[2009] LTLPI 7.4.10

Claimant, aged 72 years, attended defendant’s A&E department after sustaining a head injury in a fall. Triage nurse found her to be alert with a small laceration to her scalp but no active bleeding. Blood pressure was taken and it was noted she was taking Warfarin. Following examination by a Senior House Officer the Claimant was discharged home with an advice sheet.

Claimant was readmitted by ambulance after vomiting, a cause for concern listed on the advice sheet. Glasgow Coma Scale was initially noted at 15/15 but her condition deteriorated suddenly. CT scan performed within the hour revealing large subdural haematoma. Claimant was given a poor prognosis and decision made to implement DNR and provide palliative care. Her condition improved the following morning and she was transferred to tertiary centre for craniotomy with evacuation of the right subdural haematoma. She suffers residual right-sided hemiparesis rendering her wheelchair dependant and requiring assistance with daily living.

Defendant admitted negligent failure to admit the Claimant for observations on her first attendance. Claimant argued admission and frequent observation would have led to early recognition of her deterioration leading to immediate surgery and avoiding long-term brain damage. Defendant argued even with appropriate treatment Claimant would have sustained some neurological damage in any event.

Out of court settlement: £900,000 (estimated General Damages £100,000).