November 12, 2020

Successful fatal claim for delayed treatment of aortic stenosis

In 2012, T was diagnosed with a moderate degree of aortic stenosis. She was monitored regularly thereafter. By 2013, T’s condition had progressed, and her cardiologist discussed surgical intervention, including Transcatheter Aortic Valve Insertion (TAVI) – a minimally invasive form of treatment.

By June 2013, T developed shortness of breath and had a fainting episode. She was admitted to hospital, and a cardiac cause was suspected. It was believed that her aortic stenosis was now severe.

The delays

As a result of this episode, T had further discussions with her clinicians and was referred on to King’s College Hospital for either a conventional aortic valve replacement or TAVI in September 2013.

In November 2013, the staff at King’s College Hospital confirmed the presence of severe aortic stenosis. T was noted to be frail and accordingly that a TAVI procedure might be more appropriate.

After further diagnostic imaging conducted in January 2014, a joint clinic was eventually held on 27 February 2014. It was decided that T would not be a suitable candidate for a TAVI as there was a mobile mass on the aortic valve which would make the procedure high risk. Five months after her referral, a treatment strategy for T was devised.

On 26 March, T collapsed and was admitted to hospital and then transferred to King’s College Hospital on 31 March. She was supposed to have been having surgery on 31 March 2014. She was not operated on, due to the detection of MRSA, and the state of her teeth. Despite having been told that she would require surgery, T was again considered for a TAVI. She was told on 2 April that her risk of dying from surgery was 20%. Nobody told her that her risk of dying if she did not have surgery was around 50%.

T was discharged and then reviewed on 19 May. The possibility of aortic valve surgery was again discussed and on this occasion she was told she had a 10 – 15% chance of dying. Nobody told her that by this time, if she did not have surgery, she had at least a 50% chance of dying. In the event, T decided to think about it and speak to her family.

T eventually died in July 2014, still without having had surgery.

The claim for negligence

An expert in cardiac surgery was asked to assist with assessing a subsequent claim for negligence.

The expert was of the view that there were inordinate delays in the treatment of T’s aortic stenosis. He was also critical of the various assessments of risk she was given. He was firmly of the view that her risk of dying from cardiac surgery was never anywhere near 15%, let alone 20%.

The expert was also critical of the failure to decide upon aortic valve replacement surgery and then operate. Had she been operated upon, she would have recovered. The state of her teeth, MRSA and “frailty” were not sufficient reasons to decline surgery.

This case was extremely hard fought, and the defendant refused to concede any fault, however the matter eventually settled just before trial.

We succeeded in recovering £12,000 for T’s daughter. Whilst it would not bring her mother back, she was delighted with the settlement.

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