Family receives settlement for avoidable death of daughter from meningitis

Penningtons Solicitors LLP has negotiated settlement of a claim against St Helier Hospital in relation to the death of Natalie Naylor, a 20 year old university student from Wallington, Surrey.

Natalie became ill on 22 January 2004 and was taken to the A&E department at St Helier Hospital shortly before 11pm by her mother, Christine Naylor, immediately after she had been advised by the NHS Direct team that Natalie might be suffering from meningitis.

On arrival at A&E, Natalie showed signs and symptoms which, it was argued, should have prompted a suspicion of meningitis. It appears, however, that those managing Natalie did not consider meningitis or septicaemia as part of the differential diagnosis. Whilst she was admitted and blood tests were taken, the blood results were not requested urgently, no regular observations were carried out and no precautionary measures such as intravenous antibiotics and fluids were started.

Both Natalie and her mother were repeatedly reassured that there was nothing of concern. Based upon this reassurance, once Natalie had finally been admitted to a ward, Mrs Naylor left the hospital at around 5am, intending to return later in the morning. Two to three hours later Natalie complained of a severe headache and subsequently collapsed. At approximately the same time, the blood results were received and indicated a high white blood cell count. It appears that only at this stage was the severity of Natalie's condition and the likelihood of meningococcal infection appreciated. She was admitted to the High Dependency Unit and urgent action was taken to try and save her.

Natalie's father contacted the hospital first thing in the morning. He was advised that both parents should come to the hospital immediately. Mr and Mrs Naylor were then taken to see Natalie who was on life support and unconscious. Natalie never regained consciousness and life support was turned off the next day. The cause of death was subsequently determined as being meningococcal meningitis.

An inquest was held in relation to Natalie's death. As part of that inquest, the Coroner obtained expert evidence from a professor in infectious diseases who was critical of the A&E management of Natalie. Based upon the evidence given, the Coroner concluded in his verdict that Natalie should have been assessed more quickly and that the blood results should have been obtained and acted upon more quickly. He concluded that there was a missed opportunity to treat Natalie as a result, but was unable to say whether proper treatment would have saved her.

After the inquest, the decision was made to bring a claim on behalf of Mrs Naylor. It is her case that the hospital's management of Natalie was negligent and that this led to her death. She states that as a result of the circumstances surrounding Natalie's death – in particular leaving her alone in hospital believing her to be safe and returning to find her on life support in the High Dependency Unit - she suffered psychiatric injury. Understandably, the family felt immensely let down that not only had Natalie's condition not been appropriately managed but that as a direct result of the hospital's failure to appreciate the severity of Natalie's condition, her family were reassured and were therefore not with her at the time of her deterioration and collapse.

Penningtons Solicitors, acting on behalf of Christine Naylor, obtained expert evidence in relation to Natalie's management and the cause of her death. Both the professor in infectious diseases and the consultant in A&E medicine who reported on Natalie's management were extremely critical of the complete failure to consider meningitis and to take urgent steps to exclude or confirm it. The view of our experts was that there was a significant window of opportunity to diagnose and to treat Natalie and that had she been appropriately managed at any time up until around 5 am the next morning, on the balance of probabilities she would have survived with no permanent effects.

Based upon this expert evidence, a letter of claim was submitted to the Trust. There was a significant delay in the Trust responding. Despite the evidence given at the inquest and the strong views of our experts, the Trust disputed the case in its entirety. Although the Trust was unable to support its position, it still did not prove possible to settle this matter until a few weeks before trial. Settlement was agreed finally in February 2008.

Philippa Luscombe of Penningtons Solicitors LLP, who has managed the case from the time of the inquest, said: “We are pleased to have reached a settlement that reflects the strength of Mrs Naylor's case against the Trust. However, it has been disappointing that in a case where the Trust appeared unable to find any evidence to defend its position and where independent experts were so critical, that the Trust could not have admitted its mismanagement of Natalie at an early stage.”

Christine Naylor said: “Having lost our beloved daughter in the most traumatic and avoidable circumstances, I hope that the Trust and others who hear about this case will be more alert to the risks of meningitis and the need to act quickly where someone shows classic symptoms.”

Mr and Mrs Naylor have set up the Natalie Naylor Trust fund in Natalie's memory to fund research into creating a vaccine for the 'B' strain of meningitis and promote awareness of the disease.