Gardner v Northampton General Hospital NHS Trust
2014
QUEEN’S BENCH DIVISION
United Kingdom
CORAM
- SIR DAVID EADY
Areas of Law
- Health Law
- Tort Law
2014
QUEEN’S BENCH DIVISION
United Kingdom
CORAM
AI Generated Summary
Mrs Gardner's case involved significant delays in the hospital's diagnosis and treatment of her necrotising fasciitis, despite her evident severe symptoms. The hospital admitted multiple breaches of duty but contended that her death was inevitable. The court found that, had a competent medical team treated her on time, her life could have been saved. The breaches of duty materially contributed to the fatal delay in her treatment, leading to the hospital being held liable.
Judgment
Sir David Eady :
The issues to be resolved
Mrs Gardner was 60 years of age when she attended at 00.34 on 21 December 2010 at the Accident and Emergency department (“A & E”) of the Northampton General Hospital. She was in excruciating pain and, as later emerged, suffering from necrotising fasciitis (“NF”). Her upper limbs were discoloured and swollen and there were weeping blisters (or bullae) on one of her arms. She had fallen and grazed her left elbow on 17 December, at which time she was taking on prescription no less than three immuno-suppressant drugs in connection with rheumatic arthritis (originally diagnosed in March 1994) and these would have rendered her unusually vulnerable to infection. The only treatment she received over the next few hours was in the form of drugs for the relief of pain and the application of gauzes to the suppurating blisters. No one appears to have addressed the possibility of sepsis until 05.00 and she was not given the benefit of the hospital’s sepsis protocol before 08.30.
What she needed was an emergency operation for the amputation of both arms and, prior to that by way of preparation, resuscitation by means of oxygen, fluids and antibiotics. By the time her condition was diagnosed (08.30) it was too late and death had become inevitable. The Defendant has admitted some of the breaches of duty pleaded and has apologised to the Claimant and the family for the negligence, but maintains that Mrs Gardner would have died even if there had been earlier diagnosis and she had received reasonably competent treatment within the time available.
The Claimant’s surgical expert, Professor Winslet of the Royal Free Hospital, has expressed the opinion that if she had received the necessary surgery at any time up to 07.30 the likelihood is that she would have survived, albeit severely disabled. By contrast, Mr Earnshaw of the Winfield Hospital in Gloucester, called on behalf of the Defendant, is of the view that unless surgery commenced prior to 05.00 it would have been too late to save her. The Defendant has argued that it would be “potentially difficult” to resolve this difference between the experts but that it does not arise, since Mrs Gardner could not have arrived in theatre until 08.30 even if she had received reasonably competent treatment. In any event, timing (“the time line”) is going to be critical in this case. It is necessary, therefore, to scrutinise the history of what took place (and what did not) between 0