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22 October 2022 | Case Study | Article by Helen Dolan

Failure to monitor a patient results in her severe brain injury


Ambulance equipment aggravates brain bleed as patient transferred between two hospitals – family kept in the dark for years despite internal investigation. Angela was an average 25 year old working at a local hotel when she suddenly collapsed at work. Her colleagues called 999 and she was taken to a local hospital by ambulance.

On arrival at hospital, Angela was found to have very high blood pressure and was not fully aware of what was going on. Neurological assessments were made and Angela was given a score to reflect her condition. Her neurological score (Glasgow Coma Score) should have been 15 (the score for someone with no neurological problems) however it was only nine which was a very worrying sign.

Angela underwent a CT scan later that evening which confirmed a brain bleed. The hospital she had initially been taken to were not specialised enough to deal with brain bleeds so her scan was sent to a specialist hospital for advice.

Angela was admitted to Intensive Care due to the seriousness of her condition and neurological assessments were carried out overnight. Unfortunately Angela’s condition deteriorated and, by the following morning, her neurological score had reduced further from nine down to seven. However, Angela’s score was incorrectly taken by the doctor who saw her during the ward round that morning and so her deterioration was missed.

Angela remained in ICU but by 3.00 pm she deteriorated again and her neurological score went down further. By 6.00 pm Angela’s score was six and at 7.00 pm it was just five. Angela’s condition was very serious by that time and it was agreed that she needed transferring to the specialist hospital for surgery.

Angela was not transferred to the specialist hospital until 10.00 pm that evening. Due to the seriousness of her condition she had several people from the hospital in the ambulance with her.

Unfortunately, none of the staff from the hospital had received the proper training to be able to look after her during transfer and they did not know how to use the ventilator which was helping her breathe. Before Angela arrived at the specialist hospital, her ventilator sounded an alarm saying there was no oxygen, a second tank was then found but this was empty. The staff travelling with Angela had to take her off the ventilator and manually provide her with oxygen, this caused her chest to become hyper-inflated and her lungs collapsed.

As a result of the problems during transfer and the poor state she arrived in, the specialist hospital could not operate on Angela straight away which delayed the emergency brain surgery she needed.

Angela is now wheelchair-bound, she has very limited use of her right arm, no useful vision on the right side and her bladder is also affected. She has epilepsy and problems with her speech. Angela now lives in a care home and needs support from two people for almost everything.

Angela’s family were never told about the disastrous events which took place en-route to the specialist hospital even though it was the subject of an internal investigation and it was only unearthed many years later when Hugh James became involved in her case.

After investigations, Hugh James were successful in obtaining a full and final settlement of £1.8 million on Angela’s behalf.

Helen Dolan, Partner in the Clinical Negligence team, acted for Angela and said:

I was shocked when, as part of my investigations into Angela’s care, I discovered what had happened to her in the ambulance. It was even more shocking to find out that the hospital had ordered an investigation into the events but had never told Angela’s family. They had been left completely in the dark for years and I can only imagine how difficult it was for them to come to terms with the events.

Angela’s brain bleed was a serious condition and needed treating properly. However, the hospital missed several opportunities to operate sooner leaving her with greater problems.

I was therefore very pleased to be able to secure recognition of the additional injuries Angela suffered due to the hospital’s errors and settle her claim for an amount which will allow her to buy her own home and move back into the community, something Angela and her family have been wishing for, for many years.

The names and identifying details of the client have been changed to protect the privacy of individuals involved.

Author bio

Helen Dolan is Joint Head of the Manchester Office and Head of the Clinical Negligence team. Helen specialises in high value complex secondary brain injury, spinal cord injury (including cauda equina syndrome), birth injury, cerebral palsy and wrongful birth cases, and also has extensive experience of orthopaedic and surgical cases.

Disclaimer: The information on the Hugh James website is for general information only and reflects the position at the date of publication. It does not constitute legal advice and should not be treated as such. If you would like to ensure the commentary reflects current legislation, case law or best practice, please contact the blog author.

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