In Nov 2015, David*, aged 67, was admitted for urgent ascending aortic root replacement surgery at St George's Hospital following a stay at a different hospital for meningitis and a blood stream infection, causing endocarditis.
Surgery took place two weeks later, and our client died four days later from multi-organ failure, endocarditis, pneumococcal meningitis and diabetes. The case was referred to the coroner.
During 2015-2016, the family raised various concerns to the hospital, but these were dismissed.
In May 2019, the family were notified of an independent External Mortality Review Panel investigation by NHS Improvement (NHSI) due to a high mortality rate in the cardiac department at St George's between 2013-2018.
The Panel assessment in relation to our client noted:
- No evidence of a cardiologist seeing this patient, described as 'concerning'.
- A lack of multi-disciplinary team discussion around indication for an operation at this time.
- The Panel questioned the need for surgery and if it would have been better to wait
- Had surgery been indicated for the endocarditis, they would not have performed a root replacement and would have limited their surgery to the aortic valve.
In February 2020, the family attended a meeting with the Trust to discuss the report findings.
Post meeting, they received a letter confirming that the 'Contribution to Death Score' was 1, which represented 'problems in care identified definitely contributed to the death'. It recognised that there was no documentation to say why a root replacement procedure was undertaken instead of an aortic valve replacement. It also indicated that the Panel had very similar concerns to those raised by the family shortly after David's death.
The matter was referred back to coroner who remained of the view that the treatment provided had been acceptable.
David's family contacted Fieldfisher for advice. Arti wrote to the Trust early in proceedings and invited the Trust to make an early admission of liability, but this was not forthcoming. Instead, an early offer of settlement was made by the Trust.
Arti then obtained expert evidence, and following various exchanges of offers, settlement was reached shortly before limitation expired.
The case is among several being conducted against the Trust by Fieldfisher, following an independent mortality review ordered by NHS Improvement due to a higher than average number of deaths following cardiac surgery at St George's Hospital cardiac unit. 102 cases were reviewed, with the report concluding significant shortcomings either probably, most likely to definitely contributed to 67 deaths.
Read the NHS England report into the cardiac unit at St George's University Hospitals NHS Foundation Trust.
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