Settlement following death caused by internal bleeding after liver biopsy

Kelly Lawford, a solicitor in the clinical negligence department, has obtained a substantial settlement for a client whose wife died from internal bleeding, which was caused during a liver biopsy at the Churchill Hospital in Oxford, and went undiagnosed.

Our client’s wife, A, had been an insulin dependent diabetic since childhood and underwent kidney and pancreas transplant surgery in early 2006 as a result of renal problems caused by her diabetes. Though she recovered from the transplant well she had some periods of hospitalisation in the following months as a result of rejection episodes and the need to optimise her anti-rejection medication.

As part of investigations into these issues A underwent a liver biopsy on the afternoon of 19 July 2006. On returning to the ward after the biopsy A complained of abdominal pain. Over the course of the evening and overnight A continued to complain of abdominal pain. There were also significant changes in her clinical observations and episodes of unresponsiveness and bradycardia and A was reviewed a number of times as a result of these symptoms.

A suffered a cardiac arrest at about 6am on the morning following the biopsy as a result of internal bleeding. Although she was successfully resuscitated and ventilated, she had suffered a severe brain injury and sadly died a few days later. The hospital did not conduct an investigation into the circumstances of A’s death at the time it happened.

A’s husband B sought our help to represent him and A’s family at the inquest into A’s death so that they could obtain more information about what happened. A barrister was instructed by us to ask questions on the family’s behalf to the witnesses giving evidence at the inquest, including doctors who had treated A. As a result of the evidence given to the inquest, HM Coroner for the District of Oxfordshire recorded a verdict of death by misadventure. In addition he gave a narrative ruling which included a statement that the symptoms A suffered following her liver biopsy were “not fully appreciated”.

Failures following biopsy

The outcome of the inquest prompted the hospital to carry out a retrospective untoward incident investigation. It’s conclusions highlighted significant failings in the treatment provided following the biopsy including: communication failures which resulted in blood tests not being taken; the failure to escalate to senior medical staff when clinical parameters became abnormal; a loss of medical records and incorrect correction of records; no post liver biopsy care plan and inadequate triggers for serious untoward incident investigations. The serious untoward incident panel recommended changes in Hospital practice to address these issues.

Following receipt of the serious untoward incident report we wrote to the Trust setting out the failings identified at the inquest and in the serious untoward incident report and asked them to make a full admission of liability to minimise the distress to our client of having to investigate the hospital’s failings himself and to minimise costs. We also asked for documentation relating to the hospital’s investigation and confirmation that the recommended changes had been made within the hospital as it was of paramount importance to B to ensure that lessons were learned from the circumstances of A’s death to prevent a similar tragedy.

The Trust agreed to investigate the issues raised and 6 months later made a full admission of liability. A settlement agreement was subsequently reached before the issue of court proceedings. B hopes to receive details of the changes made by the hospital as a result of A’s death shortly.

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