Substantial award for blindness caused by failure to assess a foreign body in the eye

Our clinical negligence specialists settled a claim against the Secretary of State for Health relating to treatment provided by the former Surrey Primary Care Trust (PCT) for an eye injury.

The claimant visited the Surrey PCT walk-in-centre in 2008 following an injury to his left eye which had arisen while he had been chiselling metal in his work as a car mechanic. He was told that he had a corneal abrasion and was sent home with antibiotic ointment and an eye patch. No follow up treatment was arranged and he was advised that it would take about two weeks for the injury to heal. 

About three weeks after the original injury, he made an appointment with his GP as he was unable to see out of his left eye. His GP diagnosed a dense cataract and arranged an urgent referral to the East Surrey Hospital. It was noted by the ophthalmologists that the claimant had a penetrating foreign body eye injury. The sight in his left eye continued to deteriorate.

He eventually underwent surgery to remove the foreign body in October 2008. The vision in his left eye never recovered and is limited to the perception of light and hand movements. He developed diplopia and a left divergent squint as a result of the loss of vision. Although he underwent further surgery, he remained effectively blind in that eye. The condition was permanent. 

Supportive expert evidence from a consultant ophthalmic surgeon was obtained which was critical of the standard of care provided by both the PCT and Surrey & Sussex Healthcare NHS Trust. The claimant alleged that there was a breach of duty by the PCT for failing to arrange an X-ray examination of his left eye to ensure that it had not been penetrated by a foreign body and failing to set up a follow-up appointment. He also alleged a breach of duty by the NHS trust’s ophthalmologists for failing to appreciate or act upon the risk of siderosis (‘rusting’ of the retina) caused by a piece of iron in the vitreous of his eye. Given this risk, it was alleged that the trust inappropriately delayed removal of the foreign body. 

Had it not been for the negligence, it was contended that the claimant would have retained good vision in his left eye with the benefit of an intraocular lens. However, his spatial awareness and depth perception are now poor, his hand/eye coordination is reduced and his ability to perform certain day to day activities, as well as tasks in the workplace, is impaired. Due to his monocular vision, the claimant ended up leaving his employment as a mechanic and obtained a trainee role in another, unrelated field.

We pursued the pre-action protocol against both potential defendants and whilst a partial admission of liability was made by the PCT, causation was denied in full. Liability was disputed throughout by Surrey & Sussex Healthcare NHS Trust. 

We commenced court proceedings which continued right through the court timetable, to include joint discussions of experts. Causation was disputed until late in the timetable. After judgment was entered against the PCT in respect of liability and causation, the matter proceeded on the issues of quantum and condition and prognosis only. Shortly before trial at the High Court, the case settled for a substantial sum through negotiations.

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