Nadia Krueger-Young, Partner at Stewarts, successfully acted for *Simon Green in a fully contested claim against two NHS Trusts for delays in diagnosis of endocarditis following heart valve surgery, resulting in stroke and cortical blindness. Stewarts instructed Anna Beale KC.

The key details from the case

• Simon suffered a stroke during re-do aortic valve surgery which caused him a severe brain injury with near complete loss of eyesight and short-term memory and cognitive difficulties.
• At the time of his stroke, Simon was due to be married and his fiancée was purchasing a property they had planned to renovate together. Those plans ultimately faltered, due to the devastating consequences of his stroke.
• Simon instructed Stewarts to investigate a claim for medical negligence in relation to the advice and treatment of the development of endocarditis which caused his stroke.
• The claim was denied by the first defendant on the basis that they were under no obligation to warn the Claimant of the risks and symptoms of endocarditis following aortic valve surgery. The claim was also denied by the second defendant, on the basis it was reasonable to diagnose a sprain, in circumstances where he had symptoms of ischemic foot caused by emboli travelling from an infected heart valve.
• The claim was also denied by both defendants on the basis that the Claimant could not prove the mechanism by which his stroke was suffered during the aortic valve and root replacement surgery which took place following the delays.
• Stewarts instructed Anna Beale KC. Throughout the claim a total of three Joint Settlement Meetings were arranged with the Defendants and the case finally settled 3 weeks before trial with a 7-figure settlement being agreed.

Further details on the case

Simon was enjoying life as a young and fit healthy man, with a growing wine business and a fiancée he was due to marry and build a home with.

He was sporty and enjoyed running, swimming, tennis and boxing. Despite being young and fit, he started to feel usually out of breath when exercising. He was sent for tests and was diagnosed with a bicuspid aortic valve. Aortic valves usually have three flaps which prevents blood from flowing backwards into the heart. When an aortic valve only has 2 flaps it increases the risk of flowing backwards into the heart, known as aortic valve regurgitation. Aortic valve regurgitation can cause the heart to become enlarged, to work harder and potentially cause heart failure.

He was advised to undergo aortic valve replacement, which he did, but he was never told, that following his valve replacement he was at an increased risk of developing endocarditis, a serious, often bacterial, infection of the heart’s inner lining or valves, and what the symptoms of endocarditis were or what he should do if he developed those symptoms. Symptoms of endocarditis, which are very similar to that of the flu, include:

• a high temperature, or feeling hot, cold or shivery
• headaches
• feeling very tired
• joint or muscle pain
• regularly sweating a lot during the night (night sweats)
• feeling breathless
• loss of appetite or losing weight without trying to

When Simon developed these symptoms, he assumed he had the flu and tried to rest until he was better. His symptoms seemed to get better and then worse. He also developed a swollen and red foot despite not sustaining an injury. He attended a walk-in centre in Devon who referred him to vascular doctors who dismissed his symptoms and diagnosed him with a sprained ankle, despite the lack of injury.

Eventually, after becoming more unwell, he was seen again in hospital and investigations confirmed endocarditis. By this time, several months has passed and investigations showed that he had also developed an abscess around the root of his aorta. A further aortic valve replacement was required. Unfortunately the abbess caused the replacement to be difficult as the tissue was so friable due to the damage and it was ultimately unsuccessful. A further operation was required.

Simon’s next and third aortic valve replacement was even more difficult, due to succession of operation he’d undergone in a short period of time and during that procedure, he suffered a catastrophic stroke. The stroke caused brain damage resulting in permanent loss of eye sight and cognitive issues affecting his short term memory.

A claim was brought against the first defendant, (a London NHS Trust) who carried the initial valve replacement and failed to advise of endocarditis risks and symptoms. The claim was denied on the basis that the Trust were under no obligation to warn the Claimant of the risks and symptoms of endocarditis following aortic valve surgery.

The claim was also brought against a second defendant (a Devon NHS Trust) who denied the vascular specialists were negligent in diagnosing a sprain, rather than an ischemic foot, caused by emboli travelling from his infected heart valve.

Both Trusts also denied the claim on the basis that the Claimant could not prove the mechanism by which his stroke was suffered during third surgery and also that the third surgery always would have been needed anyway so he couldn’t have avoided the event in which his stroke was suffered. They argued that tissue aortic valves, which the Claimant had, only last 10 years, so he would suffered the stroke in any event, when his valve was due to be replaced, on the 10 year anniversary of the second value replacement.

Despite the defendants arguments, liability for the claim was eventually settled within 6 weeks of trial and a quantum agreement was finally reached within 3 weeks of quantum trial. The Claimant was awarded £1,750,000, plus costs on a reduced liability basis.

*name has been changed to protect the identity of the Claimant.

Conclusion

Simon is now able to start rebuilding his life. He is now fulfilling his dream of purchasing and renovating a property and he maintains his passion for growing his online wine business.