorating condition, she was never evaluated by the attending
physician. She died of a cardiac arrest that night.
When Libby's
father investigated his daughter's death, he found that the two
residents who evaluated her had been on call for nearly 24 hours, and
that many residents routinely worked up to 36 hour shifts. Their
sleep-deprivation may have led them to miss the fact that the medication
they prescribed Libby, meperidine, had known interactions with another
medication she was taking, and might have contributed to her decline.
Her father eventually sued the hospital for wrongful death, setting off a
national debate on medical resident work hours and supervision that has
lasted for almost 30 years.
Over the past several decades, a
growing body of medical literature has suggested that sleep deprivation
from working long hours in the hospital can lead to serious mistakes.
One study found that surgical residents who had been up all night
committed 20 percent more errors and took 14% longer to complete a
surgical task than those who had gotten sleep the night before. Another
found that the deterioration in hand-eye coordination after being up for
28 hours was similar to having a BAC of 0.1 percent (25 percent above
the legal driving limit). In response to this research, the
Accreditation Council for Graduate Medical Education (ACGME) proposed
new guidelines last year that require first-year medical students to
work a maximum of 80 hours a week, with shifts lasting no longer than 16
hours. This represents a drastic change to the regulations in place
prior to July 2011, under which residents worked up to 30 hours in a
single shift. With preventable medical errors raking $1 trillion in
losses on the US healthcare system, the ACGME hoped that these new
resident duty hour regulations would reduce medical errors while
improving patient care and enhancing resident quality of life.
Unfortunately,
a recent survey published in the New England Journal of Medicine
suggests that these duty hour regulations have had little practical
effect. The authors surveyed 6202 residents in 123 residency programs in
41 states, and found that overall, many areas that the new ACGME
regulations had targeted for improvement remained unchanged. A majority
of residents reported no change in the amount of rest they obtained
(50.1 percent) and the total number of hours worked (58.9 percent), and a
substantial portion reported a worsening of their work schedules (43.0
percent) and a decrease in the quality of their education (40.9
percent). In addition, senior residents reported a decrease in quality
of life (49.7 percent), perhaps due to the shift of workload from
first-year residents to more senior residents. Overall, more than twice
as many residents surveyed disapproved of the regulations compared to
those who approved of them (48.4 percent vs 22.9 percent).
Given
these data, it is clear that greater reform is needed. Measures should
be put into place that effectively ensure residents are getting enough
sleep, and that their work schedules and quality of life are improving,
rather than deteriorating under the new guidelines. Moreover, patient
safety should always be at the forefront of the regulations to ensure
that preventable medical errors are caught before they cause serious
harm. Enforcing measures that incentivize the achievement of these goals
will enhance both patient and physician quality of life.
This article is courtesy of The Huffington Post.
After losing their only son Josh at the age of 16, Ian and Nikki Singleton were desperate to build a family again.
They went through 13 bouts of IVF before Mrs Singleton became pregnant again – this time with twins.
But an inquest yesterday heard how the birth turned to tragedy following a string of medical failings.
Mrs Singleton was rushed to hospital suffering from severe stomach pain just 30 weeks into her pregnancy.
After being transferred to another hospital and enduring an agonising wait to be treated her baby boy Reuben was stillborn and his twin sister Esme died the following day.
The hearing found medics had failed to spot Mrs Singleton, 49, had suffered a rupture to her uterus when she arrived at the Royal Glamorgan Hospital near Cardiff in July 2009.
Her condition worsened as she waited two hours for a Caesarean section that resulted in Reuben being stillborn and Esme showing no signs of life.
After 22 minutes of resuscitation Esme began breathing again but she had suffered such severe brain damage that the Singletons – who lost their son Josh to a brain haemorrhage – agreed to turn off her life support machine the next day.
Aberdare Coroner’s Court heard midwives had ignored the warning signs of Mrs Singleton’s condition despite the fact she was in severe pain.
Consultant gynaecologist Hatel Tejura said the lack of uterine activity and a foetal heartbeat should have sent alarm bells ringing then.
The inquest was being held into the death of Esme only because there are no inquests into the deaths of stillborn children.
It heard that when Mrs Singleton arrived at the Royal Glamorgan a midwife could only detect one heartbeat instead of the two there should have been.
But at this point at 12.40pm medics believed she was in premature labour and had not diagnosed a ruptured uterus.
There was then a two hour delay before a Caesarean section was performed in which time Esme is believed to have suffered severe brain damage.
