Clinical Negligence

Publish date

9 October 2017

Failure to monitor kidneys leads to end stage kidney disease

During pregnancies in 2002 and 2003, Mrs A developed microhematuria (unseen blood in her urine) and elevated protein levels in her urine.

She was referred to a nephrologist at North Middlesex University Hospital in December 2003. Investigations revealed that her renal function was normal and she was discharged in January 2005. The registrar provided the GP with no further advice or guidance.

In February 2013 the claimant saw her GP who urgently referred her to renal medicine at North Middlesex University Hospital. Investigations revealed that she had stage 5 chronic kidney disease and that she would require an urgent kidney transplant.

A biopsy confirmed IgA nephropathy ( a kidney disease that occurs when an antibody called immunoglobulin A lodges in the kidneys) associated with advanced chronic parenchymal damage and mild vascular changes within her kidneys.

Mrs A was advised that as her renal function continued to decline, she would require a period of renal replacement therapy prior to transplantation.

She was transferred to the care of the Royal Free Hospital and underwent five months of peritoneal dialysis before, in February 2014, she underwent a kidney transplant. The kidney was accepted and she went on to make a good recovery. However she was unable to return to work until January 2017.

Mrs A’s instructed Oliver Chapman, who specialises in clinical negligence matters. Oliver obtained Mrs A’s medical records and then instructed a consultant nephrologist who reported on breach of duty and causation.

He subsequently served a letter of claim to North Middlesex University Hospital NHS Trust alleging that they were negligent when discharging Mrs A in January 2005. The registrar should have instructed the GP to monitor Mrs A’s urine, blood pressure and creatinine at least once a year. Ongoing monitoring was important as patients with renal disease often have no symptoms until their renal failure is advanced.

It was argued that had the GP monitored Mrs A following her discharge, her renal impairment, hypertension and protein urea would have been detected much sooner which would have led to further investigation and a prompt diagnosis of renal disease. Treatment would have been commenced earlier which would have delayed the progression of her renal disease. The delay in diagnosis accelerated Mrs A’s need for a kidney transplant by several years and resulted in her requiring a period of dialysis.

Oliver successfully negotiated an out-of-court settlement of £32,000, prior to the need to issue court proceedings.

Oliver Chapman specialises in renal cases. If you would like to ask Oliver a question about a potential case, or if you have a general query about any clinical negligence, contact Oliver at Thomson Snell & Passmore solicitors on 01892 701234 in confidence.

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