How Did Medical Negligence Leave A Glaucoma Patient Blind?
The Law Of… Mismanaging Eye Treatment
A Simpson Millar client lost the sight in his right eye following the mismanagement of glaucoma. Geoffrey Simpson-Scott, a Medical Negligence Partner at Simpson Millar, details a case of clinical error that resulted in permanent blindness.
Diagnosed With Glaucoma
This client's story begins with a visit to the opticians, where, after complaining of blurred vision and loss of peripheral sight in his right eye, it was discovered that visual clarity was below normal.
Undergoing an ophthalmoscopic examination, where the inside of the eye is inspected with a special instrument, it was found that the client had evidence of glaucoma. A referral to his local eye clinic was made.
Subsequent consultations at the clinic confirmed the presence of glaucoma in the right eye, with the left eye registering normal. A course of specialist eye drops and tablets were prescribed to treat the condition.
Less than a month after his first consultation, the client's medication was changed. This was due to a reassessment of the extent of the condition. He was to continue using the newly prescribed Duotrav eye drops until a review scheduled for 2 months later.
Strict adherence to timeframes was essential to ensure that the client's treatment was working, so when the appointment was cancelled there should have been a notification to alert the administrative team to this. There wasn't.
The appointment was rebooked for almost 3 months after its original date. This was also cancelled and rescheduled for the following month.
By the time the client was seen, the vision in his right eye had deteriorated to the point that he had perception of light only, meaning it was severely reduced but he could still differentiate between light and shade. A diagnosis of lost vision due to progressive glaucoma was made.
A letter from the clinic to the client's GP reported that:
"… [he] could not be reviewed in clinic since his last appointment in August 2014 [and] as a result, his glaucoma has progressed quite quickly …"
An appointment the following month found that his vision in the affected eye had degenerated further and there was now no perception of light at all. He was legally blind in his right eye, a condition that was likely to remain permanent.
Alleged Breach Of Duty And Causation
Simpson Millar was approached to make a medical negligence claim on the client's behalf, with Geoffrey Simpson-Scott taking on the case.
A Letter of Claim was sent to the hospital trust responsible for the client's care, in which allegations of breach of duty included:
- The failure to examine the client in the 6 months between August 2014 and February 2015
- The decision to continue treating the client with Duotrav eye drops, once it was established there was a significant elevation of fluid pressure in the right eye
- The failure to consider glaucoma drainage surgery or seek the expert opinion of a glaucoma specialist
- The failure to flag the client's appointments on the system as ones that should not be cancelled.
It was also asserted that the negligence leading to these failings was a direct cause of the client's loss of eyesight.
Responding to the claim, the hospital trust denied it had breached its duty of care by mismanaging the client's course of treatment. It did admit to there being an administrative error, which had prevented the patient being reviewed within 2 months, as required.
The hospital trust also denied any causation, maintaining that due to the advanced state of the glaucoma, loss of vision would have occurred regardless of the treatment or when it was administered.
An offer to settle the claim for £55,000 was made by Greg Simpson-Scott on behalf of the client. The trust had 21 days to decide whether to accept it.
Full And Final Settlement
The 21 day period passed without any response from the hospital trust. When it did, it was with an offer of settlement for £2,500. This was to compensate solely for a short period of pain, suffering and loss of amenity (PSLA) and not for the client's loss of vision in his right eye.
Confident of a strong case against the hospital trust, Simpson Millar advised him to reject this offer.
Following the rejection, and with court proceedings the only way forward, the trust made a second offer of £45,000. Heeding advice from Geoffrey Simpson-Scott, the client decided to accept it if a higher settlement could not be negotiated. When a counter offer was put to the hospital trust’s representatives, they responded by saying they now had permission to accept the initial offer even though it had expired.
Despite the significant delay this had caused, the client was very happy to receive £55,000 plus his additional legal fees in full and final settlement.
Geoffrey Simpson-Scott comments:
"This case illustrates how important it is for patients to question medical appointment cancellations. The hospital had failed to record the next appointment as urgent and so the booking staff felt able to cancel it."
"Our client got trapped in a process based on this initial error, which ultimately led to his loss of sight."
"Although an initial apology was provided, our client had to bring his case to court in order to receive justice. This flies in the face of the reforms this area of the law has seen."
If your vision has been impaired or you have suffered an eye injury as a result of medical negligence, contact Simpson Millar today.