Glamorgan coroner Louise Hunt recorded a narrative verdict saying: ‘Esme was well at 12.40pm – it is most likely there was a critical event then with things changing radically but not being appreciated by the medical staff. They have acknowledged that today.
‘Because it was not appreciated that she was in serious difficulties there was a considerable delay in doing a Caesarean section.
Esme was not delivered for two hours – more than enough for the damage to have been done.
‘She died from brain damage caused by the rupture which went undiagnosed in labour resulting in delay in the delivery.’
The inquest heard the local Cwm Taff Health Board had accepted failing in their standard of care and offered its apologies to the Singletons who were living near Cardiff at the time.
After the hearing Mrs Singleton, who now lives in Swindon, Wiltshire said: ‘This happened three years ago but the pain is still there and will never, ever go away.’
Her husband, 50, said: ‘We feel that Esme’s death was a mixture of incompetence, negligence and a cavalier attitude.’
The couple are pursuing a legal case against the hospital for negligence.
This article is courtesy the Daily Mail.
When Bernadette Cini decided to have a breast reduction after years of deliberation, she opted for a surgeon at the Harley Medical Group – a prestigious, reputable firm. Or so she thought.
Her G-cup breasts caused significant back pain and she may have qualified for NHS treatment but chose to go private for this highly complex operation.
‘I wanted the best possible result,’ says the 62-year-old.
‘The surgeon Hicham Mouallem assured me he used a technique that minimised scarring and retained sensitivity to the nipples, which could be lost. So I decided to go ahead.’
It was a decision she would bitterly regret. In the days after her £5,700 surgery in 2006, the mother of two from Croydon, Surrey, developed a rampant infection in her breasts.
It was ‘flesh-eating’ necrosis, caused by pseudomonas, bacteria normally found in soil.
Over the course of a year, she had five operations to cut away diseased tissue and repair her breasts.
The constant agony she was in meant Bernadette was unable to go on working as a nanny and eventually had to give up her job completely.
‘Everything became a horrible blur of hospitals, operations and pain,’ she recalls.
But when Bernadette sought compensation, Harley Medical Group claimed they were only ‘agents’ so not responsible, and that the surgeon had returned to Italy.
Mouallem was a ‘Fifo’ – a ‘fly in, fly out’ foreign surgeon – and had no insurance in the UK. Although all doctors treating patients in Britain must be registered by law with the GMC, they do not have to have insurance in this country.
There are no official figures on the number of Fifos operating in the UK, but the last estimate, from a report by the then Healthcare Commission in 2005, stated that two-thirds of surgeons may be from abroad. If they are uninsured, patients who suffer horrific complications struggle to obtain compensation.
It took Bernadette months to track down Mouallem and two years to build a case against him. He admitted he had not warned Bernadette of her heightened risk of infection, due to her weight, and agreed to pay her £20,000 in an out-of-court settlement, barely enough to cover her lost earnings.
Recalling the initial operation at the Highgate Hospital, Bernadette says she first noticed something was not quite right when she woke up after surgery. A drain inserted into her newly-reduced left breast to remove excess fluid was not working.
Mouallem checked Bernadette that evening. She recalls: ‘He just squeezed the suction bag adding, “It’s OK,” and then left.
‘The next day when he returned and saw the drain was still not working he squeezed my breast with his hand, until fluid seemed to move into the drain.’ The next day, a different doctor discharged Bernadette and she went home.
She continues: ‘At first I put my discomfort down to the fact I’d had surgery. Two days later, though, my breast was feeling really tight and painful. I returned to the clinic, where I already had an appointment for a routine dressing change. By the time I went in, my breast felt like it was going to burst and was clearly very infected.
‘The nurse told us she had never seen anything like it before and that I needed to see the surgeon.
‘When he saw it, he started to try to syringe it while pushing down on the breast with the other hand. I was in agony.
‘He didn’t have gloves on and kept telling the nurse “get her to turn away” and “keep her quiet”, because I was screaming.’
A new dressing was applied and she was sent home.
A couple of days later she was again in pain and feeling extremely weak. When her partner contacted the clinic, Bernadette was amazed to discover Mouallem was no longer in the UK.
She was sent to see another Harley Medical Group surgeon, who delivered the devastating news that she had a severe infection and arranged for re-admission to the Highgate.
Bernadette was given antibiotics but the bug spread into the other breast. ‘It was horrifying. There was so much discharge that it would weep through a new dressing and eventually I had to re-do the dressing myself.’
