This was an estate claim brought by the deceased’s father. Miss H was found to have right kidney stones in August 2016 and was placed on the waiting list for surgical treatment with a priority level of urgent.
Miss H was admitted to hospital via A&E with vomiting, fever and back pain. The diagnosis was chest infection and urosepsis. She was commenced on clarithromycin antibiotic for her chest but was not treated for urosepsis. A CT scan demonstrated evidence of infection around the right kidney. The known stone was seen again.
By early the following morning, Miss H was deteriorating and was transferred to intensive care for management. Despite aggressive fluid resuscitation, invasive monitoring and additional antibiotics, Miss H died later that day. Our experts advised that even when she was given the correct antibiotics for urosepsis they were too late and subtherapeutic in any event.
We invited the defendant to make an earlier admission of liability. The defendant admitted the following breaches of duty:
- Failure to recognise and treat sepsis in a timely manner;
- Failure to appropriately seek senior medical help with a deteriorating patient;
- Failure to recognise positive dip in a patient with recurrent urinary tract infections/renal stones.
However, the defendant denied that Miss H would have survived even with earlier treatment. We set out the claimant’s case to the defendant. Our experts confirmed that antibiotics ought to have been administered to treat the urosepsis by midnight on the night of admission and had they been given; Miss H would have survived.
And in fact, our case was that had the significance of the deteriorating condition of Miss H, which was there to be seen in the records, albeit sporadically recorded, from admission onwards, been appreciated and/or the case escalated to a senior clinician then the sepsis pathway would have been triggered and the deterioration and death of Miss H would have been avoided.
The defendant continued to deny liability. We issued and served proceedings. The defendant served a defence but made further admissions of breach and causation. Specifically the defendant admitted that adequate antibiotic treatment by midnight on the day of admission would have resulted in Miss H’s survival.
The defendant served a Part 36 offer with their defence which we assessed as reasonable and accepted.