Delay in diagnosing tumour on optic nerve led to total blindness

18 March 2022

Delays in investigating blurred vision resulted in a missed opportunity to save our client's eyesight, leaving her blind. Shoosmiths successfully brought a claim which will help our client obtain support for the rest of her life.

Our client, Stephanie Robertson 30 from Northamptonshire had noticed she was having intermittent problems with blurred vision and reading small print so she attended her opticians on 05 October 2018 for a check-up. The optician wrote a letter for Stephanie to take to her GP, mentioning problems with both visual acuity and visual fields in her right and left eye. Such was his concern that the letter asked for Stephanie to be urgently referred to the hospital eye department.  

Stephanie and her mother took the referral letter to the GP surgery later that same day. Her GP forwarded the letter (adding in handwriting the words “URGENT REFERRAL”) directly to Kettering General Hospital’s CAB Ophthalmology team.  However, the hospital insisted that the GP referral was processed by the ‘Choose and Book’ system and was not sent directly to the Trust’s ophthalmology team as the GP maintained.  This was to prove significant in terms of how timely her treatment actually was.

Stephanie logged on to the hospital’s Choose & Book system on 11 October 2018 to select an appointment. The earliest available date was given as 24 December 2018, although this was later cancelled by Kettering General Hospital and rearranged for 04 February 2019. But Stephanie’s vision had deteriorated further by Christmas Eve that year, so she attended her GP surgery again, where her doctor noted that her eyesight was getting much worse with poor central vision and she was bumping into things. The GP advised Stephanie to attend the Eye Casualty Department at Northampton General Hospital.

Stephanie subsequently attended Northampton General four days later and was referred again to Kettering General Hospital on 31 December 2018 – almost three months after she had been classed as an ‘urgent’ referral. On 16 January 2019 Stephanie awoke unable to see at all and again attended the Eye Casualty Department at Kettering General Hospital.  A CT scan was performed at the end of January 2019 and in early February Stephanie attended a pre-arranged appointment at Kettering General Hospital where an MRI scan was requested.  

The MRI scan conducted on 17 March 2019 discovered a large pituitary macroadenoma compressing the optic chiasm, where the left and right optic nerves intersect. Pituitary macroadenomas are benign (not cancerous) tumours composed of glandular tissue, but they can cause serious problems because they grow and press on nearby brain structures.

Stephanie was urgently referred to John Radcliffe Hospital, Oxford where she underwent emergency surgery three days later to de-bulk the tumour.  That procedure was successful, but by then the damage had been done and Stephanie was now totally blind. She had been working as a cleaner and kitchen assistant, but the delay in diagnosis and treatment with such a tragic outcome means she will be unable to work or live independently.  

The family looked for someone who might help and prevent the same thing happening to others in similar circumstances. Stephanie and her mother had received some guidance from the Northamptonshire Acquired Brain Injury Forum (ABIF Northants).  This body brings together services from the public, independent and voluntary sectors to support people and their families with any sort of brain injury. 

Shoosmiths has been involved with Northants ABIF for several years and the firm is well known throughout the county for its expertise in this sort of claim and its engagement with the local community and voluntary sector. As a result of their own on-line research and contacts within the ABIF, the family turned to Shoosmiths. Stephanie’s case was handled by Simon Towler, a senior associate Legal Executive in the firm’s Northampton office who has dealt with claims of this nature since 1992.

Simon commented:
“This was a tragic case. On reading the details, it was obvious that, following the GP referral, an urgent appointment should have been made. Stephanie should have been investigated with a CT and an MRI scan as quickly as possible, which would have meant that sight-saving surgery could have been performed by early November.”

Shoosmiths obtained copies of Stephanie’s medical records and commissioned expert evidence from a consultant ophthalmic surgeon, consultant neurosurgeon,  and experts in care and assistive technology.  The defendant Trust tried to argue that little would have changed, even with reasonable treatment and a more timely operation, and Stephanie would have been left with no useful vision and would not be capable of working of living independently. 

However, the evidence amassed by Shoosmiths medical negligence team was compelling in establishing negligence and in July 2021 judgment was entered in favour of Stephanie. It was admitted that she should have been given an earlier initial appointment and been referred to the John Radcliffe Hospital for the surgery no later than November 2018.  There were some areas of dispute that remained, such as the extent of Stephanie’s visual impairment had surgery been performed at that earlier date, but those issues too were resolved by Shoosmiths.

The claim finally settled by mediation in December 2021. Stephanie was awarded a substantial six-figure lump sum and thereafter periodic payments to help pay for the support, care, modifications to her home and special aids she will need for the rest of her life. Stephanie said:

“I found Simon and Tania to be very friendly and polite either whilst videocalling, telephone calls and they even visited me at my home before the pandemic. All of the legal team were thorough and explained every process thatwas being done , and kept me updated all the time.  I have already recommended them to various people and I will continue to do so. I feel that they always had my best interests at all times."

 
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Disclaimer

This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024

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