Study into prescribing errors in general practice finds serious errors in millions of prescriptions.

Around one in every 550 items was judged to contain a serious error.

Researchers concluded that causes included deficiencies in the training of GPs regarding safe prescribing, time pressure, and lack of robust systems for ensuring that patients receive necessary blood tests.

Read the full story on GP prescription errors by The Guardian (external link)

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If you have experienced an error in a prescription written by a family doctor and want to know your rights, please contact Pearson Hinchliffe’s medical negligence team on 0800 731 1874 or 0161 785 3500 or email john.pollitt@phsolicitors.co.uk.

The High Court has awarded a brain-damaged patient more than £6m in clinical negligence compensation.

33-year-old Christopher Lines, a patient at Lakes Mental Health Unit in Colchester, was left severely brain-damaged in June 2008 when he was prescribed the wrong regimen of medication at Severall Hospital’s Maple Ward. The Court decided he is entitled to a total damages settlement worth around £6.2 million. He is now entirely dependent his daily needs on others and cannot use his arms or legs properly and cannot look after his young son.

£6.2 clinical negligence compensation will pay for lifetime care

The clinical negligence award is comprised of a lump sum of £2.1m followed by annual payments of £205,000 for the rest of Christopher’s life – the total compensation has been calculated at £6.2million based on the cost of care.

Judge Martin McKenna presiding was told how Mr Lines was overdosed on drugs that were meant to bring down the amount of oxygen in his blood but was not monitored correctly and as a result remained unconscious for more than 18 hours.

The Court, which awarded the clinical negligence compensation, also heard of the dedication of Mr Lines’ parents, Steve and Carole, who ultimately brought legal action on his behalf against the North Essex Partnership NHS Foundation Trust, which has now admitted liability.

The judge said he was moved by the family’s dedication to Christopher’s care and wished them well for the future.

A spokesman for the health trust said the clinical negligence compensation award “will enable Mr Lines to receive suitable care throughout his life.

His father, Steve Lines, commented: “The treatment Chris received from the medical profession was appalling. He needed their help, but they have destroyed his life.”

He also paid tribute to Christopher’s “great team of carers, who take him swimming, to the park, to the cinema. And thanks to the charity, the Woolverstone Project, he has also been able to go sailing.”

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To speak to our clinical negligence solicitors call 0800 731 1874 or 0161 785 3500 or email john.pollitt@phsolicitors.co.uk if you would like advice on any clinical negligence matter.

Department of Health advice: Newborns at risk of hypoglycaemia should be regularly monitored using a heel prick blood test.

The NHSLA (NHS Litigation Authority) has admitted that it needs to set aside £235.4m in order to pay compensation claims in which NHS maternity staff failed to notice dangerously low blood sugar levels in new born babies.

The condition known as neonatal hypoglycaemia or low blood sugar affects only between one and three babies per 1,000 but consequences can be serious and long term if untreated. It can be caused by various things, and results in the baby not producing enough glucose or producing too much insulin to remain healthy. In this rare yet treatable condition babies can suffer brain damage, other complications and even death.

Peter Walsh of the medical negligence campaign charity Action Against Medical Accidents (AvMA) said: “Whilst these cases are relatively small in number, the fact the effects are so catastrophic and they are so preventable should make them a ‘never’ event in the NHS. It’s absolutely essential the NHS stops these kinds of accidents happening.

“The NHS should ensure the lessons from these cases are learned and midwives are properly trained and there are enough midwives and consultants on duty to ensure babies are monitored … The human cost of these cases is incalculable.”

John Pollitt, Partner at medical negligence lawyers Pearson Hinchliffe said of the figures obtained by the Guardian: “79 claims for damages in ten years is 79 claims too many. 60 of those claims will receive medical negligence compensation up to £7m which reflects the seriousness and devastating consequences of the avoidable error.”

He added: “The Department of Health has stated that neonatal hypoglycaemia should never go undetected in a baby who is at risk and I endorse that.

“Certain babies are particularly at risk from neonatal hypoglycaemia and they should receive special monitoring by maternity staff; premature babies or those born to diabetic mothers are a greater risk category as well as small babies, and a simple blood test at birth to determine blood sugar levels would help to identify any early danger signs. Doctors and midwives should also be given training and information to spot issues early.”

