IN THE MATTER OF:
WILLIAM HERBERT RUTHVEN
Claimant
-v-
JOHN DOVE
First Defendant
-and-
DR. J. SEDDON
Second Defendant
-and-
NORTH STAFFORDSHIRE HOSPITAL NHS TRUST
Third Defendant
Background to Clinical Negligence Claim
The Claimant was born on the 17th January 1933.
The Claimant was a retired aeronautical engineer who had been employed by British Aerospace Military Aircraft Division until his early retirement in 1991. He was divorced and lived alone in the North West, with his two grown up daughters living in the South of England.
The Claimant had always been extremely keen on walking and mountaineering, and was actively involved with the Mount Everest Foundation.
The Claimant had suffered from problems with arthritis since approximately 1984 and had cartilage operations to one of his knees in 1990 and 1991. These were only partially successful, which led to his decision to take early retirement: he continued his hill walking activities, but on a much reduced scale. He had also been diagnosed with high blood pressure in 1990. He subsequently underwent a valve replacement operation in June 2000.
However, towards the end of 1995/beginning of 1996, the Claimant experienced problems with pain in his back extending into his leg. He was referred by his General Practitioner to the First Defendant on a private basis and was initially seen by him in October 1996. The First Defendant, following an outpatient examination, suggested that it was likely that there was stenosis of the spinal canal at the L4/5 level and suggested that if this was confirmed by MRI scanning that the Claimant would be a "very good candidate for surgery to relieve the stenosis with a good chance of getting him back to serious hill walking". Following this, various further investigations were carried out and the Claimant was eventually admitted to the Hartshill Orthopaedic Hospital for an operation described as "L3-5 decompression and stabilisation". The operation was carried out on the 7th May 1997, on a private basis, by the First Defendant. However, the Claimant was on an NHS Ward, under the control of the Third Defendant. The Second Defendant was the anaesthetist.
The surgery itself was apparently uneventful and the Claimant went to the recovery room from theatre at about 14.15 and back to the Ward at about 17.00.
The Claimant's post-operative nursing instructions included instructions to observe the colour, sensation and movement of his limbs. From 17.00 on the day of surgery, until the 14th May 1997, when he underwent further surgery, the Claimant demonstrated progressive neurological deterioration caused by the presence of an extra dural haematoma, which was eventually evacuated when further surgery was performed on the 14th May 1997.
The Claimant was left with significant motor and sensory deficit which means that he cannot walk except with crutches and that his preferred method of getting around is by wheelchair. He is however extremely self-reliant and very independent-minded.
The Claimant issued proceedings on the 5th May 2000 when it was alleged that there was unreasonable and unjustified delay in the performance of exploratory surgery following the initial operation despite entries in the nursing notes which indicated neurological deterioration and which, had they been properly heeded, it was alleged would have led to appropriate investigations and further surgery. It was alleged that had the Claimant been appropriately treated post-operatively and an urgent surgical evacuation of the haematoma carried out, his neurological and functional recovery would have been full.
The Defence of the Third Defendant was received in February 2001. This relied on the fact that the First and Second Defendants had been acting in a private capacity pursuant to contracts between themselves and the Claimant. It denied any negligence on behalf of the Third Defendant and put the Claimant to proof that the period between the two operations was an unreasonable period of time or constituted unreasonable delay. Subject to that the Claimant's allegations against the Defendants were adopted.
The Defence of the First and Second Defendants was served in March 2001. It admitted that there was an unreasonable delay in the performance of exploratory surgery following the initial surgery and admitted that had appropriate communication taken place between the respective Defendants such surgery might have been performed on or around the 8th May 1997. It was their case that the delay in performing the exploratory surgery was caused or contributed to by the negligence of the Third Defendant.
The matter came before the District Judge for directions on the 26th March 2001 when the District Judge made it clear that he thought it was pointless for the Claimant to be involved in any wrangling to take place between the Defendants. He therefore ordered that Judgment for the Claimant be entered against the First and Second Defendants on the basis that the First and Second Defendants accepted breach of duty and causation in full, and he ordered that the First and Second Defendants should pay the costs of the action including the costs of the action against the Third Defendant and allowed the Claimant to discontinue against the Third Defendant with no Order for costs as between the Claimant and Third Defendant.
Further directions relating to the disposal of the matter were given on the 24th April 2001. Each party was respectively permitted to adduce expert evidence from singly instructed spinal specialists. Joint reports in relation to Occupational Therapy, accommodation, care and physiotherapy were ordered. It was also ordered that a report from a Cardiologist in relation to the Claimant's health and life expectancy should be sought on a joint basis. On the 2nd July 2001 the matter was listed for a disposal hearing to take place on the 15th April 2002.
Although there were initially some differences in relation to the issue of life expectancy, it was agreed that the Claimant's neurological injuries could be classified as Frankel D (an assessment made by both Mr Johnston, Consultant Neurosurgeon instructed on behalf of the Claimant and Mr Ravichandran, Consultant in Spinal Injuries instructed on behalf of the Defendants) and it was felt that the Claimant's life expectancy was to the age of 76.5 or 7.25 more years giving a life time multiplier of 6.64 on the basis of Ogden Table 38.
Outcome of Clinical Negligence Claim
Shortly before the disposal hearing, the Defendants made a Part 36 Offer in the sum of £400,000.00 which was accepted by the Claimant.
The Claimant's breakdown of this figure, whilst not agreed with the Defendants, was as follows:-
Head of Loss: Settlement Figure:
General Damages £120,000.00
Past Care £5,600.00
Future Care £62,739.00
Past Accommodation Costs £16,047.00
Accommodation costs thrown away £35,214.00
Roberts –v- Johnston Claim £1,660.00
New Furnishings £4,000.00
Additional running costs £7,308.00
Past one-off additional costs £1,496.00
Past recurrent annual costs £3,934.00
Future recurrent costs £53,417.00
Physiotherapy equipment £1,695.00
Future physiotherapy £2,095.00
Chiropody £850.00
Occupational Therapy £1,096.00
Aids and adaptations – capital costs £15,838.00
Aids and adaptations – recurrent costs £18,674.00
Past mobility costs £7,500.00
Future mobility costs £5,867.00
Miscellaneous costs £6,993.00
Medical costs – insurers outlay £13,211.00
Medical costs – claimant’s past additional excess £250.00
Medical costs – claimant’s future excess £332.00
Interest on general damages £4,122.00
Interest on special damages £10,062.00
TOTAL: £400,000.00
Repayable Benefits amounted to £11,888.00
Claimant's Solicitor:
Olivia Scates
JMW Solicitors.
Counsel:
Richard Pearce
Defendants' Solicitors
Radcliffe Le Brasseur
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