Written by

Alison Flaherty - Partner, Head of Medical Negligence

The Incident

Our client was a retired nurse who had worked in the NHS for 10 years. She had previously been diagnosed with mild to moderate kidney disease.

The negligence involved our client being administered an inappropriate prescription of morphine, which resulted in her suffering with opioid narcosis, type 2 respiratory failure and pneumonia.

The case

Our client was travelling on her vespa scooter when she fell off and injured her ribs. Following the accident, she was taken to hospital where it was discovered she sustained three fractures to her ribs. Our client was transferred to a trauma ward and was looked up to a line that administered morphine.

A couple of days later, our client was found unresponsive in her bed and was immediately taken to the intensive care unit. It was discovered that she was suffering with respiratory failure which was discovered to be from an overdose of opioids.

Our team obtained expert evidence from a Physician in Critical Care Nephrology. The expert’s opinion was that the initial use of morphine was appropriate, but she was prescribed too much. The expert also felt that there was a breach of duty in re-prescribing the morphine when there became clinical concern about opiate intolerance.

Our client had been previously diagnosed with mild to moderate kidney disease. The expert was of the opinion the treatment plan should have been based around monitoring for signs of opiate toxicity in light of the known kidney dysfunction.

It was proposed that there were failures by the Trust in;

  • Prescribing 5-10mg of morphine 2 hourly, which exceeded the recommended dosage
  • Failing to consider alternative pain relief
  • Re-prescribing morphine, following a failure to recognise there were concerns regarding the claimant’s respiratory rate and opioid sensitivity and a failure to reassess kidney function
  • Not completing a fluid balance chart
  • Not reviewing the claimant in a timely manner to assess the necessity for a nerve block

A Letter of Claim (setting out the allegations of sub-standard care) was served on the Defendant Trust. The Defendant Trust admitted there was a breach in the dosage and frequency of the morphine that was prescribed considering the concerns of opioid sensitivity. However, they denied the following;

  • Completing fluid chart represented a breach of duty
  • There was a failure to review the client in a timely manner to assess the necessity for a nerve-block
  • There was a delay in the referral to the ICU

The aftermath

Initially, our client was not informed about what had happened and she felt there was a lot of secrecy surrounding her condition and lung function.

Once matters had time to sink in, the claimant was extremely upset at the thought that a trusted institution, and a potential former employer, could have done this to her. This has had a significant psychological impact. Our client does not understand how, someone who at the time of the incident was a former colleague, could make such a significant error and there be so little discussion with her about it.

Following the negligence, our client was diagnosed with severe post-traumatic stress disorder. Our client believes the psychological implications of the negligence significantly reduced her quality of life and left her struggling to socialise.

The case outcome

The claim was discussed at a Round Table Meeting and an offer of £4,000.00 was accepted on behalf of our client.



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