John Pollitt concluded: “I hope the NHS will take heed of these warnings and introduce policies to prevent these types of preventable claims from occurring.”

Pearson Hinchliffe Solicitors medical negligence team investigate NHS and private healthcare failures in neo natal care and seek compensation whenever appropriate on the behalf of families.

Contacting us

If you would like specialist legal advice on medical negligence related to obstetrics, pregnancy and birth, please call us on 0800 731 1874 or 0161 785 3500, or email john.pollitt@phsolicitors.co.uk or complete this online enquiry form. We will email you or call you back at your requested time.

Pharmacist admitted negligently giving Gliclazide instead of Frusemide.

A 66 years old patient has been awarded a settlement after his pharmacist admitted dispensing the wrong drugs. Mr H had a previous history of two heart bypass operations, angina, kidney problems, hypertension and a stroke. He was prescribed a number of medications including Frusemide (a diuretic).

In May 2009, drugs dispensed upon a repeat prescription were collected for him. After taking these drugs for a period of some days he felt short of breath and disorientated.

At the end of May he collapsed and was taken to Hospital as an emergency. The medics suspected he had had a stroke. Following a review of his medications by the hospital it was discovered that instead of being supplied with Frusemide by the chemist he had in fact been given Gliclazide. This error was corrected and he made a swift recovery before discharge home.

The pharmacy admitted its error.

Our research revealed that gliclazide is an anti-diabetic used to augment insulin secretions. As a result of the temporary withdrawal of Frusemide Mr H suffered with hypotension which accounted for his collapse. He also suffered swelling in the legs as a consequence of the incorrect dispensing of Gliclazide.

Pearson Hinchliffe conducted an investigation obtaining expert evidence from a Pharmacologist to support the case in causation and following the adoption of the pre-action protocol for the resolution of clinical disputes, settlement was achieved for £3,500 plus legal costs.

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If you would like our specialist team of solicitors and medical experts to investigate a possible case of medical negligence, without initial obligation, contact us on 0161 785 3500 or at john.pollitt@phsolicitors.co.uk or contact us here.

The Government's plans to remove medical negligence claims as well as other areas from the scope of legal aid will not save as much as it thinks.

The Government predicts it will save £270 million through the proposed reforms to legal aid, but the King’s College financial analysis says less than half that will actually be realised. There is also evidence that the cuts will actually result in additional costs for the taxpayer as the burden will shift on to other areas of the public sector including the nhs, local councils and charities.

The report by Dr Graham Cookson called: ‘Unintended Consequences: the cost of the Government’s Legal Aid Reforms’ looks at family law, social welfare and clinical negligence law, which together add up to 85 percent of the total civil legal aid bill.

Dr Cookson said: ‘This research undermines the Government’s economic rationale for changing the scope of legal aid by casting doubt on its claims of realising savings to the public purse.”

For example, the study found that in the arena of clinical negligence cases, cutting £10.5m for legal aid will cause knock-on costs to the NHS of £28.5m. Or, put another way, for every £1 the Ministry of Justice saves removing clinical negligence from the scope of legal aid, the NHS could end up being liable for up to £3.

Dr Cookson, who works for the university’s Department of Management, identified subsequent knock-on costs totalling £139 million per year – leaving only 42 per cent of the savings the Government hopes to make. These unintended costs will largely be borne by other government departments.

He added: ‘Without a trial, it is impossible to say for certain what the impact of the proposals will be, just as it is impossible for the Government to assert that there will be a net saving of £270 million per annum. However, my research suggests that the net savings could be half of those predicted in the Government’s forecast, while removing legal aid for almost 600,000 cases a year.’

Last week Tory and Crossbench peers rebelled against the Government’s legal aid reforms.

The facts of the case

Mrs S was 43 years old at the time of her death. She had no significant previous medical history.

During early 2008 she noticed facial swelling and general lethargy with shortness of breath on exertion and dilated veins over the chest wall – symptoms commonly associated with the relatively rare condition, Superior vena cava (SVC) obstruction. She was seen at Royal Blackburn Hospital Accident and Emergency Department from where she was discharged with a plan for an out-patient appointment with a dermatologist. A CT scan was thought not to be indicated.

There was then a delay in arranging the dermatology assessment during which time Mrs S grew more poorly.

On the 15th April she was seen by a Dermatologist who rightly requested a CT scan. This was undertaken on the 22nd April and reported to reveal no significant abnormality.

