Medical negligence claims for spinal cord injuries

Dr James Piers on why the difficulties faced by those with spinal cord injury reach far beyond the physical limitations in ability

“I haven’t seen a sunrise or a sunset since my spinal injury."

These were the words of my client after suffering a spinal cord injury as a consequence of medical negligence.

As everyone reading this article will already know, the effects of spinal cord injury reach far beyond loss of limb function.

For somebody who previously led a fully independent life, going to work and enjoying active pastimes, adjusting to life with a spinal cord injury often seems like an impossible hurdle.

For many of my clients with a spinal cord injury, the transformation from independence to near complete
dependence happens in a blink of an eye with no opportunity to adjust gradually.

In this case, my client had been in full time work and had enjoyed walking the dog, taking the children on outings, gardening and jogging.

Upon waking from surgery, they had lost all function in their legs.

This marked the beginning of a long road of rehabilitation and ultimately heavy dependence upon others.

There was substantial reliance on carers arriving in the morning followed by a daily visit from the bowel care nurse. Following this they would be hoisted out of bed into a powered chair where they would remain for the rest of the day.

Despite having extensive needs, the locally provided carers were only able to visit twice a day.

We are all acutely aware of the financial pressures on public services, so an element of rationing is inevitable; however, it seemed that my client’s needs were addressed based on what was required to keep them safe instead of what was required to restore some of their previous levels of independence.

The process of getting out of bed would last until 11am. This was when their “new normal” day could finally start.

The availability of carers meant that they would return to start the process of transferring my client back to bed at around 6:30 pm. They were in bed by 7:30 pm with no choice in the timing.

This was in stark contrast to their pre-injury routine, where they might have gone out for a meal or to the cinema and gone to bed at around 11:00pm. That was no longer possible.

On arriving home from hospital, they were immediately confronted with the reality that they would no longer be able to access the upstairs floor of the family home.

This meant converting a downstairs room into a bedroom, complete with a hospital bed, all of which came at cost both financially and emotionally.

Ventilation was poor and there were no windows. Not only had they lost the ability to sleep in the marital bed, but they also lost the simple pleasure of viewing the outside world between the hours of 6.30pm to 11am.

This is no more than the briefest of glimpses into the total upheaval of life following a catastrophic spinal cord injury.

The broader extent of the impact of this spinal cord injury on all aspects of life was utterly devastating. However, with greater access to carers, my client’s quality of life could have been improved immeasurably.

Sadly, the inevitable rationing of public services dictates that patient safety must come first, over quality of life.

In situations where spinal cord injury has arisen because of medical negligence, compensation may be available.

The yardstick to assess the extent of compensation is loosely “the amount which the client reasonably requires to put them back in the position they would have been in had the negligence not occurred”.

This assessment, therefore has the potential to provide sufficient funds to meet the costs of care and assistance at a level exceeding that which the state can provide, and which can go some considerable way to restoring the client’s previous levels of independence and quality of life.

In some cases where a person or organisation will bear responsibility for a client’s spinal cord injury, some
compensation can be paid on an interim basis to the client as the legal process continues.

These funds enable a lawyer to engage professionals to put in place care, assistance and rehabilitation beyond that which may be available through local state provision.

It is essential to keep in mind that the simple fact that treatment has gone wrong, or a patient has had a poor outcome does not inevitably lead to a successful medical negligence case with an award of compensation.

Put bluntly, things do go wrong in medicine through no fault of a clinician.

To succeed in a case, one must prove to the Court that the care was so poor as to be considered unacceptable and that because of that failing in care, the patient sustained injury and loss that would otherwise have been avoided.

Underlying medical conditions affecting the spinal cord tend to be rare.

The initial presenting features maybe mild and may mimic other less serious common conditions.

For example, back pain with or without sciatica is an extremely common presentation and the vast majority will not lead to serious problems and will probably resolve with simple therapeutic measures.

Within that broad group of patients however will be a very small group that may have impending cauda equina syndrome, for example.

It is not currently practical to scan every patient with back pain and so a careful assessment is required to identify that group that requires further investigation and to ensure those investigations happen at the right time.

It is often the case that in assessing these patients inexperienced clinicians may miss subtle features in the
presentation that point to a more serious underlying diagnosis.

Even in legal cases where a shortcoming in the care is identified, it may still be successfully argued by the Defendant that, even with proper care, the die was already cast.

In other words, by the time the true underlying diagnosis should have become apparent, there was already insufficient time to take therapeutic steps which would have avoided injury or, at least, improved the outcome.

These cases require very careful analysis.

I have been working in the field of medical negligence for over 15 years and am a specialist in spinal cord injury matters.

I have been fortunate to have had the rare opportunity to be able to practise exclusively in the field of spinal cord injury arising from medical negligence for the last five years, accumulating a wealth of experience.

Sometimes however, a Defendant will not make a payment of interim compensation unless it thinks that it is likely to be found liable by a Court or has admitted liability.

This creates delays in the rehabilitation process, and it is the client who suffers.

Cases of spinal cord injury arising from medical negligence are rarely straight forward. They typically arise from missed or delayed diagnosis, mismanagement of trauma or surgical error.

Furthermore, prior to qualifying as a lawyer, I was a hospital doctor in the NHS for over 6 years.

This medical experience is invaluable in the careful analysis of cases and assisting clients through the process of a medical negligence matter.

These are complex matters that are unfamiliar to most clients. The process can feel bewildering, and I believe it is essential to be able to put a client at ease with simple explanations of the inevitable complex medical and legal issues.

In this article I have only touched upon a small aspect of the medical and physical consequences of spinal cord injury.

However, it must be borne in mind that the difficulties faced by those with spinal cord injury reach far beyond the medical consequences or physical limitations in ability.

Those who have suffered spinal cord injury will often find themselves experiencing difficulties and discrimination at work (for those fortunate enough to be able to find work) as well as domestic difficulties, sometimes including unemployment and relationship breakdown.

Management of a compensation fund is also complex as it must meet the costs of lifelong care and assistance.

Not only is it important to choose a medical negligence solicitor carefully, but choosing a firm such as Anthony Gold, which provides a range of services beyond a medical negligence claim, is critical to assist with the burden of additional legal challenges giving clients breathing space to simply concentrate on being the best that they can again.

Dr James Piers is a solicitor, medical doctor and barrister. He works on high value medical negligence matters. He also has a special interest in cases that involve complex medicine and surgical errors, and the management of critically ill patients. Alongside his legal practice, James regularly gives training on medicolegal report writing to senior doctors wishing to become expert witnesses and he has been asked to speak on issues of medical law and pa- tient safety at various professional conferences. Clients who work with James find that his calm and focused approach instantly reassures them that they are in safe hands. His key intention is to not only achieve the best possible compensation payment for his clients’ life changing injuries, but to also put their minds at ease about their future financial stability.”

Contact James on 020 7940 4060 or at jpi@anthonygold.co.uk.

Anthony Gold is a leading Law firm based in South London. Our solicitors spe- cialise in a wide range of legal solutions and are experts in their fields. We are negotiators and litigators, and are committed to doing whatever is best for our clients. For more information on Anthony Gold visit www.anthonygold.co.uk.