Summary of background

Following a history of suffering from ear infections, the claimant consulted the defendant and on 31st January 2005 the defendant performed a mastoidectomy. The claimant's ear was subsequently packed using bismuth idodoform paraffin paste (BIPP). On 4th February 2005 she began to experience severe pain in her ear and a profuse watery discharge. The claimant attended the hospital where the defendant practiced and was advised to attend the accident and emergency department which in turn referred her to another hospital where she was seen by an on-call registrar who prescribed Augmentin and some painkillers. Three days later the defendant carried out a post-operative examination of the claimant and advised her that the discharge was normal and removed the packing and sutures. The defendant advised her to continue taking Augmentin for a further seven days.

The claimant began to feel increasingly unwell. The watery discharge was replaced by a thick yellow discharge. She experienced occasional stabbing pains in her ears, lost her appetite and suffered a constant headache and backache. On 18th February 2005, the claimant's general practitioner attended the claimant at her home and immediately telephoned for an ambulance. The claimant was admitted to hospital, suffering from type-one respiratory failure, was clinically septic and was suffering from a pulmonary oedema. She was diagnosed as suffering from candida septicaemia. The claimant was transferred to the intensive care unit where she remained until 15th March 2005. Whilst in the unit she required treatment for acute renal failure and was found to have significant liver impairment. She developed gangrene in her right third and fourth toes and bilateral foot drop. Following her discharge from the unit, the claimant spent two weeks on a medical ward where she undertook rehabilitation until she was discharged from the hospital on 1st April 2005. During her stay as an in-patient, the claimant was diagnosed as suffering from critical illness polyneuropathy, manifesting as foot drop.

Claimant's case

The claimant sustained injury and brought an action against the defendant alleging that he was negligent in (i) failing to properly treat and record her post-operative acute inflammation of the ear canal which, she alleged, was likely to be secondary to a BIPP allergy; (ii) performing the surgery when there was no clinical need to do so; (iii) providing substandard care by failing to carry out a suction clearance on February 7, 2005, to remove as much of the BIPP packing as possible, failing to then place her in intensive antibiotic therapy and then failing to admit her to hospital. The claimant alleged that if the defendant had carried out such action, she would not have developed candida septicaemia and would not have developed paralysis and ongoing complications with both her feet but predominantly the right.

Defendant's case

Liability was strongly disputed. The defendant averred that the claimant was given proper and reasonable counselling upon her treatment options and maintained that there was no indication to prescribe postoperative antibiotics. It was also asserted that in the postoperative clinic visit the defendant conducted a proper and thorough examination. The defendant alleged that it was reasonable to reach the conclusion that the claimant did not have a postoperative infection, nor a BIPP allergic reaction. Further, it was reasonable for the defendant to arrange to see the claimant in three weeks.

Settlement

The claim settled out of court in the sum of £212,270 which can be broken down as follows:-

Background to damages: C's allegations were supported by medical evidence provided by an ear-nose-and-throat consultant.

Breakdown of General Damages:- £40,000;
Future therapy, aids and equipment costs:- £5,000;
Future loss of earnings and pension:- £97,770.

Breakdown of Special Damages:
Past loss of earnings:- £48,000;
Past care costs:- £500;
Past travel and miscellaneous expenses:- £5,000;
Past medical expenses:- £16,000.