Ian | Severe Brain Damage

In late December 1997 Ian was a victim of an assault in his own home. He was taken to the local hospital by ambulance, and was later diagnosed as having suffered a penetrating stab wound of the abdomen which required a laparotomy.

Following this operation Ian was showing various unusual signs including absence of bowel sounds, high temperature and pulse and small urine output given volume of fluid administered. The Consultant ordered intravenous fluids be increased and that he should be “nil by mouth” until he passed flatus.

In the days following an x-ray revealed elevation of the right diaphragm and collapse of the right lung and the consultant was summoned to review the patient by which time his symptoms included distress, shortness of breath and an abnormally fast breathing rate. However, he was still alert and orientated. It was decided that he required urgent transfer to ITU and a nasogastric tube (used to drain fluid from the stomach) was instructed to be passed before the transfer. However, as attempts were made to insert it, Ian aspirated fluid from his stomach. As a result, he suffered a cardio-respiratory arrest and cardiac output was obtained only after 15 minutes of resuscitation. Ian was discovered to have suffered brain damage due to the insufficient supply of oxygen and blood in this time.

The case involved the main allegation of negligence as the failure to pass the nasogastric tube before or during the laparotomy, which would have avoided the aspiration of fluid which led to the cardio respiratory arrest.
Ian did not regain consciousness after his collapse. He is cared for in the Leonard Cheshire nursing home and has subsequently been diagnosed with bronchictasis and requires chest physiotherapy 7 days per week. His life expectancy in January 2003 was 6 years.

Ian suffered with the following:

 Severe brain damage
 Severe spastic quadraparesis with upper limb and lower limb contractures
 Blindness as a consequence of optic atrophy
 Marked startle myoclonus (sudden spasm of the muscles)
 No obvious language comprehension or production
 Severe dysphasia

Ian was not in a persistent vegetative state as defined by the Royal Colleges. He was recorded as showing some awareness, a response to sound and was shown to have semi-purposeful movement. He was in a state of minimal awareness. He was dependent upon others for all activities of daily living, unable to sit unsupported and unable to feed himself.

Ian claimed damages for pain, suffering and loss of amenity together with special damages consisting of past and future care provided by his mother who visited him every day, treatment and equipment.

Proceedings were issued early in 2003. The Defendant NHS Trust conceded that if the nasogastric tube had been inserted, Ian would not have suffered the cardio-respiratory arrest. However, the Defendant’s case was that the failure to insert the nasogastric tube was not negligent. Following a joint settlement meeting and further ongoing negotiations, in October 2003, the Defendant offered to settle the case for £200,000 with no admission of liability.

It was agreed that this sum would consist of £40,000 in respect of past services and travel expenses for the Claimant’s mother and £3,500 for a wheelchair. Ian’s solicitor estimated General Damages at £115,000.

The remaining £41,500 covers other elements of the special damages claim including lost earnings, future care and additional aids over and above those provided by the nursing home together with Court of Protection/receivership fees.