Case study: Badly Managed Insulin Therapy Leads to Brain Damage
Compensation: £2.1 million
Baby Claire, Liverpool
With the help of JMW, a young girl has been awarded £2.1 million after badly managed insulin therapy led to brain damage.
Claire was born with a congenital heart abnormality in which the left coronary artery originated from the pulmonary artery rather than the aorta - in other words on the wrong side of the heart.
Aftermath of corrective heart surgery
When Claire was nearly one year old she underwent corrective open heart surgery at Royal Liverpool Children's Hospital (RLCH).
After the operation Claire was admitted to ICU in a stable condition. It was decided that it was in her interests to commence glucose/insulin/potassium (GIK) therapy.
Stress-induced hyperglycaemia frequently occurs in critically ill patients, including those undergoing open heart surgery, and can result in increased morbidity and mortality. The aim of GIK therapy is to maintain a normal blood glucose level thereby increasing the chances of recovery. The treatment that requires very close biochemical monitoring as insulin lowers both blood sugar and potassium levels. It is well known that very low or very high potassium levels can lead to cardiac arrhythmias and very low blood sugar levels can result in brain damage.
Claire's potassium levels varied between normal and very low and her blood sugar level was at the lower end of normal. The GIK therapy continued throughout for two days despite Claire’s potassium falling dangerously low. A fast pulse was also noted, which was almost certainly the result of the very low potassium level.
Change in medication and cardiac arrest
On the third day after the operation, Claire appeared to be improving although her heart rate remained fast. The GIK therapy continued and a diuretic was commenced even though the potassium level remained very low. That night Claire’s blood sugar level was exceptionally low so the insulin was reduced and the dextrose increased.
The following day Claire suffered an episode of ventricular fibrillation resulting in a cardiac arrest. She was resuscitated although it is not known how long this process took. Claire’s potassium at this time was very low. As a direct result Claire’s brain was starved of oxygen and this resulted in severe and permanent brain damage.
The case for negligence
JMW Solicitors argued that the management of the GIK therapy in Claire’s case was inadequate and substandard for the following reasons:
- The dose of insulin was excessive.
- The balancing of insulin, dextrose and potassium infusions to maintain near normal (and therefore safe) blood chemistry was not achieved.
- A careful treatment plan to ensure this biochemical balance was achieved was not implemented.
- The persistently low potassium levels were not acted upon.
- Digoxin was administered even though it is well recognised that in the presence of low potassium it can cause ventricular fibrillation and cardiac arrest.
- A diuretic was administered in the presence of already low potassium levels even though it is known to deplete levels even further.
- Claire's blood sugar was allowed to fall to dangerously low levels.
Permanent effects
Claire is now severely brain damaged and although she is now 28 years old she has the developmental age of a 7-year-old. She has frequent epileptic seizures and requires full-time supervision as she cannot tolerate being left alone for more than a few minutes. She has behavioural problems, particularly anxiety and aggression.
Claire must rely on the dedicated care of her mother and father, together with other members of her family, to provide for all of her care needs.
Compensation
The hospital admitted that the care afforded to Claire was negligent. Compensation was awarded in way of payment of a lump sum of £2,150,000 and a periodical payment schedule ranging from £82,500 a year to £132,500 a year for the rest of Claire’s life.
Have you or a family member suffered brain damage due to poor management of care?
Contact JMW today either by our online enquiry form or by telephone on 0800 054 6512 and let us help you move forward with your claim.
Back to main falls from height claims page
More Case Studies
When Phil was 49 years old he was referred to North Manchester General Hospital by his GP for investigation into problems he was having with deafness and balance.
Michelle was left with a permanent brain injury after she suffered a major stroke that her family believe could have been prevented with better care. JMW Solicitors obtained a six-figure compensation settlement.
Ann-Marie experienced severe headaches which were misdiagnosed at A&E. JMW won £150,000 for her family.
Claire was born with a congenital heart abnormality in which the left coronary artery originated from the pulmonary artery rather than the aorta - in other words on the wrong side of the heart. When Claire was nearly one year old she underwent corrective open heart surgery.
Colin was taken to his local hospital when he began to experience a sudden severe pain in the head, immediately followed by vomiting. He was transferred straight away to a larger centre for a CT scan, as a sub-arachnoid haemorrhage (SAH) was suspected.
Charles had a history of a significant nasal deformity since he was hit in the face during a rugby match. He was referred to Hospital by his GP.
Glenda presented at A&E with head and neck pain, which she had suffered from for a couple of hours. She had taken two Paracetemol but with no relief. She felt nauseous but had not vomited.
Claire had a normal pregnancy until 37 weeks when it was noted that she had raised blood pressure and a trace of protein in her urine. When Claire was 4 days over due, she was seen by a midwife at home who noted that her blood pressure was still high.
Violet won £400,000 in compensation after she was left with severe brain damage when doctors failed to diagnose her sub-arachnoid haemorrhage.
John underwent an operation to remove metalwork from his lumbar spine that had been inserted at a previous operation. At the time is used a wheelchair because of chronic back problems.
'Peter' suffered a major stroke after being wrongly send home from hospital without treatment when he developed worrying warning signs. He was left permanently disabled but medical negligence specialists ar JMW secured him £1 million in compensation to help him cope with the financial consequences.
'Andrew' is severely physically and mentally disabled after a delay in diagnosis meant a serious thyroid condition went diagnosed, leading to his collapse and a permanent brain injury. JMW's Sally Leonards secured Andrew £3.9 million in compensation to provide the specialist care he requires.
Shauna was left with severe cerebral palsy and requires 24-hour care for the rest of her life after maternity failures. Our specialist cerebral palsy team secured her compensation totalling £10 million to provide her with financial security.
'Bobby' was left with severe cerebral palsy and very significant disabilities after meningitis failures when he was a baby led to permanent brain damage. Bobby is not expected to live beyond his teens but a JMW medical negligence partner secured a £4.6 million care package that will enable him to have as comfortable a life as possible.
Luke suffered catastrophic brain damage due to appalling failures by midwives. He was left with severe cerebral palsy and will require 24-hour care for the rest of his life. The brain injury specialists at JMW obtained over £7 million in compensation to cover the cost of this.
A partner in the JMW medical negligence team and a specialist in cerebral palsy cases, obtained £13 million in compensation for two siblings who were tragically both brain damaged by hospital errors.
Claire had a normal pregnancy until 37 weeks when it was noted that she had raised blood pressure and a trace of protein in her urine. When Claire was 4 days over due, she was seen by a midwife at home who noted that her blood pressure was still high.
'Olivia' suffered catastrophic brain damage after she contracted tuberculosis on the postnatal ward, which caused meningitis.Screening errors meant the disease was not identified at an early stage when it was treatable and serious injury preventable. Nothing could make up for these appalling failures but Eddie Jones, head of medical negligence at JMW, was able to secure Olivia a lifetime care package worth £5 million.
Nicola Wainwright, a partner specialising in medical negligence based in JMW's London office, has won a case against a hospital for a child who suffered catastrophic brain damage due to meningitis that went untreated. Nicola is now assessing what care needs 'Maisie' will have for the rest of her life so that she can secure significant compensation to cover the cost of this.