The Dermatologist was puzzled. She thought that all the signs had indicated superior vena cava obstruction (SVC obstruction is a narrowing or blockage of the superior vena cava -the second largest vein in the human body), requiring anticoagulation.

At a multi disciplinary team meeting it was found that the report of the CT scan had been in error and that it in fact showed significant thrombus including superior vena cava obstruction. At about this time Mrs S suffered collapse and was admitted as an emergency. Despite thrombolysis her condition deteriorated and she sadly died.

Pearson Hinchliffe Solicitors work in the case

Following our initial investigations the medical negligence team at Pearson Hinchliffe obtained expert medical evidence from the following disciplines:

• Haematology
• Cardiology
• Renal medicine

Mr S was understandably profoundly affected by his wife’s death and witnessing the events surrounding her death. We asserted a claim for him as a secondary victim and obtained psychiatric evidence in support of his case.

In response to a Protocol Letter of Claim, the Trust admitted negligence by the Radiologist but argued that Mrs S’s condition was untreatable and that she would have died in any event.

Medical compensation awarded

We prepared a Schedule of the valuation of the claim and a fully pleaded Particulars of Claim indicating an intention to pursue the matter through the Court. After service of the Schedule and Particulars the Trust’s solicitors indicated a willingness to settle the claim (including Mr S’s claim as a secondary victim).

The matter was settled for £140,000 plus legal costs.

Contacting us

If you would like our specialist team of solicitors and medical experts to investigate a possible case of medical negligence, without initial obligation, contact us on 0161 785 3500 or at john.pollitt@phsolicitors.co.uk or contact us here.

Review of BBC radio 4 programme, Doctor - Tell Me The Truth in which Professor James Reason explores how patient safety can be improved by doctors admitting to mistakes.

In case you missed it, you can listen to it again via BBC iplayer: Doctor – Tell Me the Truth

Programme Summary

Each year a significantly high number of people are injured or killed because of the medical treatment they receive. James Reason, Professor Emeritus at the University of Manchester, examined a more open and honest approach to dealing with these mistakes adopted in parts of the US, and asked whether such an approach could be adopted by health professionals in this country.

In the US between 45,000 and 98,000 Americans die each year because of the treatment they receive in hospital. In that country doctors are encouraged to admit their mistakes which has improved patient safety.

In the documentary we first hear the infamous case of ten-year-old Robert Powell who had been an inpatient at Morriston Hospital, Swansea in 1996. Roberts’s parents took him to hospital with symptoms at first thought to be gastroenteritis. The doctors responsible recognised his symptoms as similar to Addison’s disease, a serious yet treatable condition, but failed to order the appropriate tests that would have confirmed their suspicions. Robbie initially got better and was sent home but his conditions got worse and he was seen seven times by 5 doctors over a two week period, some of whom failed to read his medical notes. In the 2 weeks leading to Robert’s death his father protested that he should be admitted to hospital, on the day of his death the GP refused him admission twice. The Powells’ request for an ambulance was also refused resulting in them taking him themselves by car. Tragically, Robert died shortly after reaching hospital. His parents believe he didn’t have to die.

One in ten patients in acute care suffer injury or death as a result of their medical treatment and what compounds the injuries is the way doctors treat their medical mistakes.

The House of Lords subsequently agreed to consider whether getting access to medical records should be easier and if hospitals should be more open; the amendment known as the Duty of Candour, or Robbie’s Law, was subsequently defeated in 2011.

Professor Reason then shifts his attention to the U.S. where work has been underway to change the way doctors deal with errors, both human and organisational, from a confrontational approach between doctors and aggrieved patients to more confession, disclosure, apology and compensation. The professor then discusses what changes in attitude the NHS has made and what further changes may occur in the future.

One US study of New York hospitals found that between 45,000 and 100,000 patients died as a result of the care they received. Harvard University’s Professor Lucian Leape conducted the groundbreaking study which was largely ignored by medical circles at the time despite the shocking findings it describes.

When the report, entitled: To Ere Is Human, was finally publicised in 1999 is paved the way for the seemingly paradoxical notion in the arena of patient safety to be accepted that doctors were not infallible and that mistakes made were a personal shortcoming on their part possibly due to a lack in training. However, medical professionals see a vast array of conditions which are treated using a multitude of techniques, drugs and equipment and mistakes are inevitably going to be made as perfection is virtually impossible, it is argued.

