Gastroenterology cases
AB v. North West London Hospitals NHS Trust
(2004)
Ulcerative colitis - restorative procto-colectomy and ileostomy
- failure to diagnose peritonitis - patient died - settlement
£250,000
On 26 July 2001, B died aged 45 at the St Marks Hospital. He was
survived by his wife and three young children.
B had suffered from ulcerative colitis and in April 2001, he had
been admitted to St Marks Hospital to undergo a restorative
procto-colectomy and ileostomy. He had been advised that with
successful surgery his health would have returned to near normal
with a normal life expectancy. B worked as an engineer for British
Telecom.
He was discharged from hospital on 9 May 2001. At that date, he
still had a significant stoma output and he was not eating. No
advice was given by the hospital to his GP for continuing care.
Unfortunately, B deteriorated at home notwithstanding that he was
being seen by the stoma nurse and his GP.
On 2 June, B was admitted to Harold Wood Hospital with a
presumptive diagnosis of pneumonia, wound infection and oral
thrush.
After some 20 days of admission, during which the doctors
attempted to stabilise him, he was transferred back to St Marks
Hospital for specialist review. Following various diagnostic tests
on Thursday 19 July, B underwent an examination under anaesthesia
and reversal of the ileostomy. After the surgery, B deteriorated
and became tachycardic, hypertensive with significant pain to such
an extent that he was unable to speak to his wife on the telephone.
His condition was suggestive of an infective process within the
abdomen. No investigation was carried out to establish the cause of
this until 23 July when an emergency laparotomy was performed late
in the day. Post-operatively, B was admitted to the intensive care
unit but developed multi-system failure and died on 26 July.
It was contended on behalf of his family that St Marks was
negligent in discharging B on 9 May 2001 without adequate follow up
and that their treatment of B on or after 21 July was negligent
because the doctors failed to investigate the cause of his swinging
pyrexia, tachycardia, hypertension, no urine output and pain. It
was alleged that with appropriate treatment after discharge and/or
appropriate investigations on or after 21 July, B would have
recovered to lead a normal life.
Paul McNeil issued proceedings on
behalf of the family on 10 April 2003. On 16 July 2003, the
defendant admitted liability for failing to ensure that AB was
adequately followed up at home, failing to diagnose peritonitis on
22 July and failing to perform surgery on 22 July.
There were subsidiary issues in relation to AB’s ability to work
following the surgery, although the matter was eventually settled
on 13 May 2004 for £250,000.
The case was conducted with the assistance of Public
Funding.