Over the last 18 months numerous cases have been reported in the media where problems have arisen due to treatment by out of hours GPs. This case study demonstrates the expertise of our Clinical Negligence team who recently recovered £1.9 million for a man given a three-fold overdose of diamorphine by an out of hours GP.
The claimant, who was in his early 50s, suffered an episode of acute back pain. The painkillers prescribed by his GP were ineffective. That evening, his wife called out the out of hours GP service. A doctor attended. He decided to give an injection of diamorphine but took the wrong size phial out of his bag and, by mistake, gave a three-fold overdose. The claimant said that he felt strange but the doctor left within minutes of giving the injection. After the doctor left, the claimant stopped breathing. An ambulance was called but the claimant suffered a cardiac arrest en route to the hospital.
Emergency treatment was commenced and cardiac output was obtained. On arrival at hospital, however, the claimant's Glasgow Coma Scale (a scale for recording the conscious state of a person) was 3/15, indicative of very severe brain damage. The claimant was resuscitated and admitted to intensive care. Anti-epileptic therapy was instituted for seizures.
Against all the odds, the claimant emerged from the coma one month later. His intellect was intact but he had a number of neurological difficulties. He underwent a period of neuro-rehabilitation and made progress beyond expectation.
Today, the claimant can now walk indoors independently using a wheeler or wheelchair. He can climb the stairs, although with difficulty and significant risk. His upper limb coordination has improved markedly. Unfortunately, increased activity has led to increased myoclonic jerking (brief, involuntary twitching of a muscle or muscle group). The claimant has a stutter linked to the myoclonus. He suffers from cognitive problems, particularly in respect of memory. He has mild dysarthria (poor articulation), mild dysphonia (impairment in the ability to produce spoken words) and high level language deficit. Further specialist input is required.
Despite the improvements, these deficits meant that the claimant was unable to return to work, that he needed care and assistance for some activities of daily life and his accommodation was unsuitable as he needed to use a wheelchair.
We were approached by the claimant's wife three months after the original incident, although the claimant ultimately had capacity to instruct us himself. We encountered difficulties because the out of hours service run by the local primary care trust said they were not responsible as the doctor was an independent contractor. There were difficulties in locating the doctor who had by then returned to Nigeria. Eventually, he was tracked down.
In due course the doctor's defence organisation admitted liability on behalf of the doctor. Judgment was entered with damages to be assessed. We made a contested application for a large interim payment in order for the claimant to purchase a suitable property. The application was successful and an interim payment of £650,000 was ordered. The new house was purchased and adaptations were carried out. A few months after the application, the claimant and his family were able to move into the new house.
The case was due to go to trial on quantum (to assess the value of the damages to be awarded) but the case settled at a round table meeting two months before trial for £1.9 million plus the claimant's legal costs.
Read more about our experience in GP negligence.