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Breach of duty at A&E leading to death from pneumococcal septicaemia

Tracy Edwards was instructed by Mr X’s widow in relation to a potential clinical negligence claim that resulted in the death of her husband. In 1973 the deceased, Mr X underwent a splenectomy. In March 2004 he attended an A&E Department following a period of dizziness, cold and shivering feeling. When he attended A&E he was recorded as hyperventilating, pins and needles following an episode of stress and it was queried “panic attack”. Pulse was 99, respiration 20, blood pressure 131 over 62 and oxygen saturation 99%. He was described as being shaky, vomited and in his past medical history it is recorded that there was NAD this was despite Mr X always carrying a splenectomy card and if asked would openly tell anyone. He was subsequently discharged. Unfortunately by the following day he was even more unwell.

A local GP attended and made a diagnosis query – “slightly septicaemic” and he was admitted into hospital at 16.30. Unfortunately he was then diagnosed with sepsis and transferred to the ICU and Mr Fowkes died on the 13th February 2004 at 04.50. Cause of death with noted “pneumococcal septicaemia”.

Initial investigations were in relation to breach of duty and his attendance at A&E. We also obtained evidence in relation to causation from a microbiologist and General Surgeon. The evidence was technical and required careful analysis but was supportive that there was a failure by the clinicians in the A&E Department to take a full history and if further basic tests including blood sugar measurement, ECG and lying and standing blood pressure measurements were undertaken than a diagnosis would have been made and a prescription of antibiotics would have followed and prevented Mr X’s untimely death.

The claim was bought on behalf of his estate and also a dependency claim on behalf of his widow and his young child. Proceedings were issued under the Law Reform (Miscellaneous) Provisions Act 1934 and also the Fatal Accidents Act 1976.

Following the defence being filed denying liability the defendants made a Part 36 offer in the sum of £300,000.00 which was rejected and through negotiations an offer of £425,000.00 was accepted. Counsel’s advice was sought in terms of the approval for the infant and also the apportionment between the dependents. Detailed investigations had to be undertaken in relation to the dependency claim to include detailed analysis of his and his widow’s income.