Daniel Lee, from member law firm Clear Law, recently settled a case at a Joint Settlement Meeting where the claimant, suffered Idiopathic Intracranial Hypertension, leaving her with loss of vision and health issues which will require significant help and care for the rest of her life.

Case Study Background – LV v Cwm Taf University Health Board

The Claimant, aged 31, received £2,600,000 as a result of the Defendant’s delay in adequately treating the Claimant’s condition of Idiopathic Intracranial Hypertension (IIH).

In late May 2013, the Claimant developed persistent headaches and subsequently suffered from deteriorating vision. She visited her General Practitioner on two occasions before being referred to the Royal Glamorgan Hospital for further assessments.

In June 2013, a CAT head scan was carried out which showed a normal result, however a lumbar puncture confirmed moderately raised intracranial pressure. On 4 June 2013, the Claimant was diagnosed with IIH but the doctor considered that Acetazolamide was not necessary as most people respond to lumbar punctures without the need for this medication.

Some days later the Claimant returned to Royal Glamorgan Hospital due to headaches and double vision. She was advised to have a contraceptive implant removed and to lose weight. She was discharged with no follow-up.

On 21 June 2013, the Claimant returned to Accident and Emergency with a worsening headache, blurred vision and ringing in the ears. It was noted that a referral to Neurology and Ophthalmology were already in place so she was advised to come back if there was worsening of the symptoms.

Later in July 2013, the Claimant was seen in the Eye Clinic where clinical examination revealed swelling of both optic discs.

On 30 July 2013, the Claimant was seen in the Neurology Clinic where the Neurologist was outraged that the Claimant had not been urgently referred to the hot clinic as opposed to the normal clinics. He states “as you know our waiting list is four to five months even for an urgent appointment and seven to eight months for routine and I am sorry that she was not prioritised any further. I think she is now the second patient who has had what could be permanent visual field loss while on the waiting list. I think she should have been treated with medication and probably would have had further lumbar punctures and certainly ophthalmological monitoring. We should really be trying to see these patients with sight threatening problems such as this in our weekly hot clinics in University Hospital of Wales as quite simply there is absolutely no capacity for the normal clinics in the Royal Glamorgan Hospital as you are well aware.” The Neurologist made a diagnosis of sight threatening intracranial hypertension and she was urgently referred to University Hospital of Wales for treatment.

The following day the Claimant was given a lumber puncture and a further lumbar puncture a few days later. On 5 August 2013 a right ventricular peritoneal shunt was inserted to manage the Claimant’s intracranial pressure.

Liability

The Defendant admitted in their Defence that on 28 May 2013, the Defendant ought to have taken immediate steps to investigate, diagnose and treat the IIH such that the Claimant would have been referred for an urgent neurological assessment within 2 days. It was admitted that on 4 June 2013, following the establishment of the probable diagnosis of IIH, there was a failure to provide the Claimant with appropriate management and treatment in the form of Acetazolamide, Lumbar Puncture, ophthalmological monitors and Ventricular-Peritoneal Shunt.

The Defendant accept that with appropriate management, she would have avoided some pain, injury, loss and damage however the Defendant denied that the symptoms would have reversed and she would have made a full recovery.

Injuries

As a result of the Defendant’s failure to adequately treat the condition the Claimant continued to experience significant raised intracranial pressure. This in turn caused pressure to the optic nerve resulting in severe papilloedema. As a result of the failure to treat the condition within a reasonable period the Claimant developed permanent loss of vision. In addition, she also suffered continuation of headaches, nausea and other related symptoms.
The Claimant has been left with extremely poor vision in both eyes and is registered as severely sight impaired. There is no prospect of return of vision and she will remain with a severe sight impairment on a permanent basis. As a result of this condition, the Claimant has been left with a significant disability.

Bilateral loss of peripheral vision makes it extremely dangerous to leave home alone and at home she requires a significant level of support and assistance. She is unable to adequately care for her daughter without the support of her parents and requires help with most domestic activities. She has lost any ability to drive. The Claimant will be unable to live independently without ongoing support and assistance.

In addition to the physical injuries the Claimant suffered a considerable psychological reaction. She has been left with low mood, low energy, reduced motivation, sleep impairment, poor appetite and a reduced ability to experience pleasure. The ongoing disability has had a significant effect upon the Claimant’s outlook on life. She has lost her ability to return to employment and her independence. The ongoing psychological symptoms will cause permanent restriction.

Damages

Pain, suffering and loss of amenity: £110,000
Past Losses
Past loss of earnings: £30,000
Past care: £60,000
Past travel: £2,700
Interest on Past Losses: £1,390

Future Losses
Future earnings: £315,000
Future pension: £12,000
Future care: £1,620,000
Case management: £20,000
Future Services: £27,500
Future Therapies: £33,500
Aids & Equipment: £30,000
Future holiday: £50,000
Future travel: £104,000
Future Accommodation: £200,000

Stephen Maguire, Counsel, instructed by Clear Law Solicitors for the Claimant
Owain Thomas QC, Counsel, instructed by NHS Wales Shared Services Partnership for the Defendant

Produced by Clear Law Solicitors

This article was produced by Brain Injury Group member law firm Clear Law.

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