Patient recovers damages after a brainstem stroke
In a recent case a woman who suffered a severe brain injury after surgery recovered £1,250,000 in damages.
an operation to relieve trigeminal neuralgia went wrong
She had suffered from trigeminal neuralgia for many years. This is a condition affecting one of the nerves of the face (the trigeminal nerve) and causes pain. Even gentle actions like brushing teeth or putting on makeup can trigger severe pain. She had been treated with glycerol injections but at the age of 44 went into hospital for neurosurgery.
During the operation she suffered a serious brainstem stroke. Bleeding (haemorrhage) caused damage in 3 areas of her brain: the cerebellum, where she suffered swelling, the pons and the lateral (side) part of the medulla, where there was a lack of blood and therefore oxygen supply to the tissues. She also suffered damage to 2 nerves, the oculomotor and facial nerves.
What was her claim?
She brought a claim against the hospital alleging that her neurosurgeon had been negligent. 3 of her complaints concerned the advice he gave her. They were that:
- He failed to advise her that her previous glycerol injections had increased the risk of adhesions (scar tissue), which would complicate surgery;
- He failed to advise her of other less risky treatments;
- He failed to advice that he may have to stop the operation because of the risk of stroke if he came across problems with adhesions.
A further complaint was that, once he came across adhesions, he continued to operate when he should have stopped. This led to her stroke.
What were her symptoms after the brain stem stroke?
She was left with left-sided weakness and difficulty walking. The nerve damage meant she could not full control her facial muscles and in particular her eyelids. She had a number of problems with her eyes, needed 2 further operations on them and was only partially sighted. Her ability to speak and swallow was limited. She had to take care when drinking so as not to dribble or choke. Through rehabilitation she managed to improve the movement and strength of her left leg and arm and she recovered her ability to walk, although she needed aids.
A successful claim after a brain stem stroke
Her claim succeeded and the hospital trust admitted liability. Although she had to issue proceedings which progressed to shortly before trial, a settlement was negotiated. She recovered damages of £1,250,000. This included her lost earnings and the costs of making it easier for her to manage her disability in the future. For instance, there were awards to provide her with care and support, adapt her housing to make it more suitable, provide her with equipment and the therapy she needed for the best long-term recovery.
Claiming after negligent neurosurgery
The law and medicine behind claims like this is complex but the story highlights a number of points.
First, it shows the seriousness of neurosurgery going wrong. This woman recovered the ability to walk and use her left arm but was still disabled and able to recover a large award.
Secondly, it shows how damages are really designed to help best manage the challenges they will face in the future. The award for ‘pain, suffering and loss of amenity’ – in effect for having to put up with the condition itself – was around £160,000, just over 12% of the full award. Most of the damages were designed to help her manage life better day to day by paying for the support and assistance she needed.
Thirdly, 3 of the 4 allegations of negligence concerned the advice she was given. There have been significant developments in the law in recent years and an increased emphasis in patients being given the information they need to make the right decision. The Supreme Court case, in the leading 2013 case on the subject. This would not only respect their rights but probably lead to fewer claims, as patients were encouraged to take responsibility for their decisions.