Medical negligence is a vast and complex subject. What’s more, a claim for compensation must be settled or legal proceedings must have been issued within three years of the event causing the injury. Legal action will become statute barred if this time limit is exceeded; however, there are some exceptions to this rule.
Below are just two examples of the main types of medical compensation claims which can be made.
Anaesthetic awareness
Anaesthetic awareness is the spontaneous recall of events by a patient during general anaesthesia. A patient who can subsequently describe events as they happened has suffered this problem, which can occur at any stage in an operation.
Most reports indicate that it happens for only part of the surgical procedure; however, a significant number of patients endure it for the entire operation. The general incidence while the patient is supposedly under the influence of a general anaesthetic ranges up to 1%. The incidence involving pain can be up to 10% in obstetric cases, and the highest incidence occurs during caesarean section – especially when carried out as an emergency operation.
Anaesthetic awareness causes can be categorised as follows:
- Faulty technique (70%)
- Failure to check equipment (20%)
- Faulty equipment (2.5%)
- Justified risk taking (2.5%)
The most common sensations of inadequate anaesthesia
include:
- Pain which is most commonly associated with skin incision and insertion of sutures
- Paralysis, accompanied by feelings of great distress at being unable to signal wakefulness
- Psychological disturbances, including panic, a sense of disaster, a feeling of death or dying with subsequent recurrent nightmares, depression, anxiety, panic attacks, agoraphobia, claustrophobia and thoughts of suicide. Some mothers resent their baby for the agony it caused and some are too frightened to have more children or further surgery.
Awareness during anaesthesia is a problem that surgeons are well aware of, and while some people are particularly resilient to anaesthetics, there are a number of things that can be done to reduce the incidence.
They include:
- Obtaining a thorough preoperative history
- Adequate premedication
- Checking of all apparatus to exclude faults and malfunctions
- The proper use of all new or unfamiliar equipment should be fully understood
- All syringes should be labelled to ensure the right drug is given at the right time
- Vaporisers should contain sufficient chemicals and monitoring devices should be used to detect inadequate concentration
- Opiate anaesthesia may need to be supplemented for certain resilient patients
Cauda equina syndrome
Cauda equina syndrome compensation claims usually arise as a result of negligent surgery or because of delay in diagnosis. Late treatment may result in a worsening of the condition, often rendering it untreatable and leaving considerable discomfort and disability, which can in the most serious cases include paraplegia. Cauda equina syndrome most commonly results from a prolapsed disc pressing on the bundle of nerve roots at the base of the spinal column.
Delay in treatment can cause irreparable damage and it is incumbent on treating physicians to ensure that they are familiar with the ‘red flag’ signs of the condition and ensure surgical intervention by a competent neurosurgeon at the first possible opportunity.
The cauda equina, which is Latin for ‘horses tail’, is the bundle of nerve fibres at the base of the spinal column which radiate out to the legs and lower areas of the abdomen and control movement and feeling. Pressure on this bundle of nerves causes distinctive symptoms, including pain, sensory loss in the sacral region, weakness in the legs and loss of bladder control. It can be confirmed by such diagnostic techniques as MRI scan, myelography and CAT scans.
The condition is frequently referred to as rare; however, prolapsed disc problems are very common and about 2% of lumbar disc protrusions result in pressure on those nerves. The surgical treatment of an acute nerve compression is usually regarded as a medical emergency due to the potential for serious damage and consequences to the victim if treatment is delayed.
The ‘red flag’ signs of the condition may include:
- Localised low back pain with tenderness to applied pressure
- Abnormal reflexes, which typically include loss or diminution of reflexes
- Pain in the legs or radiating to the legs
- Loss or reduction of sensation in the ‘saddle’ area, which may show skin breakdown
- Muscle weakness or muscle wasting if CES has been present for a lengthy period
- Anal problems and incontinence
- Alteration in bladder function including urinary incontinence
Failure to diagnose resulting in delay in treatment with subsequent unnecessary disability is a frequent cause of cauda equina syndrome compensation claims. Damages can be very substantial, particularly in younger victims due to the potential for debilitating injury resulting in reduction of earning capacity for the foreseeable future, in addition to damages for pain and suffering.