Miss S-GH (a child by litigation friend CH) v Great Western Hospitals NHS Foundation Trust

The Claimant’s father and Litigation Friend became concerned about the claimant’s eating and drinking during the week of 10 January 2020, just short of her first birthday. The Claimant was taken to her GP on 10 January 2020 where she was diagnosed with a viral upper respiratory tract infection. The Claimant’s father had already contacted the NHS 111 service prior to her attendance to the GP as well as after the visit.

On 11 January 2020 the Claimant was taken to the Urgent Care Centre, and the medical staff were given a history of the Claimant being unwell for five days with a runny nose and marked “drippling”. This was the fourth contact the Claimant had had with health professionals over a two-day period (10 and 11 January 2020). The Claimant’s father informed the health professionals that she was drinking less, had had a five-day history of a runny nose and a one-day history of vomiting. The Claimant had routine observations undertaken and a diagnosis of viral upper respiratory tract infection and teething was made.

The Claimant’s Litigation Friend contact the NHS 111 service on 12 January 2020 and the reported condition was a sore throat and not eating or drinking. There was also mention of stools looking back and tarry. An ambulance was called and the Claimant was taken to Great Western Hospital. The hospital diagnosed tonsilitis and dehydration and the management plan was for a fluid challenge and treatment with oral penicillin.

On 17 January 2020 the Claimant was seen again and a differential diagnosis of laryngomalacia or a vascular ring was made and lateral and anterior-posterior chest x-rays were requested, however no x-rays were performed.

The Claimant continued to be unwell and her GP recorded on 24 January 2020 that she had tonsillitis, teething, intermittent episodes of choking on lumpy food over the previous month, no vomiting, no fever and passing urine.

The Claimant continued to be seen by medical professionals on multiple occasions. She attended a paediatric appointment on 13 May 2020 where a lateral chest x-ray was requested and the report informed of a radiodensity projected over the neck centrally. The Claimant was then transferred to Bristol Children’s Hospital. The medical professionals reviewed the chest x-ray and it was noted that the Claimant had ingested a button battery, and she was taken urgently to theatre.

Following surgery it was confirmed the Claimant had sustained an oesophageal perforation secondary to ingestion of a foreign body that had likely occurred in January 2020. There was significant trauma and injury to the oesophagus. There has also been an oedema posterior to the sub glottis and trachea over approximately 3cm. The Claimant was treated with triple intravenous antibiotic therapy with Augmentin, Metronidazole and Gentamicin.

The Claimant was further admitted to Bristol Children’s Hospital on 25 June 2020 to 1 July 2020 for dilatation of an oesophageal stricture. The management plan was to keep the Claimant nil by mouth for four weeks and to feed via a gastrostomy tube. The Claimant was readmitted on 21 and 23 July 2020 for further oesophageal dilatation of a caustic stricture. It was noted at that time that the Claimant would require frequent attendances for further dilatation procedures over a period of some months.

The Defendant denied any negligent treatment from the 11 and 12 January 2020, but admitted there was negligence during the Claimant’s attendances on 17 January 2020 and in May 2020. They admitted causation but only from the 17 January 2020.

The Defendant made a Part 36 offer of £3,000.00, and so advice was sought from Counsel regarding the prospects of the claim and quantum.

The Claimant’s legal representative made a Part 36 counteroffer of £20,000.00 after a conference was had with the medical experts and Counsel.

Quantum was eventually settled after multiple telephone conversations with the Defendant’s representative.

The Claimant suffered four months of pain, discomfort, cough and cyanosis; more severe scaring and structuring; a significantly greater number of dilatations; ICU care; a gastrotomy; laparotomy, scarring from the gastrostomy and laparotomy; 4-8.2% risk of future intestinal obstruction from adhesion; surveillance of the oesophagus and malignancy.

The case was settled on a global basis with no specific breakdown of damages, though the Claimant’s solicitors estimated that general damages for pain, suffering and loss of amenity amounted to £9,450.00, with a further £450.00 for past gratuitous care. The Claimant was represented by RWK Goodman (formerly SJ Edney Solicitors), while NHS Resolution acted for the Defendant, and Counsel Emily Raynor appeared on behalf of the Claimant. The Quantum report was prepared by Stephanie Sanderson of RWK Goodman.