Summary of background
On 23rd August 2005 the claimant attended an accident and emergency department at a hospital of the defendant trust, complaining of headaches, recurring numbness and paraesthesia in his left leg and hands. He had a history of thrombocytosis and leukaemia. He was assessed and diagnosed as suffering from mononeuropathy. He was given a neurology outpatient appointment and was discharged from hospital. However, the claimant's symptoms persisted and on 7th September 2005 he was taken back to hospital by ambulance. He was admitted and was diagnosed by the on-call team as suffering from neuropathy. The following day the claimant was reviewed by a consultant physician who considered that he might be suffering from an upper neurone lesion. A cranial CT scan was sought and in the meantime the claimant was provided with regular physiotherapy. The claimant's limb weakness initially improved but on 9th September 2005 he started to suffer weakness in his left arm and the weakness in his left leg became worse.
On 12th September 2005 the claimant was assessed by a locum consultant neurologist who diagnosed him as showing signs of the cerebral shock phase of an acute stroke which it was believed he had suffered on, or after, 9th September 2005. After being diagnosed, the claimant was given aspirin therapy and a cranial CT scan was carried out. The scan results showed that there was an infarct in the right anterior cerebral territory. A Doppler/Duplex scan was carried out which showed occlusion of the right internal carotid artery and stenosis of the left internal carotid artery. On 28th October 2005 the claimant was discharged from hospital.
The claimant sustained injury and brought an action against the defendant alleging that it was negligent in (i) failing to recognise on August 23 that his symptoms were consistent with recurrent transient ischaemic attacks; (ii) failing, on 7th September 2005 to include recurrent transient ischaemic attacks in the diagnoses; (iii) failing to arrange for Doppler/Duplex scanning to be carried out urgently; (iv) failing to promptly diagnose the stenosis of his right internal carotid artery; (v) failing to prescribe aspirin until 12th September 2005; (vi) failing to provide a timely cranial CT scan. The claimant alleged that if, on 23rd August 2005, staff had recognised that his symptoms were consistent with recurrent transient ischaemic attacks, they would have carried out the scan promptly and the stenosis would have been diagnosed and there would then have been sufficient time to organise the removal of the obstruction before he suffered the stroke.
The defendant admitted that the diagnosis on 23rd August 2005 should have included transient ischaemic attacks; a cranial CT scan should have been ordered; failure to prescribe aspirin between 7th September 2005 and 12th September 2005 and the delay in carrying out a scan after admission on 7th September 2005 amounted to substandard care.
The claim settled out of court in the sum of £300,000 total damages which can be broken down as follows:
General damages:- £35,000
Past travel:- £5,000
Past care:- £30,000
Future travel:- £25,000
Future aids and equipment:- £15,000
Future therapy:- £9,000
Future care:- £281,000