Alan, 30, Greater Manchester

With JMW's help a man has been successful in obtaining £115,000 compensation following doctors consistent failure to diagnose a heart infection which led him have a stroke.

30-year-old Alan worked in the family business and was generally fit and well. At a routine medical examination, a heart murmur was heard, but this was not thought to be significant, although he was advised to take antibiotics if undergoing dental treatment to avoid the risk of developing an infection of the lining of the heart (bacterial endocarditis).

Sent home from a GP twice

Three years later following an operation on his hip Alan began to feel unwell with flu-like symptoms. When after about four weeks he was no better he consulted his GP, Dr P, who noted a history of excessive sweating day and night for the previous two weeks with no obvious signs of infection. He advised Alan to continue taking plenty of fluids and paracetamol but he did not check his bloods or listen to his heart.

Five days later as his symptoms were getting worse Alan attended a private GP/walk-in clinic attached to a private hospital. He was complaining of extreme fatigue, night sweats, dizziness, fever and visual disturbances. Bloods were taken and the doctor advised him to buy some vitamins and travel sickness pill for his dizziness. It would appear that he thought his symptoms were due to anaemia.

Admitted to a private clinic

Alan did not improve and almost two weeks later he returned to the private clinic where a urinary tract infection was diagnosed. Further bloods were taken and the following day Alan was recalled and admitted to the private hospital where, following blood cultures, a diagnosis of aortic valve bacterial endocarditis was made.

The infection was aggressively treated with intravenous antibiotics and further investigations revealed a congenital abnormality of the aortic valve, which was the cause of his heart murmur. After a number of days he was transferred to the cardiac unit of the NHS hospital where several days later he had a stroke due to the rupture of a mycotic aneurysm in the brain.

A mycotic aneurism is a well-recognised complication of bacterial endocarditis and is caused when the infection in the heart travels via the blood stream to a vessel in the brain weakening the vessel wall.

Consequences of the negligence

Following this Alan’s condition deteriorated and he was transferred to ICU where he required artificial ventilation for several days. Once sufficiently recovered he underwent a successful coiling (repair) of the aneurysm followed by an aortic valve replacement and aortic root graft. The root graft was necessary because of the extent of the tissue damage caused by the infection and, because of the extent of the surgery, he required a permanent pacemaker.

Lasting effects

On the whole Alan has made a good recovery but he has been left with a degree of memory loss and poor concentration. He also has some hearing loss due to the large doses of Gentamycin he required to control the infection. He has made a big effort to regain his previous level of fitness and has returned to work in the family business.

The claim for negligence

It was claimed that both Dr P and the doctors at the private clinic were in breach of their duty of care to Alan in not suspecting that he might have bacterial endocarditis despite the history of a heart murmur and a persisting fever. If he had been referred to a specialist sooner the infection would have been picked up and treated before it could spread to the brain and the stroke would therefore have been avoided. He would have still needed an aortic valve replacement but the aortic root would not have been involved and he would not have required a pacemaker.

Settlement

It was not possible to proceed with the claim against the private clinic because the company went into liquidation and the insurance cover of the doctors involved could not be established. However, the claim against Dr P proceeded and after obtaining a number of expert medical reports his insurance company made an offer of £100,000 but refused to accept liability. Negotiations followed and the case was eventually settled by one of JMW’s expert solicitors for £115,000.