Brian Owens, a specialist litigation executive with FDR Law, based in Palmyra Square, Warrington discusses how medical negligence resulted in blindness.
A 73 year old lady suffering from cataracts in both eyes was referred by the NHS to an independent clinic to carry out the procedure. The lady had worn glasses for 30 years and had previously undergone laser treatment to correct a retinal tear.
Having been accepted as a suitable patient for the cataract operation an Anaesthetist administered a local anaesthetic into the eye using a fine needle. No pain was experienced during the administration but following the injection an eye pad was applied to her eye and pressure applied. Upon the surgeon attending and viewing the eye, it was decided that the operation would have to be cancelled.
A new pad was applied to the eye with a bandage and the lady discharged home.
Over the coming days, despite re-attending the clinic, the pain increased, and periortibal bruising occurred. The clinic notes recorded that the operation had been cancelled due to haemorrhage from the peribulbar block.
No additional treatment had been provided during her attendance at the clinic on the subsequent days and sight in the eye was lost, with the exception of her being able to determine between light and dark. The clinic formally discharged her from their care.
It was at this stage that the lady sought legal advice . She wanted to understand what had occurred during the procedure and what further treatment was available to her (if any).
We instructed an independent examination of her medical records by a Consultant Ophthalmic Surgeon, who was extremely critical of the care provided by the Clinic in his subsequent report.
This report indicated that the peribulbar block administered caused haemorrhage into the back of the eye leading to the eye being pushed forward and pressure building. Without relief of such pressure, blindness was an inevitable result and such occurred.
Had appropriate treatment been given immediately following the haemorrhage by decompressing the orbit of the eye with a lateral canthotomy or an inferior cantholysis, the pressure would have been released and eyesight would have been retained though the cataract operation , would have to have been cancelled and performed at a later date.
On her behalf we submitted a formal compliant letter of claim. A denial of liability was maintained by the clinic. However prior to any legal proceedings being issued, experts representing both parties met and it was concluded that there had been negligence and causation, and the lady was successful in her claim.
The claim was settled without litigation for £45,000 following a report upon condition prognosis and preparation of a Schedule of Losses. The claim was funded by way of a Conditional Fee Agreement (CFA) with an After the Event (ATE) insurance policy.
This incident had a devastating effect upon the lady who had a cataract in the untreated eye but declined any further surgery for fear that that also would result in loss of vision.
This case shows that even in what many consider to be a routine operation, when things go wrong it is vital that the attending medics have the necessary skills and equipment to perform emergency procedures to avoid harm being caused.
Case reference COL1430-1