During Boyes Turner’s campaign to raise awareness of brain injuries, we talked to Julie Marsh, a senior associate - solicitor in the clinical negligence group, about her experience of handling claims arising from delayed diagnosis and treatment of craniopharyngioma (a type of brain tumour).
What information do you need from an individual who has concerns about delays in the diagnosis and treatment of a brain tumour?
I need details about the timing of the onset of symptoms, when the symptoms were first noticed and what those symptoms were. If the patient is a child, their family might be the first to notice that something is wrong, such as a change in behaviour, difficulties with walking or with vision. It is very important that I understand how the symptoms progressed over time, whether they deteriorated or stayed relatively stable, and over how long a period of time leading, finally, to a diagnosis.
It also helps to know when, and following which medical investigations, the diagnosis was made. Various different medical investigations can take place before a brain tumour is diagnosed.
I need to understand what treatment has been received since the diagnosis, whether further treatment will be needed in future and what information, if any, the patient or their family have been given about the long term prognosis.
Can you investigate a case even if an individual is still having treatment?
Yes. There are good reasons for contacting a solicitor as soon as you can after suffering any severe injury through medical negligence.
There are time limits associated with bringing claims. These vary depending on the patient’s age and the severity of their brain injury.
The sooner we can establish liability, the sooner we can obtain interim payments to help pay for care, specialist equipment, therapies and other costs arising out of the negligently caused injury and to ease the financial hardship that often arises following brain injury, often long before the case is finally concluded.
It is, however, important to have a clear diagnosis of a brain tumour, as the type of tumour will determine how the tumour has developed over time and its rate of growth – some cancers grow more quickly than others - and this is relevant to the claim.
An ongoing investigation should not affect the provision of any treatment. In one of my cases, the client’s family approached me shortly after the diagnosis of brain tumour had been made. My client needed ongoing medical reviews and went on to have proton beam therapy and further surgery to treat the brain tumour. In the meantime, we were able to establish liability for the claim.
How are claims arising from delayed diagnosis and treatment of brain tumour funded?
This type of claim is usually funded by way of a Conditional Fee Agreement (sometimes called a ‘No Win, No Fee Agreement’) backed by after-the-event insurance. This means that there are no upfront costs to the client to get the investigation underway and that the client will not be liable for any legal costs if the investigation is unsuccessful. In a successful claim, the Defendant pays the majority of the legal costs.
We always discuss the funding arrangements for bringing a claim with a client at the outset, so that they understand the terms of the agreement and are entirely comfortable with them before any action is taken.
Where a claim, even if successful on its merits, will not be financially viable for the claimant, I let them know at the outset.
How do you investigate whether a GP or the hospital acted negligently?
We investigate the treatment that the patient received from their GP or their hospital doctors by reviewing their medical records, detailing the recollections of the patient and their family in witness statements, and then obtaining the opinion of medical experts on the standard of the care that was given.
In cases involving a brain tumour, presentation can include issues with vision or with balance and coordination, and if the child has been assessed by a specialist, then it would be necessary to review the records from that assessment as well.
How do you calculate the level of compensation in a case arising from delay in diagnosis of craniopharyngioma?
The valuation of any claim is entirely tailored to the individual client, the impact of their injury on their life and their personal circumstances. Here again, we work with experts, such as occupational therapists or visual rehabilitation experts, according to the client’s needs, to explore and quantify the injury that has been caused by the negligent delay.
In brain tumour cases we sometimes have to account for the fact that some degree of brain injury may well have occurred as a result of the tumour, even if it had been diagnosed correctly at an earlier time. It takes considerable expertise to ascertain what difference the delay in diagnosis made, in terms of the injury itself and the impact it will have on the client, (such as loss of vision), and their ability to function independently in future life. We then have to translate that into the financial cost of meeting their additional needs for care, aids and equipment, specialist education (SEN) in the case of a child, and so on, along with any future loss of earnings arising from reduced ability to work.
Why do you think it’s important for cases like this to be investigated?
The consequences of any delay in treatment can be devastating for the individual and their family, whether physically, psychologically, educationally or financially. Through interim payments and compensation settlements we can alleviate our client’s financial hardship, facilitate rehabilitation and therapies, and restore a degree of independence.
If you or a member of your family have suffered from a brain injury as a result of medical negligence contact our specialist solicitors on firstname.lastname@example.org.