Negligent provision of ambulance services

The deceased underwent haemodialysis three times weekly at first at St James’ Hospital in Leeds and subsequently at Dewsbury. Throughout his treatment the deceased was transported by West Yorkshire Metropolitan Ambulance Service in either an ambulance or car. It was noted on the booking forms utilised by WYMAS for this transport that the deceased required assistance both to and from the vehicle due to his frailty. The level of service provided varied between visits. At times two members of staff would attend, at others only one would attend.

In order to reach the transport it was necessary to negotiate a short but very steep flight of steps which lead from the house to the street.

On the 24th February 2006 the deceased was being aided by a driver sent by WYMAS to transport him for his regular dialysis. At the top of the steps, whilst the driver had turned away to close the gate, The deceased fell forward onto the metal rail and slipped half way down on his midriff. At that point he fell backwards, hitting the back of his head on the concrete steps and rolled to the foot of the steps.

The incident report prepared by the ambulance service stated that the driver was supporting the deceased’s right arm at the time of the fall by cupping his elbow with his left hand.

An emergency ambulance was called and both a rapid response car and a regular ambulance responded. At this time the deceased was breathing independently but was unresponsive to stimuli. Once at Dewsbury & District Hospital the deceased was diagnosed with a subdural haemorrhage. Do not resuscitate orders were given by the hospital staff and surgery was considered inappropriate.

The deceased died on the 25th February 2006 without ever regaining consciousness.

The post mortem listed the causes of death as (1) subdural haemorrhage, (2) head injury and (3) ischaemic heart disease. The coroners report also details a large fracture on the left side of the head and a subdural haemorrhage on the right side of the brain, making it clear that the sudden head injury sustained in the fall had caused the deceased’s death.

An inquest was held at Bradford Coroners Court on the 20th September 2006. The coroner recorded a narrative verdict in which he stated that the deceased had died as a result of the injuries sustained.

The inquest into the death of the deceased criticised the failure of the ambulance service to provide adequate arrangements for the transport of the deceased. In particular there had been an absence of adequate risk assessments which would have identified that the deceased required a high degree of aid to and from the transport provided. It was clear that actual support given on the day the deceased died was inadequate.

Claimant’s Case

It was alleged that the care provided by the ambulance service had been insufficient as there had been a failure to perform an adequate risk assessment for the deceased’s transport requirements despite there being a policy in force requiring such an evaluation. The service were actually already aware that the patient was particularly unsteady on his feet. It was also argued that the driver had failed to adequately support the deceased whilst he was being assisted to the transport provided. Had the ambulance driver provided adequate support then the deceased would not have suffered the fall which caused his death.

Discrepancies were noted between the accounts of the driver and the wife of the deceased who had been present at the time the deceased was being escorted to the waiting vehicle and also with the statement provided by the son of the deceased.

Progress of the Case

A protocol letter of claim was served on the Defendant on 3 December 2007. There was significant delay in the defendants providing a letter of response. This did not arrive until 8 August 2008 and liability was denied in full.

Proceedings were issued on a protective basis on 25 February 2009. A defence was filed which denied liability in full, instead it was asserted that the circumstances had been no more than a ‘tragic accident’.

Settlement

The claimant put forward a part 36 offer of £60,000 on the 18th December 2008 which was not accepted nor rejected by the Defendant. Following correspondence, it took until the October 2009 when the Defendant contacted the claimant to ascertain whether settlement could be achieved for £45,000.

Full and final settlement was reached in the matter for the sum of £55,000 on the 13th December 2009.