H (BY HER LITIGATION FRIEND, MF) v SOUTH CENTRAL STRATEGIC HEALTH AUTHORITY (2010)
Total Damages: £4,000,000 plus periodical payments
PSLA: £215,000 (£228,846.15 RPI))
Trial/settlement date: 14/7/2010
Type of Award: Out of Court Settlement (approved)
Judge: Tugendhat J
Court: Out of Court Settlement (Approved, QBD) Age at trial: 22 Age at injury: 0
Sex: Female
The claimant, a 22-year-old woman, received a lump sum of ?4,000,000 and periodical payments of ?110,000 per annum for the remainder of her life after she developed periventricular leukomalacia after an alleged failure to monitor her serum sodium following her birth in September 1987. She suffered mixed dystonic and spastic quadriplegic cerebral palsy, but causation was disputed.
Claimant: Female: 6 days old at date of accident; 22 years old at date of settlement.
Clinical Negligence: On September 9, 1987, the claimant (C) was born prematurely at a hospital of the defendant health authority (D) and was subsequently transferred that day to the neonatal unit. Whilst there C suffered hyponatraemia and a respiratory arrest and subsequently developed periventricular leukomalacia. D accepted that C suffered all those conditions but disputed their causation.
C sustained injury and brought an action against D alleging that it was negligent in (i) failing to monitor her serum sodium between September 9 and September 13; (ii) administering or prescribing her 10 per cent dextrose solution without adding any electrolytes; (iii) administering excessive quantities of water to her. C alleged that competent measurements of her serum sodium between those dates would have detected a radical fall in her sodium levels, the failure to add the electrolytes placed her at an obvious risk of hyponatraemia, and the administration of excessive amounts of water meant that by September 13, her sodium level was dangerously low and her potassium concentration, urea and creatinine levels were low.
Liability admitted in part. D admitted breach of duty but disputed causation, arguing that there were other possible causes of C's disabilities, such as her prematurity, an infection or a period of hypocarbia. C accepted that there had been a very unusual mechanism of injury and that there was very little help available in published material which established a causative link between hyponatraemia and periventricular leukomalacia.
Injuries: C developed periventricular leukomalacia.
Effects: C suffered mixed dystonic and spastic quadriplegic cerebral palsy which affected all four limbs, she was visually impaired and had some cognitive impairment. She was able to mobilise with sticks for very short distances but required a wheelchair for the majority of manoeuvres. She required assistance with personal care.
C previously attended school in Budapest at a specialist institute. Shortly before settlement of the claim C returned to France to her family home. The intention was that she would live in purpose built accommodation, annexed to the family home. The care experts agreed that C would need 24-hour care.
Capacity issues had to be explored very carefully; C spoke fluent Hungarian and could also converse in French and English. However, she did not have insight or understanding to manage her property and affairs and she lacked capacity.
The geneticists agreed that C would have had a 10 point reduction in IQ as a result of the neurofibromatosis, unrelated to D's negligence. C had no realistic prospect of paid employment.
Prognosis: C required 24-hour care at home and a care regime had been put in place by her parents before settlement of the claim. C's expert believed that her life expectancy was 80 years, whereas D's expert believed that she would survive until aged 60.
Out of Court Settlement (approved): ?4,000,000 lump sum and periodical payments of ?110,000 per annum for the remainder of C's life.
Background to damages: C's parents were anxious that C continue with the care regime followed by the institute and so the claim for care costs was made on that basis. C was diagnosed as suffering from NF1 (Von Recklinghausen) which was linked to cognitive impairment and reduced life expectancy. Her life expectancy was reduced by both the cerebral palsy and the NF1.
C's care costs were assessed in Euros to reflect the real costs that she would incur.
The settlement took into account the litigation risk on causation.
Breakdown of General Damages: Pain, suffering and loss of amenity: ?215,000; Capitalised miscellaneous future costs comprising costs of care, accommodation, equipment, assistive technology, travel expenses, therapy, private medical treatment, private education, holidays and loss of earnings: ?7,000,000.
Breakdown of Special Damages: Miscellaneous past costs comprising costs of care, accommodation, equipment, travel expenses, therapy, private education and interest: ?690,000.
Elizabeth-Anne Gumbel QC and Henry Witcomb instructed by Henmans LLP (Oxford) for the claimant. Angus Moon QC instructed by Weightmans LLP for the defendant.
LTLPI 24/11/2011
This Quantum Report was provided courtesy of Susan Booker of Henmans LLP (http://www.henmansllp.co.uk/), solicitor for the claimant.
Reproduced by kind permission of Lawtel (www.lawtel.com).
Document No. AM0201862