BRAIN & SPINAL CORD INJURY CASES
Posted in [Blog] on Thursday, May 12th, 2022
I am a Solicitor who specialises in medical negligence cases and I have brought a number of brain and spinal cord injury cases during my career. In the last six months, I have settled a brain injury and (separately) a spinal cord injury case which have been very unusual from a causation perspective. I will discuss these cases below but before doing so, I have set out a little background information as it provides context and may be informative.
The brain and the spinal cord make up the Central Nervous System (“CNS”) which are comprised of highly specialised cells (neurons) which can send and receive chemical or electrical signals. The brain controls the things we choose to do like talking and movement and the things our body does automatically like digesting food and breathing. This CNS is a very complex system but simply put the brain receives information (chemical or electrical signals) internally (from the body) or externally (from the environment) via our sensory organs. It interprets those messages and sends motor commands to the body. The spinal cord carries the information (the chemical or electrical signals) between the brain and the body. Any injury to the brain or the spinal cord has the potential to cause an interruption of information (the chemical/electrical signals) being transmitted to and from the brain. If the precious nerve cells are damaged to a particular degree, they never recover and cannot be replaced. Therefore, an injury to the brain and the spinal cord carries with it a high degree of mortality and morbidity. Unfortunately, in my experience, these types of injuries culminate in the person suffering permanent catastrophic injuries involving the loss of some bodily function(s).
In November 2021, Conor McCormack’s case https://www.irishtimes.com/news/crime-and-law/man-left-blind-and-unable-to-walk-settles-case-against-hospital-for-25m-1.4739750 was settled for the sum of €25 million. This was a very complex case with two separate episodes of negligence, some 15-16 years apart, and Conor sustained catastrophic brain injuries on both occasions. The first limb of the case relates to the events which occurred in early infancy. In July 1998, a brain CT scan demonstrated abnormalities. Initially, Conor was diagnosed with benign external hydrocephalus (a self-limiting absorption deficiency of infancy that resolves without treatment). The plan was that he be reviewed clinically. Unfortunately, Conor’s care fell down. The causation experts were of the opinion that in the first CT scan on the 8th July 1998, the brain and in particular the white matter, were normal but on subsequent scans from May 1999 onwards, the white matter was not normal. In the 10-month period, the raised intercranial pressure which was localised from the cyst, caused compression of the brain and displacement of the frontal lobes and distortion of the temporal lobes. This caused underdeveloped of the brain which was irreversible. Conor had a frontal cysto-peritoneal shunt (“shunt”) inserted in May 1999 which drained the cyst. Subsequently, he was diagnosed with global developmental delay and with a moderate learning disability. Thereafter, he attended a special school for children with intellectual disabilities although non-verbal he was able to communicate his needs with a mixture of words and sing language. He was fit and well he was fully mobile and he was able to entertain himself on his own computer. Socially, he was a happy sociable child/adolescent and he was above all content. The experts were of the opinion that if the cyst was surgically drained by mid-April 1999, Conor would have escaped all his disabilities and he would have had a normal developmental outcome.
On the 7th October 2014, Conor had a seizure set against the background of vomiting and diarrhoea. He was admitted to Cork University Hospital. Although radiological investigation demonstrated that the shunt tubing was fractured, the treating clincians formulated the opinion that there was no raised intercranial pressure and a positive decision was taken not to carry out neurosurgery and replace the shunt. Unfortunately, Conor’s condition deteriorated during his three-week admission. He developed locomotor issues and when he lost his sight, he then had emergency surgery and the shunt was replaced. The causation experts instructed were of the opinion that the initial CT demonstrated obstructive hydrocephalus and that the three-week delay in replacing the shunt caused catastrophic injuries consisting of vision loss, locomotor issues and further cognitive impairment. As a result of Conor being bedridden, he developed contractures in his legs and he was a wheelchair user for a considerable time. The loss of mobility and vision had a catastrophic impact on Conor. He could no longer entertain himself with his computer and he was no longer happy and content. Conor’s family got him mobile again but he is not back and will never return to his 2014 baseline. This case highlighted that Conor had, what could be described as, a structural defect in his brain and although they are not uncommon, they are not usually successfully litigated.
In March 2022, we settled a case for our Client who had an incomplete spinal cord injury. In 2014, the Client was mountain biking on a designated cycle route when the bike skidded (for no apparent reason) and he was thrown over the handlebars. The Client hit his head on the ground (he was wearing a helmet) and he was winded but there were no apparent injuries. However, our Client was on anticoagulants (blood thinners) and he subsequently developed neurological signs and symptoms which got progressively worse. On admission to Cork University Hospital (“CUH”), our Client was already paraplegic with significant motor and sensory deficits. However, CUH in 2014 did not have 24/7 MRI facilities and although a CT identified a subarachnoid haematoma (clot in the brain which did not require surgery) the CT spine did not assist in establishing if our Client’s spine was stable he required an urgent MRI. He was transferred to the Mater Misericordiae University Hospital Dublin (“the Mater”) by road ambulance. On arrival in the Mater Hospital, an MRI identified a clot which was causing compression of the delicate spinal cord which required urgent evacuation. Once the clot was surgically evacuated, our Client was noted to have wriggled his toes. Thereafter, he underwent extensive rehabilitation to include an inpatient stay at the National Rehabilitation Hospital where he learned to walk with two crutches, then with one crutch, graduating to two sticks and then one stick. In September 2016, our Client eventually walked unaided. Unfortunately, he has extensive residual permanent disabilities which have impacted on his social, domestic and industrial life. However, our Client is a resilient, determined man and he re-entered the employment market and although incapacitated, he has set about rebuilding his life. The expert expressed the opinion that the Client’s clotting mechanisms were artificially deranged because he was on anticoagulants. As a consequence of the trauma and the anticoagulants, he developed an acute subdural haematoma (“ASH”). We argued that the failure to have MRI facilities in CUH delayed the emergency surgical intervention by approximately double the length of time that it would have been if MRI imaging and surgery had been undertaken on a timely basis. This case demonstrates that a complete motor and sensory paralysis is not a bar to a complete recovery of neurological function provided the haematoma (clot) is evacuated promptly.
Contact us at Cantillons Solicitors at +353 (0)21 -4275673 or email@example.com if you would like more information.
* In contentious business, a solicitor may not calculate fees or other charges as a percentage of any award or settlement.