Clinincal Negligence
Case Studies - Psychiatric
This claim was brought on behalf of a client, through the client's father and Litigation Friend, against a Healthcare Trust operating a psychiatric unit, for failures of management, care and monitoring during our client's compulsory detention under The Mental Health Act, as a result of which our client attempted suicide by hanging, resulting in a brain injury.
We were critical of the Defendant who provided the electric flex used by our client to attempt the suicide; their failure to maintain sufficient observation and their failure to install curtain rails which would collapse under weight. The court ordered that this matter should be dealt with by way of a split trial, dealing with liability, i.e. breach of duty and causation, first. A matter of weeks prior to the liability hearing, the Defendant admitted liability. We then had to assess the value of the claim.
Within the Defence, the Defendant had stated "and "The Defendant admits that the Claimant's attempted hanging has given rise to hypoxic brain damage. It is the Defendant's case that the Claimant would have suffered from some intellectual deficit in any event as a result of his underlying schizophrenia and/or his anti-psychotic medication. It is also the Defendant's case on causation that the Claimant's motor impairments result, at least in part, from a side effect of his anti-psychotic medication".
Medical evidence was obtained and exchanged, from a neurologist, a neuropsychologist, consultant psychiatrist and care expert. A joint report was obtained from a speech and language therapist and a joint physiotherapy report was obtained.
At the risk of oversimplifying the medical evidence disclosed, the client's neurologist believed that the majority of the client's motor function impairment in terms of gait, co-ordination and speech, was due to the hypoxic brain damage but that between twenty and thirty per cent of the client's motor impairment was due to the effects of drugs. That could change if the medication were changed. However, the majority factor limiting the client's independence, was his impairment of intellectual function and memory and that, in the client's expert's view, was not affected adversely in any way by the drugs the client was receiving for underlying schizophrenia. It was the impairment of mental function in the form of intellect and memory impairment that rendered the client incapable of self-care. We were also of the opinion that there was only a modest reduction in our client's life expectancy.
The Defendant believed that all of our client's motor problems were due to the effect of the drug therapy.
In respect of the psychiatric evidence, we believed that our client would have been capable of a reasonable level of work ability had our client not suffered the brain damage. The Defendant's expert had concluded that the client would not have been successful in sustaining gainful employment had the incident not occurred.
The experts were agreed that the client required a high level of care and supervision, thus, the client's case was that this care was required as a direct consequence of the negligence. The Defendant believed that the client would have required this care even had he not attempted suicide, due to his underlying mental illness.
Whilst we were in the process of preparing agendas for the joint meeting of our respective experts, the Defendant made a Part 36 offer in the sum of £2,000,000. The client went on to accept this offer, which was approved by the court.
This was not an easy case to run. The Defendant would not initially agree that our client was under a disability, thus proceedings had to be issued within three years from the date of injury. As we were not in a position to serve, we had to make an application to the court to extend the time in which we had to serve proceedings.
The Defendant did not disclose all of the medical records we requested of them and, indeed were entitled to, and, accordingly, we had to make an application to the court for specific documentation.