Complex Meningitis Brain Injury Case Settles For £2.6million

Bringing a medical negligence claim (also known as clinical negligence) can be a complex and challenging process, as the case report below shows.

We acted for a child (though his mother and litigation friend) who suffered a brain injury following a delay in diagnosis and treatment of meningitis when he was 11 months old, in a highly complex claim where liability was denied throughout.

What is medical negligence?

Medical negligence refers to situations where healthcare professionals, including doctors, nurses, or others providing clinical care fail to achieve a reasonable standard of care towards a patient, leading to harm or injury.

Meningitis cases often centre on an unreasonable delay in diagnosing meningitis, not referring promptly to more specialist care or failing to start the correct antibiotic or antiviral treatment in time to stop the disease progressing. In many cases the available timeframe can be short and clinicians need to be able to recognise the signs of meningitis and act promptly before it is too late.

In this case the child’s mother was concerned enough about her son’s condition, including a persisting fever, that she took him to an out of hours GP surgery adjacent to the Defendant hospital. The GP was also concerned by his condition, and referred him onwards to the main emergency department for specialist review. Unfortunately the paediatric team, having assessed and examined him, felt he was suffering from gastroenteritis and discharged him home.

In the early hours of the following morning his mother found him having a fit: he was taken to hospital by ambulance, resuscitated and given antibiotics for what was by now recognised to be meningitis.

Unfortunately brain scans showed that he had suffered a significant brain injury. Developmentally he regressed and he required considerable care and hospital follow-up. As he grew up he failed to reach developmental milestones and eventually attended a school for children with special educational needs. Although he could walk his mobility was significantly impaired, he struggled to express himself and had limited language skills, and expert opinion confirmed that he would lack capacity to manage his affairs into adulthood.

When we were instructed we first obtained extensive medical records and reviewed these. Expert paediatric evidence was then obtained, which supported the fact that this child had received substandard care. This alone is not enough and we needed further experts to confirm that the injury was caused by the substandard care (this is known as ‘causation’ and is often one of the most difficult aspects of liability to establish), and confirm that earlier antibiotics would have affected the outcome.

In this case the child had been referred to the community paediatric team prior to his meningitis because of concerns about his early development. Because he was so young at the time and because he had not been seen and assessed before the meningitis episode it was difficult to assess the significance of this, but it was something that we and our experts were aware of.

The causation experts were also supportive of a claim against the Defendant hospital, and therefore the Defendant was put on notice of the claim using a formal Letter of Claim.

The Defendant denied breach of duty, but did not say a great deal about the causation aspects of the claim in their initial response. This gave us the first indication that they had not obtained evidence from causation experts, and were perhaps hoping that this would be enough to deter the Claimant.

Our experts remained supportive and therefore we issued court proceedings. Full details of the allegations were set out in court documents, but the Defence continued to make denials of breach of duty, and causation.

Because of the robust defence and the issue of the pre-meningitis developmental delay this was a case where it was appropriate to ask for directions from the court towards a trial on liability only (in other words leaving valuation or ‘quantum’ to a later stage in the court proceedings). This allowed us to focus on the complex issues around liability, including obtaining detailed witness evidence of fact as well as testing the evidence of our medical experts further, to ensure they continued to support the claim.

In the meantime the Defendant was clearly alive to the issue of the pre-developmental delay and requested that the child and his mother underwent genetic testing, in order to assess whether his ongoing difficulties might be caused by a genetic mutation rather than the meningitis. Whilst this was resisted, the Defendant took the step of applying to the court to obtain this evidence and the court, with all necessary safeguards, agreed that this should take place (but only with fully informed consent from our client’s mother).

The genetic testing did in fact show that the child had an underlying genetic mutation that could explain some of his developmental issues, but not necessarily all. This added a new layer of complexity to the case. In light of this finding we were obliged to obtain our own genetics expert to comment on the findings and their significance, in addition to our other many causation experts.

We reached the stage of joint discussions between the experts and our experts stood up well to the Defence experts. However there was a significant litigation risk to both parties, and before trial a settlement meeting was arranged. Without any admission of liability significant life changing damages were agreed (£2.6 million pounds), and the Claimant and his mother were able to leave the lengthy and stressful litigation behind them and significantly improve their quality of life, including re-accommodation in future.

Our client was represented by Emma Wray, a Partner in our Medical Negligence team. As a former Nursing Sister in Coronary Care Emma has twelve years’ experience of working in healthcare. Her practice encompasses a wide range of cases from high value complex cases (including child brain injury and spinal injury) to cases of more modest value across the whole range of medical negligence practice.

To speak to Emma Wray or one of our medical negligence experts please call 0330 822 3451 or request a callback online.