Clinical/optical negligence

Advice and Assistance from Cohen Cramer

We represented the Claimant in proceedings brought against the Defendant for damages for injuries and losses arising out of a clinical negligence claim. The Defendant was the NHS Trust responsible for the management and provision of ophthalmological treatment and care to the Claimant over a period of several months.

The initial condition

Following a diabetic eye screening, the Claimant was diagnosed with pre-proliferative retinopathy in both eyes and maculopathy in the right eye. He was referred to the Defendant’s Ophthalmology department. By the time he was seen, he had been suffering from visual loss for a few days together with pain, discomfort and photophobia.

The Claimant`s Intraocular pressure (“IOP”) in the right eye was noted to be very high and a diagnosis of neovascular glaucoma in the right eye was made. A decision was made to start medical treatment in an attempt to control the pressure and reduce inflammation. However, it was not possible to treat the proliferative disease in his right eye with pan-retinal photocoagulation (“PRP”) due to the inability to visualize the retina.

The negligent treatment

The situation was different in the left eye and PRP was booked in. The problems with the right eye were not treated as an emergency. The Claimant was not started on anti-VEGF treatment and no consideration was given to referring him for early vitrectomy, as recommended by the Royal College Guidelines on Diabetic Retinopathy. There was no plan to promptly review the Claimant or check his IOP in the following days. His IOP was not checked for another 13 days.

The Claimant attended hospital and underwent PRP on the left eye. Treatment by way of Cyclodiode laser on the right eye was arranged in an attempt to reduce the IOP. However, such treatment would not address the underlying problems in the right eye.

The Claimant re-attended hospital. No laser treatment was possible on this occasion and his IOP was still high. The Claimant was still not started on anti-VEGF treatment nor referred for a vitrectomy. He underwent Cyclodiode laser to his right eye. PRP was still not possible because of the difficulties visualising the retina. His IOP was not checked and he was still not referred for anti-VEGF treatment or vitrectomy.

Failure to arrange treatment

The Claimant attended his optician and was referred back urgently to A & E Department on account of hemorrhages in both eyes.  More PRP was planned in the left eye though not the right but in any event that PRP was not arranged.

The Claimant saw his GP suffering from headaches, pain and reduced vision. He could not see out of his left eye. It was noted that he should be reviewed in the laser clinic for further assessment and possible further laser.  An appointment was made but was cancelled by the hospital. The Claimant attended another appointment and was told nothing more that could be done. He was referred to a different hospital but there was a delay in making this appointment. When he was seen at then new hospital immediate plans for treatment were put in place including Vitrectomy and endolaser.

The result of the negligence

The Claimant now has extremely poor vision in the right eye, with acuity of hand motions only. His vision in the left eye is impaired but to a lesser extent.  He has no vision in low light, darkness, bright light or sunlight.

Preparing the claim

Work was undertaken to obtain medical evidence in support of the Claimant’s claim. A Letter of Claim was prepared and the Defendant provided a Letter of Response denying each and every allegation. Ultimately, court proceedings were issued and both parties obtained further expert medical evidence. As the court proceedings progressed, the parties’ experts were duly instructed to meet and prepare a joint report. Within the joint report, the Defendant’s expert changed her stance and accepted that there had been numerous breaches, that glaucoma should have been managed better, conceding some ground on the Claimant’s ability to work, agreeing minimal consultant cover and chaotic note keeping.

Settlement of the claim

Following the joint report, in light of the number of concessions now made by the Defendant’s expert, we entered into settlement negotiations and ultimately the claim settled for just under £175,000.00.

Your negligence claim

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