Delayed diagnosis: Substantial sum in incomplete spastic quadraparesis case
On Friday 28 May, the Claimant's symptoms were much worse. She was suffering from pain in her arms, with difficulty in gripping and holding a pen and signing her name. She also had impairment of bowels, cramping weakness, pins and needles in her legs and experienced electric shock symptoms in her body.
She attended her GP on an emergency appointment at around 12.00 noon complaining of this constellation of symptoms. We alleged on her behalf that the GP did not listen to her or examine her properly. She dismissed the Claimant's symptoms and prescribed a topical cream and refused a request for an MRI scan of her neck.
The symptoms worsened during the day. Terrified, the Claimant called the ambulance service in the early hours of Saturday 29 May who put her onto NHS Direct. The transcript of the telephone call corroborated the earlier complaints to the GP. However, the operator was unsympathetic and advised that she contact the out of hours GP service or she attend Ealing A&E under her own steam.
By now she could hardly walk but her husband took her to the A&E department by taxi where she was admitted at around 04.00.
Even then it took some time for the doctors to admit her to a ward and begin investigations. Meanwhile her condition was rapidly deteriorating. At around 9am the Claimant was referred to Charing Cross Hospital for the undertaking of an MRI scan of her neck. The MRI revealed an annular tear in her C6/7 disc. Urgent surgery was mandated.
At about 9pm an emergency anterior cervical discectomy and fusion at the level of the 6th and 7th cervical spinal vertebrae was carried out and shortly afterwards the Claimant was transferred to Stoke Mandeville Hospital for rehabilitation.
As a result of the tear (and the delay in diagnosis) she suffered a severe incomplete spastic quadraparesis. Given her poor state at the time of surgery she made remarkable recovery. However she remains in significant pain, was unable to mobilise outside the house without crutches and/or a wheelchair and was unable to climb stairs or look after her children in her former capacity.
Paul McNeil alleged on her behalf that with treatment 12 hours earlier she would have made a very good recovery so as to walk without a crutch, carry out normal activities of daily living and care for her children. She would have returned to work in some capacity. Her bowel and bladder control are both likely to have been much better.
Proceedings were issued on her behalf and a trial date fixed The main allegation of negligence was that with the constellation of symptoms complained of the GP should have referred her to the hospital urgently. The case was defended strenuously both on breach of duty of care and causation of injury. The defendant argued that even if we succeeded in showing that the Claimant should have been referred to hospital in the early afternoon a reasonable response time by the hospital doctors would not have allowed earlier intervention which would have made a difference to the outcome.
In September after lengthy negotiations a substantial sum was paid to the Claimant.
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