Death of 8-year-old resulted from delayed treatment of hydrocephalus at Croydon University hospital

Alex's* mother, Ms W, became concerned that her previously well baby had started to appear jittery and had a weak, high-pitched cry. She raised concerns with the Healthcare visitor and was reassured. Ms W continued to be concerned about Alex's regression in development and had also started to notice his head visibly increasing in size. Alex's GP eventually referred him to a paediatrician at Croydon University hospital.

A cranial ultrasound scan showed excess fluid in Alex's brain and he was referred for further neurosurgical assessment at Kings College Hospital, London. Alex was diagnosed with Obstructive Hydrocephalus. He was taken for emergency surgery and a ventriculoperitoneal shunt was inserted to relieve the blockage. Regrettably, during the period of delay, the building pressure caused irreversible damage to his brain.

Alex lived with severely impaired cognitive function and only spoke a few works. He communicated largely through gestures, pointing and Makaton until he mastered eye-gaze technology aged 5. He had bilateral retinal haemorrhages impacting his vision. He was severely epileptic. He was doubly incontinent had a gross motor score function of 5 and was entirely dependent on others for transfer and positioning.

Tragically, when Alex was eight-years-old, he died as a result of complications associated with the damage to his brain.

Ms W instructed Iona to pursue a claim for damages arising from the delay in diagnosing and treating Alex's hydrocephalus. It was her case that there was a negligent failure by the hospital trust (responsible for the healthcare visitor) to investigate the cause of Alex's abnormal cry and his jittery movements and his increase in head circumference. There was a further delay once under the paediatricians to arrange for timely imaging and onward referral to a specialist neurosurgical unit.

The Claimant's case was that the delay in diagnosing and treating Alex's hydrocephalus caused or materially contributed to his catastrophic brain injury and to the complications which caused his subsequent death.

Following several delays in response over 18 months, the Defendant's position was to deny that Alex exhibited an abnormal cry or jittery movements and contended that there was no indication to investigate earlier than they did. The Defendant conceded a narrow breach of duty in failing to refer Alex for further investigation/imaging once under paediatric care, but causation was denied in full. Their case was that Alex's catastrophic brain injury was unavoidable and caused by an intraventricular haemorrhage upon which the delay in diagnosis had made material deterioration in his overall condition.

Iona maintained her position and expert evidence was exchanged. At a Round Table meeting, damages were duly agreed and the claim was resolved.

*Name changed

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