Summary of background
Mrs Rogers instructed Russell-Cooke LLP to pursue a claim for clinical negligence in relation to treatment provided to her husband prior to his death. Mr Rogers had been referred to the gastroenterology team at St Helier Hospital because the results of liver function tests he had undergone were found to be abnormal. Investigations were performed at the hospital which revealed that he had haemochromatosis (a condition involving absorption of excessive quantities of iron within the body).
It is known that this condition can cause liver damage and so a liver biopsy was performed, which showed that Mr Rogers had developed cirrhosis of the liver as a result of his haemochromatosis. Scarring of the liver can cause malfunction or death of cells in the liver, which in turn can lead to progressive liver failure and/or liver cancer.
Mr Rogers underwent some initial investigations in relation to his 'AFP' level (a tumour marker in the blood) and an ultrasound scan was performed of his liver. However these investigations were not repeated and he was subsequently discharged to the care of his GP surgery. No recommendation was made by the gastroenterology team to Mr Rogers, his GP or the haematology team at the hospital (by which Mr Rogers continued to be seen) that further screening for signs of liver cancer should be performed.
Over two years later, Mr Rogers was found to have developed liver cancer (hepatocellular carcinoma) and plans were made for palliative care, as it was not thought that active treatment would be of benefit at that stage. Mr Rogers' condition deteriorated and he passed away only a couple of months after the diagnosis had been made.
The Claimant's case
Russell-Cooke obtained expert medical evidence which advised that patients with cirrhosis of the liver are at risk of developing liver cancer and that this risk is heightened in males and in individuals with haemochromatosis. Surveillance of at risk patients, such as Mr Rogers, permits the identification of early cancers, which may then have a better prognosis than larger cancerous lesions. Such surveillance is therefore recommended for patients suffering from liver cirrhosis by the British Society of Gastroenterologists and by other professional bodies.
Russell-Cooke alleged, on behalf of Mrs Rogers, that staff at the hospital were in breach of their duty of care to her husband and that, had appropriate screening been performed for liver cancer, it was likely that his liver tumour would have been detected over two years earlier than it was.
The Defendant's admission
The Defendant trust, which was responsible for St Helier Hospital, admitted that its staff failed to put appropriate arrangements in place or to continue monitoring Mr Rogers for liver cancer, despite having recognised that he was at increased risk of this. The trust acknowledged that Mr Rogers should not have been discharged from gastrointestinal follow up when he was, without appropriate ongoing monitoring being arranged.
It was also accepted that had appropriate screening been arranged, it was likely that the tumour would have been detected, though the trust did not say how early they think this would have occurred.
The Claimant's medical expert advised that, had Mr Rogers' liver cancer been diagnosed earlier, he would not have been a candidate for surgery but that he could have undergone radio frequency ablation treatment. This would not have been likely to cure Mr Rogers' cancer, but would probably have extended his life by approximately two years and nine months.
Mrs Rogers therefore claimed damages for her husband's additional pain and suffering caused by the delay in diagnosing and treating his condition, as well as for bereavement. She also claimed for loss of a proportion of her husband's income and for loss of the services which he would have provided during the period he could have been expected to survive, had the negligence not occurred.
After a period of negotiation, compensation was agreed between the parties in the total sum of £32,500.00, with the Defendant also agreeing to pay the Claimant's legal costs.