With this understanding, when errors occur doctors should be encouraged to learn from them and not to deceive people as to the cause for fear of litigation.

The programme then visits Rick Boothman and Darrell Campbell at the University of Michigan, the creators of a programme where doctors have to be open about their errors. They describe how previous to their work surgeons would ‘ bury their mistakes’, vigorously ‘deny-and-defend’ and stonewall any complaints made against them almost up until the point of a trial and then settle out of court – a costly and time consuming approach which would increase the anguish for patients and delay the implementation of any clinical learnings from cases. We then hear moving stories about face-to-face apologies from patients, doctors and lawyers.

Boothman and Campbell then contrast this with the present system in which investigations into errors can be started even before the patient comes round from their anaesthetic. How did telling patients that the hospital had made a mistake, even if the patient didn’t realise they had been harmed, affect the patients’ propensity to sue? Surprisingly, patients were far less likely to sue. By making an early admission of negligence and an early offer of compensation, the Michigan study found administrative costs were consequently reduced.

Could the US experience be tried here? One commentator suggest that this more open approach could be adopted in the UK because doctors are normally not personally and financially liable under the NHS umbrella which is in contrast to the US position where a doctor could be individually liable for any damages awarded.

Next Week’s Episode

In episode 2, to be aired on BBC Radio 4 on Monday 5th March at 8pm, Professor Reason will consider whether an open disclosure approach is worth trying in the NHS and do the authorities in this country have the power to insist doctors tell the truth?

The Advancing Quality Alliance (AQuA) show Pennine Acute Trust figures improve but treatment of heart failure still poor.

The third annual results, published by the Advancing Quality Alliance which is funded by North West healthcare organisations themselves, show improvements in key quality measures designed to drive up standards.

Under its flagship, Advancing Quality programme, the organisation aims to reduce complications, lengths of stay and readmissions for patients in regularly performed treatments including heart attacks, hip and knee surgery and heart failure by promoting consistent good practice.

Royal Oldham Hospital Results

Results in four clinical areas of Pennine Acute Trust, which runs the Royal Oldham Hospital, have been made available. The good news is that the trust did better for important clinical measures: in heart attacks (97 per cent), hip and knee replacement surgery (87 per cent) and pneumonia (84 per cent). All of which improved on the results the previous year’s results.

However despite the results improving by 3 percentage points on the previous year, in the heart failure category standards were met only 60 per cent of the time. Part of the poor result in heart failure treatment was due to low scores in advice given to patients upon discharge and adult smoking cessation advice and counselling.

the Trust’s associate medical director, Dr Christina Kenny, countered that she expected the heart failure treatment result to improve by at least 10 per cent in the next set of Advancing Quality Alliance figures.

A further £185m is required to cover the increased costs, especially in birth injury claims.

The reason for additional funds being made available by the Government has been put down to the increasing levels of high cost claims brought against the NHS for medical negligence compensation, especially for birth injury claims which require 24-hour care and compensation settlements often reaching £6m to cover those lifetime costs.

According to recent figures the amount of compensation paid out by The Authority, which handles medical negligence claims made against the NHS, has increased from £277m to nearly £1 billion in the last ten years.

The government has given the NHS Litigation Authority £185m until April to cover the cost of claims and legal fees.

Peter Walsh, chief executive of the charity Action against Medical Accidents, said most of the increased costs came from a judgment that injured children are entitled to more compensation.

‘The government and the NHSLA have known about this for a long time and it shouldn’t have come as a surprise.’

NHS managers have stated that one of the major reasons behind the increase is a rise in the number of birth injury claims which involve a high cost of lifetime care.

Birth Injury Claims

Official statistics from the NHSLA reveal that there are nearly 100 birth injury claims against the NHS each year, which involve new-born babies that suffer brain damage at birth. The medical negligence compensation paid out per child in such cases is around £6 million due to the  improvement in the survival rates and life expectancy of brain damaged babies.

Health Minister, Lord Howe has commented that the vast majority of NHS patients receive a high standard of care; however, when mistakes are made it is only right that medical negligence compensation should be paid.

Contacting Us

If you require legal advice on making a birth injury claim, or any other medical negligence claim, please contact us on 0161 785 3500 or at john.pollitt@phsolicitors.co.uk or contact us here.