P had suffered from fairly severe rheumatoid arthritis for a number of years. This had limited his ability to work and had resulted in a number of joint replacements but despite this he was an active and involved member of his family.

He was 48 years old when he was investigated for hearing loss and problems with balance. As part of routine investigations he underwent a CT scan of the head that demonstrated a middle cerebral artery aneurysm (approx 5-6 mm). This was a wholly coincidental finding unconnected to his symptoms.

The aneurysm was recorded in his medical records but for reasons that are unclear neither P nor his GP were informed and no follow up was arranged despite it being recommended.

11 years later the aneurysm ruptured resulting in a sub-arachnoid haemorrhage. After several days the aneurysm was clipped but by this time P had sustained a severe brain injury resulting in left hemiparesis and significant cognitive impairment.

If P had had a neurosurgical review when the aneurysm was first discovered it is likely that it would have been surgically clipped .This would have greatly reduced the chances of a cerebral bleed with the resulting brain damage and disability.

P remained in hospital and then rehabilitation for over a year and was left with a dense weakness of the left arm and leg and a supra - pubic catheter. He initially had epileptic seizures although these eventually resolved.

P is cognitively impaired, unable to manage his own affairs and is wholly dependent on others for all aspects of daily living including toileting, dressing feeding and mobility.

Liability was admitted by the defendant Trust despite an expert opinion that the bleed might have occurred anyway even if the aneurysm had been clipped when first discovered. Damages of £2 .25 million were eventually agreed (some of this in periodic payments)