For the next six weeks she was in and out of the hospital but nothing stopped the infection. It was only after she demanded a meeting with the hospital director that she was referred to another specialist, Charles Nduka.
‘He was brilliant, but he had to cut a huge amount of tissue out in order to stop the infection. I’m lucky that I still look relatively normal, with a small scar underneath both breasts.
‘I had hoped that having a breast reduction would allow me to start doing more exercise and get slim. But being so ill and immobile led me to put on weight. Mouallem treated me like something on a conveyor belt.’
Mouallem, who now claims to have UK insurance, said earlier this year: ‘She was a fat lady. She had an infection, it was from the hospital, not from me. The blame gets put on me because it is easier for the company. It wasn’t like she was dying, it was an infection. It can happen with any surgery.’
This article is courtesy of the Daily Mail.
A grandmother died because of appalling blunders by a German surgeon flown in by the NHS.
Ena Dickinson, 94, lost nearly half the blood in her body during what should have been a routine hip operation.
Werner Kolb cut the wrong muscle, severed an artery and used the wrong cutting tool in what an expert witness described as the worst case of negligence he had come across.
The case highlights again the problems of using foreign doctors to cover staff shortages.
Often recruited through agencies, they are not tested to see if they are up to NHS standards because Brussels rules enforce freedom of movement for EU workers.
In the most notorious case, Daniel Ubani, another German locum, was found to have unlawfully killed a 70-year-old by giving him ten times the proper dose of a painkiller.
Mr Kolb was woefully out of practice for the procedure at Grantham Hospital in Lincolnshire, an inquest was told.
He had performed a relatively small number of hip operations during his career and had been mainly lecturing in the four years before the incident.
He became so flustered in the operating theatre that he started speaking German. Another doctor had to step in amid the chaos.
Incredibly, Mr Kolb was free to work in the UK for eight months after the horrific blunder in August 2008, which left Mrs Dickinson bed-bound. Her inability to walk led to pneumonia that killed her eight weeks later, on October 26.
Professor Angus Wallace, the expert witness, told the court that 70 per cent of elderly hip replacement patients survive for more than a year, meaning that Mr Kolb's error was likely to have caused her death.
Professor Wallace, who has 25 years of experience as an orthopaedic surgeon, told the coroner: 'Mr Kolb was out of his depth and unable to deal with the situation.
'I believe that the operation brought forward her death.
'This is the worst case of negligence that I have come across in my career.'
Mr Kolb refused to attend the inquest and is back working in Germany.
Coroner Stuart Fisher told hospital bosses at the hearing: 'This case leaves me deeply shocked. The trust has to accept responsibility.
'Your role is to provide competent staff and in that you manifestly failed.'
Mrs Dickinson's daughter, Kathy Ingram, 57, a lecturer in decorative arts, said last night: 'My mother's treatment was horrific and devastating. She trusted the NHS and as a nurse, put her life's work into it. She should have been protected.'
She is considering legal action. Her solicitor, Paul Balen, said: 'The current system is disgraceful. There must be closer monitoring of locum doctors otherwise more people will lose their lives.
'Doctors being investigated should be required to co-operate with investigations and not be allowed to get away with appalling negligence.'
Mr Kolb, 51, based at Bethesda Hospital in Stuttgart, was three weeks into a six-week placement at the hospital as holiday cover for another surgeon.
The operation on Mrs Dickinson was the first he had carried out on his own.
Sleaford Coroner's Court in Lincolnshire heard he was not a 'hands-on' doctor and had been working on a thesis.
He cut through the wrong muscle and into a 'danger zone' known as the femoral triangle before plunging the knife into Mrs Dickinson's artery.
He continued with the operation, using an inappropriate power saw to remove a large piece of hip bone, the inquest heard.
It was not until 15 minutes into the procedure, after blood began gushing from the wound, that Mr Kolb realised what he had done.
He became 'upset' and 'agitated' and slipped into his mother tongue, prompting a nurse to demand that he speak English.
A nurse ran for help and a second surgeon, Odathurai Paramasivan, was forced to step in to save Mrs Dickinson's life by stemming bleeding from the large hole in her hip.
Mrs Dickinson was a few minutes from dying on the operating table and lost more than two litres of blood, Mr Paramasivan told the coroner.
'The operation relied on basic anatomical knowledge, even at a junior level. I was horrified by what I saw,' he said.
