Damages secured for failure to treat a life-threatening cardiac condition following heart surgery

Our clinical negligence team has reached a six-figure settlement for the family of a man in his 70s, who died following heart surgery after doctors failed to treat a life-threatening condition which caused a build-up of fluid in the tissue surrounding his heart. While the man’s family may never fully recover from his death, the money secured will help support them with the financial losses and expenses they have incurred, and will continue to incur, as a result of his loss.

Early in February 2020, the patient underwent an urgent triple coronary artery bypass graft at a specialist cardio thoracic hospital. The surgery itself went well and the patient seemed to be making a good recovery, such that he was discharged from hospital two weeks later. 

After a week at home, his recovery plateaued, and he then began to deteriorate. One night, his condition became so poor that his wife called 999 and he was taken to the hospital via ambulance, arriving at around 10am. While at the hospital, he was investigated for a pericardial effusion and/or cardiac tamponade (the condition which was later responsible for his death). In particular, he underwent an echocardiogram demonstrating large pericardial effusions (an accumulation of excess fluid in the pericardial sac which surrounds the heart), with impaired contraction of the chambers of the heart. 

However, despite these results being reported competently by a trained cardiac radiographer, a consultant cardiologist saw fit to perform his own bedside echocardiogram and considered that there was no clear evidence of a pericardial effusion. He advised that a CT thorax needed to be performed, but gave no indication as to the urgency of the investigation. 

During the night, the patient seriously deteriorated and in the early hours the on-call medical registrar at the hospital was asked to attend. She telephoned the specialist hospital for advice and spoke with the on call cardiothoracic registrar, who recommended an urgent CT thorax. This was duly performed, and it confirmed the large pericardial effusion as first reported by the cardiac radiographer following the first echocardiogram the previous day.

Upon completion of the CT scan, the patient went into cardiac arrest at 05:10am. An attempt was made to drain the excess fluid, with a significant amount being drained from the pericardial area of his heart. CPR was also performed on the patient for 45 minutes without response. The patient was declared dead at 05.51am. 

A post-mortem was performed, and the report listed the principal cause of death as cardiac tamponade, a medical emergency that occurs when too much fluid accumulates in the pericardial sac, such that the heart is compressed to the extent where it can no longer pump enough blood around the body.

Following his untimely death, an inquest was held in November 2021, where the patient’s wife and family were represented by Paul Reynolds at 1 Crown Office Row. At the inquest, the coroner found that his death was entirely preventable, and the result of a number of shortcomings of the staff at the hospital. 

Notably, it was found that the consultant cardiologist who had reviewed him did not appreciate the size of the pericardial effusion visible on the echocardiogram, the risk of deterioration, and the urgency of the need for the CT thorax, and thus did not order the CT thorax to take place the same day. Had this been done, it would have confirmed the significant pericardial effusion, and the patient would have been transferred to the specialist hospital for urgent intervention, and would likely have survived.

We were instructed to act on behalf of the patient’s wife shortly following his death. After the inquest, a letter of claim was served on the defendant trust, which alleged that, but for various failings in his care, the patient would have survived.  

The defendant trust responded by admitting liability for his death. Following this, we obtained evidence as to his life expectancy, had the admitted negligence not occurred, and also worked with his family to understand the losses they had incurred, and would continue to incur, as a result of his death. 

After this, we prepared a detailed schedule of loss, setting out the value of the claim, and represented the patient’s family in negotiations with the defendant to settle the claim for a considerable sum, avoiding the need to issue court proceedings. 

Rosa Shand, an associate within the clinical negligence team at Penningtons Manches Cooper, who represented the family, commented: “It is always shocking when we see cases, such as this, where a patient’s signs and symptoms are not properly assessed by the health care professionals charged with their care. It is even more shocking in this case, where the clinician chose to ignore a life-threatening abnormality that was clearly reported following an echocardiogram.

"This case is one of the saddest of its kind, where, by the time appropriate treatment was provided and a diagnosis was made, the condition was so acute it had become irreversible. Bringing a clinical negligence claim is not an easy decision to make in these circumstances, as they can present their own challenges. However, while the family of the deceased will never gain full closure from the dreadful events surrounding his death, obtaining an admission of liability from the hospital trust and a significant settlement sum has helped them move forward with more peace of mind and comfort than would have otherwise been the case.”

Return to case studies