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Clinical Negligence: Ruptured Aortic Aneurysm

No 2 claims are ever alike, a fact which often makes it difficult to know whether a medical error is clinical negligence. However every now and then I have a sense of déjà vu in looking at a claim and remember seeing a very similar scenario before.

One example is a fatal error in failing to diagnose a rupture Abdominal Aortic Aneurysm (AAA). The main blood artery from the heart is the aorta. It curves upwards and then heads downwards in front of the spine. Sometimes the wall of the aorta weakens and the pressure from the blood inside forces that section to expand. This is known as an aneurysm. The aneurysm can then burst (rupture). A ruptured aneurysm is an emergency. The key to survival is prompt surgery but even then there is a significant risk that an operation will not save life.

The condition is more common in men than women. The symptoms are sudden onset of abdominal pain spreading to the back, collapse, vomiting, a drop in blood pressure and an increase in respiratory rate. When patients arrive in Accident and Emergency it is crucial that doctors recognise the symptoms, arrange a CT or ultrasound scan to confirm the diagnosis and refer the patient for surgery urgently.

In 2 of my cases recently doctors missed the diagnosis. In one case an Accident and Emergency doctor thought the patient had a heart condition and referred him to cardiologists. But the time they realised what was wrong it was too late and the man died in surgery. In the other the Accident and Emergency doctor got the diagnosis right and referred the woman to surgeons. They missed it and discharged her. She died at home 15 hours later.

These tragic stories illustrate quite how important it is to get difficult judgment calls right in Emergency Departments. I have sympathy for overworked doctors seeing a large number of different people with different conditions with constant pressure to move on to the next patient. But some mistakes just should not happen.

In both cases the hospitals concerned accepted that the mistakes were serious errors which should not have occurred. And the consequences were tragic.

Paul Sankey is a solicitor specialising in clinical negligence. If you or a member of your family have a clinical negligence enquiry please call our expert clinical negligence solicitors on 0800 916 9049, fill in our short online claim form or email and one of our specialist clinical negligence team will be in touch.