Mr Kolb was sacked by United Lincolnshire Hospitals Trust the following day - but it failed to report him to the General Medical Council because Graham Hale, the deputy medical director, was on leave and then awaiting advice from other agencies.
It was only when Professor Wallace was commissioned by the coroner to examine the evidence in June 2009 that the GMC was notified and Mr Kolb was suspended.
The doctor and the NHS-approved agency, Athona Doctor Recruitment, which hired Dr Kolb, have refused to cooperate with the investigation, the inquest was told. Both have denied wrongdoing.
Mr Kolb told the Mail: 'I consider myself in no way guilty or responsible for the death of this woman. I can clearly recall that after the procedure she was in a good condition.
'She was old and there would always be a risk for a patient of her age but I repeat, the procedure was carried out properly and I say my work had nothing to do with her death.'
Lincolnshire Police are not investigating Mr Kolb.
A spokesman for the United Lincolnshire Hospitals Trust, which spends £20million a year on locum staff, said: 'The trust has done everything possible to learn from this incident and to prevent it happening to another patient.'
It has not explained why it had to hire a surgeon from abroad as holiday cover.
Michael Summers, chairman of the Patients Association, said: 'We are against foreign doctors coming over here from European countries with inadequate experience and poor language skills.
'We must stop and think again about how to protect NHS patients and insist the rules are changed.'
Dr Ubani escaped a manslaughter prosecution in the UK after a German court convicted him of death by negligence and gave him a nine-month suspended sentence.
This article is courtesy of the Daily Mail.
More than 30 families have taken legal action against a hospital in north-west England for a catalogue of baby and maternal deaths and injuries.
They blame poor care and medical negligence at Furness General Hospital at Morecambe Bay in Cumbria.
Parents also allege that important reports were suppressed in the run-up to the local NHS trust achieving foundation trust status in March 2010.
The trust said there was "no denying" families were let down in the past.
The hospital is at the centre of the scandal which is now the subject of a number of investigations including a police inquiry.
Since June 2011, a team of 15 detectives have been investigating a number of deaths at the hospital.
Every time we were told Joshua was fine and that there was nothing to worry about. At no stage was a doctor ever called”
James Titcombe
Parents and NHS staff have been interviewed and the BBC understands that police are looking into the possibility of bringing corporate manslaughter charges against the University Hospitals of Morecambe Bay Foundation NHS Trust.
James Titcombe, a nuclear engineer living near Barrow-in-Furness, told the BBC how he watched his son Joshua die at just nine days old in November 2008.
Mr Titcombe and his wife, Hoa, are one of five sets of parents to have settled their claim with the trust.
The coroner heard that midwives and medical staff made 10 serious errors that contributed to Joshua's death including a failure to detect and monitor the baby's infection and a failure to provide care before and after birth.
"We asked repeatedly if Joshua should have antibiotics and we were told 'No, he didn't'," said Mr Titcombe.
"He was wheezing and he wasn't feeding properly and my wife called the emergency bell because he was grunting.
"And every time we were told Joshua was fine and that there was nothing to worry about. At no stage was a doctor ever called."
Mr Titcombe described how and his wife watched helplessly as Joshua died from sepsis.
To make matters worse, Joshua's progress chart went missing, never to re-emerge and the coroner later said there was a suspicion that it may have been deliberately destroyed.
Investigation
The government has announced an inquiry to be held in public and there are other investigations into two other NHS bodies in relation to Morecambe Bay.
The Care Quality Commission (CQC) stands accused of hindering an investigation into parents' concerns, as well as allowing the trust to get foundation status despite allegations about the standards of the maternity services.
The Health Ombudsman is investigating allegations of poor supervision by the North West Strategic Health Authority.
One of the most serious allegations against the trust is that it suppressed the damning findings of an internal inquiry into maternity services led by nursing expert Dame Pauline Fielding. The report made wide-ranging criticisms.
There is no denying that the trust has let women and their families down in the past and there are things that should have been done differently”
John Cowdall Morecambe Bay NHS Foundation Trust
The report described the team working as "dysfunctional in some parts of the maternity services" and that consultants were preoccupied with their own agendas possessing "little confidence in the clinical leadership" while the management had failed to "establish a common culture… within which good practice could flourish".
In February 2012, a separate report commissioned by the foundation trust's supervisory body, Monitor, also criticised managers.
In the report, the accountants PricewaterhouseCoopers said the trust lacked a "risk management culture", adding that some doctors who had voiced concerns over patient safety had felt ignored.
