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<p><a href="https://www.parklaneplowden.co.uk/our-barristers/howard-elgot/">Howard Elgot</a> and <a href="https://www.parklaneplowden.co.uk/our-barristers/megan-crowther/">Megan Crowther</a> of Parklane Plowden Chambers, instructed by David Bradshaw of <a href="https://www.hay-kilner.co.uk/">Hay & Kilner LLP</a>, acted for the Claimant in her claim against the Newcastle-Upon-Tyne Hospitals NHS Foundation Trust, in a 5-day High Court trial at the Royal Courts of Justice, in June. The trial was to determine breach of duty and causation. Liability had been strongly contested by the Trust; but the Claimant succeeded on issues of<br>(1) informed consent;<br>(2) breach of duty by the surgeon in the planning of the operation; and also<br>(3) in establishing that 13 minutes of cerebral hypoxia would have been avoided had the operation been planned appropriately.<br>The matter will proceed to an assessment of damages hearing in due course.</p>
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<p>The claim was brought after the Claimant, who can be referred to only as HQA because of an anonymity order made by the High Court, suffered severe brain damage after undergoing open heart surgery at the Freeman Hospital, Newcastle. The Claimant had suffered congenital heart problems from birth and had undergone many operations and other procedures over her lifetime.<br><br>In order to gain access to her heart, the surgeon used an oscillating saw. The saw slipped, and instead of the saw cutting through only the anterior section of the Claimant’s sternum, the saw went fully through the sternum and into her aorta, causing catastrophic bleeding which led to the cutting off of the blood supply to her brain.<br><br>It then took so long for the surgeons to put the Claimant on cardio-pulmonary bypass that she suffered very severe hypoxic brain damage. The time was prolonged in part because another surgeon, who had been called in because of the emergency, attempted to cannulate one femoral artery, but the artery dissected, and another femoral artery had to be prepared and cannulated.<br><br>Following the operation, HQA’s family were told to expect the worst, but the Claimant has at least made a partial recovery.</p>
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<p>The Court held that the Defendant failed to obtain the Claimant’s informed consent for her surgery and further, that the surgeons failed to plan adequately for the possibility of the catastrophic event that occurred.</p>
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<p>The Court accepted the general thrust of the Claimant’s expert’s evidence that the Claimant’s aorta was sufficiently close to the rear of her sternum, at least in places, to mean that no surgeon could be confident, in a re-do sternotomy, of being able to open the sternum without causing injury to the enlarged aorta. As a result, the minimum level of precaution required was to expose and prepare the relevant groin vessels as a preparatory step, in case emergency bypass was required. The Defendant failed to take this step. The Court held that more than half of the time taken to establish cardiopulmonary bypass would have been saved, but for the negligence. As a result, the Claimant sustained a prolonged period of hypoxia.</p>
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<p>Furthermore, the Court found that the above mitigating steps should have been discussed with the Claimant during the consenting process: “It is not for the surgeon to determine, for the Claimant, what the Claimant’s risk appetite should be”. It was also held that in this case, it was “unacceptable practice” for the surgeon to see the patient for the first time on the day of the intended surgery in order to explain the risks of the operation for the purposes of seeking to obtain informed consent. The Court agreed with the Claimant’s expert’s view that the consenting process was “chaotic”.</p>
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<p>The claim is estimated to have a value of over £5,000,000.<br></p>
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