Woman who was brain damaged after Achilles tendon operation is awarded £11m
BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6717 (Published 27 November 2019) Cite this as: BMJ 2019;367:l6717
A woman who had a cardiac arrest and sustained brain damage after a simple operation to repair a torn Achilles tendon has won a settlement of over £11m (€12.9m; $14.2m) from the NHS.
The unnamed woman, who was in her early 40s, went to the emergency department at North Middlesex University Hospital in 2010 after rupturing her Achilles tendon while playing sport. She had the operation the following day.
She was slow to wake up after the procedure, so the anaesthetist gave her doxapram, a respiratory stimulant. The drug is effective for only a short period, and its effects can wear off before the effects of the drug that it is being used to reverse. Even if spontaneous breathing returns initially, the patient remains at risk of significant breathing problems.
After the operation she was taken to the recovery room and was left under the care of a nurse. Fifteen minutes later the emergency bell rang: the patient had had a cardiac arrest and sustained brain damage.
Her lawyers argued that the anaesthetist should have told the nurse that doxapram had been administered and that the patient’s breathing needed to be closely monitored in case the effects of the drug had worn off before she started breathing spontaneously. They claimed that the warning was either never passed on to the nurse or never acted on.
On the balance of probabilities, the lawyers alleged, the cardiac arrest would have been avoided had she been closely monitored and respiratory problems detected early, and she would have been uninjured.
Care needs
The claimant, who had worked as an executive in finance, can no longer work or live independently and requires 24 hour care. The court has made an anonymity order to protect her identity, and her funds are managed by the Official Solicitor.
She has motor impairment involving slowness of movement, weakness in both hands, and problems with balance. Other effects include major difficulties in memory, mental speed, and executive function; limited insight into her condition; and complex psychiatric symptoms. She has also developed a condition that causes involuntary muscle jerks.
Olive Lewin, a partner in the clinical negligence team at the law firm Leigh Day, said in a statement, “This was a particularly devastating case of negligence. My client went into the hospital a fit and healthy woman for a relatively simple operation.
“Due to failings in her care, her life has been completely changed and she now requires 24 hour care. Not only is she unable to do a job or to take part in the sports she loves, but she cannot live independently. I am pleased we managed to secure compensation which will help provide for her care needs going forward.”
In a statement a spokesperson for North Middlesex University Hospital NHS Trust said, “The trust apologises unreservedly for the lasting injuries caused to the patient in 2010 and accepts full responsibility.”