This client was an elderly patient whose hip fracture was not identified when she first attended hospital, resulting in a significant delay in treatment and a lasting deterioration in her mobility.
Although the Defendant initially accepted that it had failed to identify the fracture, it disputed that this amounted to a breach of duty or caused the extent of the Claimant’s subsequent problems. After court proceedings were issued, responsibility was ultimately admitted, and the claim progressed to an assessment of the substantial losses arising from her injury.
Summary
The Claimant suffered a fracture to her left femur which was not identified on a CT scan. Despite returning to hospital the following day, the fracture remained undiagnosed for several weeks.
The Defendant eventually admitted responsibility for the failure to identify the fracture, but only after court proceedings had been issued, more than three years after the original incident. It accepted that the delay resulted in additional pain, a more difficult recovery and a permanent reduction in the Claimant’s mobility.
The case highlights the importance of identifying serious injuries promptly and properly assessing the long-term consequences when a diagnosis is missed. It also demonstrates the role of detailed medical and financial evidence in establishing the full extent of a claimant’s losses, particularly where an injury has resulted in a permanent loss of independence.
Context
The Claimant was 74 when the negligence occurred. Following the delayed diagnosis, the fracture became displaced, and treatment was less straightforward than it would have been had the injury been identified promptly.
The consequences were significant. The Claimant experienced prolonged pain and suffered a permanent reduction in hip function and mobility beyond the deterioration she would otherwise have experienced. She subsequently became wheelchair-dependent, and her quality of life was significantly affected.
The Claimant was ultimately forced to sell her home and move into residential care, where she required 24-hour nursing support. She became dependent on carers for transfers, personal hygiene and medication, requiring hoisting and assistance from two carers when moving between her bed and chair.
These changes affected every aspect of the Claimant’s daily life, from her ability to move around safely to her need for assistance with even the most basic personal tasks. The case required careful consideration of the difference between the limitations she would have experienced as a result of her original injury and the additional disability caused by the delayed diagnosis.
The claim therefore needed to address not only the original injury, but also the substantial financial consequences of the Claimant’s loss of independence and long-term care needs.
Challenge
Although liability was eventually admitted, the extent of the Claimant’s losses remained strongly disputed.
The Defendant accepted that earlier treatment would have avoided the additional period of pain and would probably have resulted in better hip function. However, it did not accept the full extent of the Claimant’s ongoing injury, care requirements or associated financial losses.
Detailed evidence about the Claimant’s condition, daily life and future needs was therefore critical to demonstrating the true impact of the injury. This involved looking beyond the immediate medical consequences to establish the practical support the Claimant required and the financial resources needed to meet those needs over the longer term.
A further complication arose when the legal discount rate used to calculate future financial losses changed significantly during the proceedings. The discount rate is used by the courts when calculating compensation for losses that will arise in the future, such as care costs. It accounts for the fact that compensation may be paid as a lump sum, which the claimant can invest to help meet future expenses.
A change in the rate can significantly affect the amount of compensation required to cover those expenses over a claimant’s lifetime. The change therefore required the financial assessment of the claim to be revisited to ensure that the Claimant’s projected future losses were properly valued.
Solution
Detailed evidence was obtained covering the Claimant’s orthopaedic condition, psychological wellbeing, general health, care needs and accommodation requirements.
Evidence was obtained from specialist clinicians, an occupational therapist and a chartered surveyor, supported by statements from members of the Claimant’s family.
Each expert’s evidence helped build a detailed picture of the Claimant’s circumstances, both at the time of the claim and in the years ahead. This was particularly important in establishing the level of care and support she would require on an ongoing basis, as well as the associated costs.
The evidence demonstrated the practical consequences of the injury, including the Claimant’s dependence on carers for fundamental daily activities and the need for suitable long-term accommodation and care. Family evidence also helped illustrate how the Claimant’s life had changed and the extent to which she had lost her independence.
Following the change in the discount rate, the financial assessment of the claim was revised to reflect its effect on the calculation of future losses. By bringing together the medical evidence and the practical realities of the Claimant’s daily life, the team was able to present a more comprehensive assessment of the losses arising from the negligence.
Impact
The significance of the claim extended far beyond the original missed diagnosis. The delayed treatment changed the Claimant’s day-to-day life: she lost mobility and independence, became reliant on a wheelchair and 24-hour care, and could no longer remain in her own home.
The compensation claim therefore had to reflect the long-term financial consequences of that change in circumstances. This included the cost of residential care, assistance with everyday activities, appropriate accommodation and other support arising from the reduced mobility caused by the injury.
The Claimant’s revised Schedule of Loss valued her losses at more than £2.49 million, compared with the Defendant’s revised valuation of approximately £66,656. These figures represented the parties’ respective assessments of the claim, rather than a final award of compensation.
The substantial difference reflected a fundamental disagreement about the financial consequences of the Claimant’s disability and the support she would need in the future. A detailed assessment was essential to ensure that her long-term care and accommodation needs were fully considered, rather than focusing solely on the immediate consequences of the injury.
There was also important legal significance in establishing the consequences of the admitted breach. The Defendant accepted that, had the fracture been identified promptly, the Claimant would have avoided the additional period of pain and would have been likely to regain significantly better hip function. It also accepted that the delay caused permanent additional loss of mobility.
The Court entered judgment in the Claimant’s favour on liability, leaving the amount of compensation to be assessed. This meant that the key issue became ensuring that the financial consequences of the injury were properly evidenced and valued. The claim eventually settled at a settlement meeting shortly before the trial date for an agreed sum of £480,000, as the local authority agreed to meet some of her care needs.
For the Claimant, the purpose of the claim was ultimately practical: to secure financial resources to meet the consequences of losing her independence and requiring long-term care. The evidence ensured that those consequences were properly placed before the Court, recognising that a serious injury can affect every aspect of a person’s life, not simply their immediate medical condition.
Taylor Rose’s clinical negligence team helps clients pursue compensation where failures in diagnosis or treatment have changed the course of their lives. We look beyond the medical diagnosis to understand what the injury means in practice, now and in the future, and build the evidence needed to reflect those needs in the claim. This includes considering the long-term costs of care, accommodation and support, helping ensure that the full impact of an injury is properly recognised when compensation is assessed.
