In late September 1993 Simone, a female medical student at a London teaching Hospital (then aged 19), began to suffer from epileptic type seizures.
In February 1994 she was referred by her GP to a consultant neurologist at the Royal London Hospital for assessment of her seizures.
The consultant neurologist considered that the seizures were “of the major generalised type, although without marked convulsive features”. He ordered an EEG, but declined Simone’s father’s request for an MRI scan.
On 19 March, Simone suffered another seizure. An EEG was performed on 22 March and Simone was diagnosed with primary generalised Epilepsy.
Simone’s father again requested an MRI scan but this was refused. Simone was prescribed daily Carbamazepine.
At review in July 1994, there having been no fits, the consultant neurologist advised Simone to continue with the Carbamazepine. A second EEG was planned for the Autumn.
On 17 September Simone suffered a further seizure. The consultant neurologist advised Simone to increase the Carbamazepine and advised that he would review the clinical situation at the next outpatient appointment in light of the planned second EEG.
On 2 November, a second EEG was performed and the report indicated that the epilepsy could well be focal rather than generalised.
Simone attended further appointments on 19 January, 6 October, 3 November 1995 and 26 July 1996. At the last appointment Simone informed the consultant neurologist of the further recent fits in March and July.
The consultant advised increasing the Carbamazepine. Simone’s father again pressed for an MRI scan but the consultant neurologist stated that this was a clear case of generalised epilepsy and declined.
Simone had four seizures in October 1996, and November 1996 and two in January 1997. On 31 January 1997, Simone was reviewed and advised that Epilim would bring better control of her epilepsy.
Only reluctantly after further requests from Simone’s father did he agree to refer her for an MRI scan. MRI scans were performed out on 9 March and 14 March 1997 and illustrated a cerebral tumour. Simone underwent a craniotomy on 28 April when the tumour was successfully removed.
Our experts confirmed that with appropriate review and MRI imaging in early 1995, the cerebral tumour would have been diagnosed earlier.
As a result Simone suffered anxiety and stress due to additional seizures and the stigma of having epilepsy, difficulty with memory and concentration due to anticonvulsant medication, the avoidance of post-operative seizures/lessening of them if the surgery had been carried out earlier and a contribution to memory problems caused by the post-operative seizures.
Simone did not suffer from any psychiatric illness but the delay in diagnosis caused her psychological distress and affected her confidence and self esteem to a serious extent.
Simone instructed us to investigate a claim for medical negligence. Initially the claim was funded by legal aid but by August 1998, Simone was no longer entitled to public funding as she had taken up a job as a Junior Doctor.
The case therefore proceeded under a Conditional Fee Agreement. We put forward a Part 36 offer of £7,500 and suggested a letter of apology. The offer was rejected. The case was listed for trial. Shortly before trial, the claim was settled in the sum of £7,500 plus costs and Simone received a letter of apology.
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