K. V ROYAL FREE
HAMPSTEAD NHS TRUST OUT OF COURT SETTLEMENT FEBRUARY
2007
Our client received £19,500
damages for a delay in diagnosis of scleritis affecting his left
eye in March 2003 resulting in approximately 20% permanent loss of
vision in the left eye and visual distortion.
Our Client: Forty years of age at date of
injury; 44 at date of settlement.
Clinical negligence: Our client was employed
as an electrical engineer. On 13th March 2003 he developed eye pain
which worsened and he attended his GP on 20th March 2003. The GP
diagnosed possible scleritis and our client was advised to go to
hospital.
Our client attended the Defendant's hospital
on 21st March 2003 and was diagnosed with conjunctivitis and
prescribed topical broad spectrum antibiotics for 7 days.
The client had no history of ophthalmic
complaints, other than short-sightedness for which he wore a
spectacle correction principally for driving. Over the next week
the pain in his left eye intensified and he re-attended his GP on
24th March 2003 and was referred to a specialist eye clinic within
the Defendant Trust and diffuse scleritis was diagnosed in the left
eye.
He was prescribed topical steroid therapy and
oral non steroidal anti-inflammatory therapy (Ibuprofen). He was
told to come back in two weeks. He re-attended his GP on 1st April
2003 and reported an area of visual loss in the left eye adjacent
to the line of sight affecting his ability to read.
Pain in the eye had increased although
swelling around the eye was improved. He was referred back to the
Defendant Trust and was seen by a Consultant who advised that
treatment should continue for a further 4 weeks.
In the event, he re-attended the Defendant
ahead of schedule on 17th April on account of deterioration of
vision in the left eye. Vision was reduced to counting fingers
only. Intensive topical steroid therapy was prescribed.
On 22nd April 2003, he attended for a further
review and diagnostic ultrasound showed gross thickening of the
posterior sclera and an urgent referral was made to Moorfields Eye
Hospital.
The diagnosis was confirmed as severe left
posterior scleritis with optic nerve involvement and marked serous
retinal detachment. Steroid therapy was commenced. A Letter of
Claim was put forward by our client in April 2006 alleging that the
diagnosis of scleritis was missed at the first appointment and that
when seen again on 1st April 2003 the appropriate management would
have been to immediately proceed to diagnostic ultrasound to
exclude posterior scleral involvement.
It was further alleged that an ultrasound
examination should also have been performed on 17th April 2003. Had
our client been referred for an immediate ultrasound on 1st April
2003, it is likely to have revealed posterior scleritis and
involvement of the optic nerve requiring the need to initiate
systemic steroids at that time. By 17th April 2003, our client had
already suffered retinal detachment and involvement of the optic
nerve and, it was alleged, earlier steroid therapy following his
attendance on 1st April 2003 would have prevented this
development.
Our client accepted that even if posterior
scleritis had been diagnosed correctly and promptly then high dose
systemic steroids would still have been required but the
involvement of the optic nerve and detachment would have been
avoided and it is more likely than not that normal vision would
have been preserved. A Letter of Response was received in July 2006
which admitted breach of duty but reserved their position on
causation.
Our client obtained a condition and prognosis
report in August 2006 following which negotiations commenced and a
settlement was achieved in February 2007.
Injuries:
Overall deterioration in vision of approximately 15 to 20% (10 to
15% reduction of visual acuity of the left eye together with
associated power - central field defect in the left eye, together
making up the 15 to 20% overall deterioration).
Our client was employed as a senior test and
measurement engineer who was left with difficulties of depth vision
which would require a period of readjustment upon returning to work
during which time he would be handicapped on the labour market,
were he to lose his current job.
Breakdown of damages: Whilst the claim was
settled on a global basis, we estimate that approximately £12,000
was awarded for general damages together with a 6 month period of
handicap on the labour market plus additional miscellaneous
expenses making up the remainder of the award.
Olivia Lawson represented the interests for
our client; Bevan Brittan for the Defendant.