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Case Study

Six figure settlement in missed diagnosis of DVT in A&E at Kingston Hospital

In September 2013, Sivasakthy Mahindan noticed some pain and swelling in her right calf. She attended her GP who referred her to Kingston Hospital A&E department on a DVT pathway. She attended a few days later, where she underwent tests. A positive D-dimer result was noted, and she was subsequently referred for a Doppler ultrasound scan which identified clots in her right leg. She was diagnosed with superficial thrombophlebitis and given an iron infusion.

Over the next few months, Sivasakthy developed new symptoms of acute chest pain, difficulty breathing, and right leg swelling, for which she sought medical attention.

In the early hours of 20 December 2017, Sivasakthy awoke complaining of pain in her right calf, chest pain, shortness of breath, and heart palpitations and asked her husband, Mahadeva, to call an ambulance. To save time, their neighbour, a taxi driver, took them to A&E at Kingston Hospital. She was triaged before being seen by a junior doctor, who noted the history of DVT but performed no examination of her calves nor an assessment of her vital signs. She diagnosed Sivasakthy with an ear infection, despite there being no evidence of any abnormalities in her ear or throat. She was discharged with a course of antibiotics and to attend for an ECG test.

Over the next 2 months, Sivasakthy attended her GP as her symptoms continued. She was becoming increasingly tired and could not walk very far. By the end of December 2013, a thin black line had appeared on her right leg, going from her calf to her thigh. A chest x-ray was performed which was normal.

On the morning of 1 February 2014, Sivasakthy complained of chest pain and then collapsed suddenly and began foaming at the mouth. Mahadeva called an ambulance immediately and she was assessed by the paramedics as having a GCS score of 3 (deep coma) with an unrecordable heart rate. CPR was commenced before Sivasakthy was taken to Kingston Hospital. The handover noted a 3 month history of DVT. Investigations identified she suffered extensive pulmonary emboli (PE) and she was diagnosed with a hypoxic brain injury at the age of 36. She remained an inpatient for almost 6 months, before being transferred to the Royal Hospital for Neurodisability in Putney. She was placed on the border of being in a vegetative/minimally conscious state.

In August 2014, Sivasakthy was discharged to Wingham Court Care Centre, a residential care home where she received 24 hour care. She remained in a minimally conscious state until the time of her death in October 2017 at the age of 37 having developed acute pancreatitis.

Mahadeva contacted Arti, following which she began investigations, including obtaining 4 reports dealing with liability. All 4 experts were highly critical of Sivasakthy's treatment. A Letter of Claim was served, with the Trust making a formal admission of liability 10 months later. The Trust accepted that the treatment Sivasakthy received fell below a reasonable standard of care, and that had she received appropriate treatment, she would have been treated with medication and on the balance of probabilities, have avoided her cardiac arrest and hypoxic injury, and survived. They indicated a Letter of Apology would follow, but this did not arrive until almost a year later, and a day after Sivasakthy died.

Proceedings were issued and served, and Arti entered judgment. The parties were in the process of quantum investigations at the time of Sivasakthy's untimely death. The Defendant sought to argue that her death as a result of the acute pancreatitis was not causatively linked to her condition. Arti issued an application to rely on additional expert evidence which indicated that but for the brain injury, Sivasakthy's pancreatitis would have been treated, and she would have gone on to have a normal life expectancy.

Expert evidence was exchanged and the parties attended an RTM in December 2018, following which a 6 figure settlement was reached. Trial was to commence in January 2019. Sadly, Sivasakthy and Mahadeva never got to fulfil their dream of having a family.

At the end of the case, Mahadeva said "I contacted several lawyers who did not want to take the case. Arti took a chance, and I knew from our very first meeting that she was the right person who would fight for my wife. She has been on hand for the last 4 years whilst I suffered a terrible ordeal, providing reassurance and comfort in some of my darkest days. Arti's compassion is matched by her diligence and obvious expertise in her field, staying on top of things throughout and patiently explaining next steps clearly. I had full faith in her abilities to get the right result, and even though I cannot get Sivasakthy back, I can never thank Arti enough for getting justice for us."

Arti said, "This has been one of the most tragic cases I have come across, and Mahadeva has conducted himself with dignity throughout. Sivasakthy suffered an avoidable, devastating life changing injury at the young age of 36, which was then compounded by subsequent events at Wingham Court for Mahadeva. I have the utmost respect for him in how he has dealt with things over the last 4.5 years."

Arti's case was reported in the Evening Standard in January 2019, and you can read more about it here:

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For further information about delayed diagnosis claims and medical negligence compensation claims, please call Arti Shah on 03304606739 or email


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