Case study: £170k for widow after ambulance failed to take husband with traumatic head injury to hospital

Charlotte Tracy, Senior Associate in our Medical Negligence team, recently helped a client (Janet) claim compensation for the avoidable death of her husband, John.

Names are anonymised to protect the privacy of our clients.

Medical history and background

John, a man in his late 70s, had a history of atrial fibrillation (a type of irregular heart rhythm) which he managed with anti-coagulants (commonly known as ‘blood-thinning’ medication.

John fell outside his home and hit his head. An ambulance was called and, when it arrived, a paramedic performed a quick assessment during which a cut on John’s head was noted. No secondary neurological assessment was undertaken, which should help identify serious head injury. It was noted that John was taking anticoagulants. John was not transferred to hospital.

Multiple failures to follow clinical guidance

When a patient is taking anticoagulants, they are at a high risk of developing a serious bleed in the brain following a head injury. This combination is a clinical red flag; the patient must be transported to hospital for further assessment. This was reflected in the ambulance service’s own guidance. John’s clinical presentation fit this description. However, this guidance was not followed.

In the following days, John attended his GP surgery four times to follow up about his head wound. A GP reviewed him, noting rib pain but no headache after the fall. She saw he was taking anticoagulants and felt it appropriate to arrange an outpatient appointment, but that immediate admission to hospital was not required. John also saw two nurses for wound care.

John saw another GP who noted he was feeling off balance, not able to sleep and could not turn his head. No neurological examination was undertaken, and John was referred, on a non-urgent basis, to the falls service. John’s wife (and our client), Janet, stated that he was very slow and unsteady on his feet at this time, and the GP noted her concern.

Diagnosis of a large haematoma in the brain

Two days later, and around two weeks after the fall, John collapsed and was taken via ambulance to hospital. He was subsequently diagnosed with a large subdural haematoma (a collection of blood in the brain) on an emergency CT scan.

A neurosurgeon reviewed John and explained that the likelihood of a functional recovery after life-saving surgery was very poor, and therefore, a decision was made not to operate, but to transfer him straight to a ward for palliative care. John sadly passed away the following day, and the cause of death was a traumatic subdural haemorrhage. 

The clinical negligence claim

Our medical negligence solicitors initially relied on an internal investigation by the ambulance service, which, whilst it did not make a legal admission that the paramedic’s care had been substandard, acknowledged that John should have been transferred to hospital after his fall, in line with the ambulance service’s own guidance.

An early request for an admission was put to the ambulance service, relying on national guidance for the management of head/brain injuries to allege what would have happened to John had he been cared for appropriately. The ambulance service admitted substandard care (a breach of duty) but would not confirm their position on whether John likely would have survived.

We obtained a supportive expert report from a Consultant Neurologist who agreed that, had John been transferred to hospital after the fall, he likely would have met the criteria for a CT brain scan. This would have shown the bleed, but it would have been much smaller and less impactful than when it was discovered two weeks later. John would have been treated with medication, and it was the expert’s evidence that John would have fully recovered within weeks.

Admission of liability

This evidence was set out in ‘Letters of Claim’ to both the ambulance service and the GP surgery. Eventually, we received admissions of liability from both.

The medical negligence claim was valued; this included John’s avoidable pain and suffering before his death, funeral expenses, loss of income from his pension, claims on behalf of his grandchildren (to whom he made minor contributions to ISAs and pocket money), and the value of his assistance around the home.

The Defendants failed to respond to an opening offer of settlement within a reasonable timeframe, so we issued formal court proceedings. Negotiations later commenced, resulting in a £170,000 settlement for Janet, now in her early 80s, and her two minor grandchildren.

Summary

Our focus in this case was obtaining answers and an admission of liability for Janet, who was grieving the loss of her husband, but also maximising her claim. Janet had lost her life partner and her previous financial security.

Medical negligence claims related to those who have passed away in their later years can often be dismissed as potentially low value; this is because the law in England and Wales significantly restricts awards for bereavement itself, and any significant value will likely be found in how the Deceased supported loved ones financially and practically.

In claims relating to older people, compensation can be further reduced based on a limited remaining life expectancy. However, it is important to recognise that it may not always be the case that these claims are low value, and each potential claim must be considered carefully. In this case, there was a substantial amount of compensation awarded to Janet, who settled her claims whilst in her 80s.

The circumstances of John’s death show the importance of raising public awareness of the realities of brain injury, whether as a result of an accident or medical negligence. It also demonstrates the significance of quick action in the immediate aftermath of an accident.

Get in touch with our medical negligence solicitors

If you have any concerns about your care or the care of a loved one following brain injury, or are worried about the circumstances of a loved one’s death, please get in touch with our medical negligence solicitors.

Call our specialist team on 0117 325 2929 or fill out our enquiry form.