Dr John Ashton, currently director of public health for Cumbria, told the BBC that he had concerns about the management of the trust for some years.
"I was with a senior manager at Morecambe Bay when he was told about the death of neonatal baby some months after it had taken place," said Dr Ashton, who has recently been appointed as the next president of the Faculty of Public Health.
"It beggars belief that the trust kept the Fielding Report secret. If you've got weak clinical governance, that's a disaster waiting to happen.
"And I think it's quite clear that there's been weak clinical governance at Morecambe Bay for a long time and it wasn't being taken seriously at a board level."
Baby deaths
Of the 37 cases of litigation, 23 were started in the past two years. These 23 cases involve nine baby deaths and eight cases of cerebral palsy. Since 2002, the legal cases have involved the deaths of 14 babies and two mothers.
The CQC said it would publish the findings of an inquiry into its alleged failings by accountants Grant Thornton. A spokesman for the University Hospitals of Morecambe Bay NHS Foundation Trust said he could not comment on individual cases due to the police inquiry.
John Cowdall, trust chairman, said: "There is no denying that the trust has let women and their families down in the past and there are things that should have been done differently.
"Although we can't change the past, the new trust board is determined that we can learn from it and we will ensure we continue to do so.
"Due to the ongoing police investigation into the deaths of babies and mothers following care received at Furness General Hospital, it would be inappropriate to comment on individual cases. We will continue to co-operate fully and openly with the police."
"The new trust board is resolute in its determination that this trust will never let anyone down again in the way it did in the past, and we will not accept second best for our patients."
This article is courtesy of BBC News.
When they signed up to risk life and limb for their country, they expected in return to receive a decent level of care if they were wounded.
But new figures have revealed troops returning injured from the battlefields of Afghanistan and Iraq are suing a specialist hospital for medical negligence.
Over the past three years, 13 soldiers have launched compensation claims against the Royal Centre for Defence Medicine at Birmingham’s Queen Elizabeth hospital.
The site cares for heroes airlifted home from the frontline and has won a string of awards for its work.
But details released under the Freedom of Information Act show soldiers taking legal action after claiming to have received poor treatment.
And experts say there is a gap between the world-class care frontline soldiers receive on the battlefield and the aftercare they receive when they are repatriated.
Clinical negligence specialist Philippa Tuckman said: ‘I think as far as Birmingham is concerned, there is a gap between the emergency care and what comes next.
‘The acute care is usually very good. The battlefield and emergency treatment is an example to others which has been picked up around the world.
‘What they are not so good at is the general practice and the day to day less dramatic care, which is just as important.
‘Often you have newly qualified military GPs who are not experienced at dealing with the full range of cases they are presented with, unlike an experienced GP.
‘I have clients who say to me, “I assumed as a serviceman I would get the best care possible” and they are surprised when they don’t.’
University Hospital of Birmingham NHS Trust, which runs the Queen Elizabeth Hospital, refused to comment on matters involving military patients.
As well as physical injuries that have been misdiagnosed or mistreated, Ms Tuckman believes the devastating impact of Post Traumatic Stress Disorder (PTSD) is still being overlooked, with sufferers being sent back to the frontline.
‘The biggest area relating to active service is psychiatric harm,’ she said. ‘Part of the deal for servicemen is going to warzones like Afghanistan, seeing horrors and having terrible experiences.
‘In some ways PTSD is to be expected, but there are regulations which are supposed to look after you and make sure you aren’t sent back while you are still vulnerable. We’ve got a number of cases where that simply hasn’t happened.
‘It can lead to depression and drinking. It really can snowball and become very serious if people are subjected to tour after tour of duty when suffering psychiatric problems.
‘A better system is needed for dealing with the problem, particularly for helping those with PTSD who are medically discharged.’
The Ministry of Defence refused to go into any detail on any of the medical negligence claims.
But a spokesman pointed out that a fund which could total hundreds of thousands of pounds over the lifetime of a serviceman was available for anyone injured on duty.
In 2008 wounded ex-serviceman Scott Garthley, from Northampton, fought a £2.8million compensation battle with the MoD claiming he had been the victim of negligent treatment.
He claimed he had to pay more than £60,000 in private hospital bills just to ensure he received the vital care not offered to him by the MoD.
Mr Garthley was also ordered to take off his uniform at Selly Oak hospital - then home of the Royal Centre for Defence Medicine - in case it offended ethnic minority patients, sparking national outrage.
This article is courtesy of the Daily Mail.
