Six figure sum received by man following delay in diagnosis of autoimmune encephalitis

Our client, now in his 50s, was diagnosed with anti-IgLon5 autoimmune encephalitis after suffering a wide variety of physical and psychological symptoms, and behavioural problems, for more than 3 years.

He had regularly sought medical advice for his difficulties, which included: anxiety, difficulty sleeping, low self-esteem, breathlessness, difficulty swallowing, neck pain, behavioural changes such as opening a car door while being driven on the motorway, shouting in his sleep, and sleepwalking.

What is Anti-IgLon5 autoimmune encephalitis?

This is a very rare type of autoimmune encephalitis and it only affects around 400 patients a year in the UK. It is associated with sleep disorders, difficulties in gait, difficulty in swallowing, hoarseness and cognitive difficulties. Breathing disorders also commonly occur.

The condition is diagnosed by performing a lumbar puncture which will show a raised white cell count. If there is a presumptive diagnosis of autoimmune encephalitis treatment should commence with steroids and intravenous immunoglobulins. The condition is diagnosed by detecting auto antibodies in the serum and cerebrospinal fluid.

Background to the case

In December 2014 our client was seen by a physiotherapist who wrote to the Claimant’s GP, suggesting an urgent referral to neurology. Our client’s GP made an urgent referral to the Neurology Department of the Defendant Trust enclosing a copy of the physiotherapist’s letter and GP consultation notes from the past 5 months, which referred to our client’s symptoms and behavioural problems.

The neurologist assessed our client, noted that he was waiting for an MRI scan of his upper spine, and did not think any other investigations or follow up were needed at that stage. The neurologist noted that he could not rule out functional symptoms (physical symptoms without an obvious physical cause) playing a role in our client’s symptoms and behaviour. Our client’s condition worsened. It appears that a further appointment was arranged with the same neurologist six months later, but our client was never informed about this appointment.

In October 2015 an urgent referral was made to a neurologist at a different Trust, who advised admission to hospital for urgent investigation. Our client was subsequently treated with steroids and intravenous immunoglobulins.

He was readmitted to hospital after suffering falls and worsening agitation, confusion and memory. He started plasma exchange (a process where components of blood are separated before discarding the ‘old’ plasma) during that admission and non-invasive ventilation was also commenced. He required a further admission to intensive care in March 2016 following a rapid deterioration of his respiratory function. A few months later he was diagnosed with anit-IgLon5 autoimmune encephalitis.

The allegations of medical negligence

Allegations included failure by the neurologist at the Defendant Trust to arrange an MRI brain scan and routine blood tests including inflammatory markers, failure to make any review appointment – including an appointment with a member of the Claimant’s family so a collateral history could be taken and negligently discharging the Claimant from care.

Had these things being carried out, and a full history been provided by his wife at the review appointment, a lumbar puncture would have been arranged, which would have led to a provisional diagnosis of autoimmune encephalitis. Our client would have been started on treatment with steroids and intravenous immunoglobulin around nine months earlier and he would have made a much more rapid recovery and avoided the life threatening episode in March 2016 and the need for admission to intensive care. His continuing symptoms would be much less severe.

How Moore Barlow helped

Proceedings were issued and served, witness statements were exchanged and expert evidence was obtained and served from a neurologist, a respiratory physician, a neuropsychologist, a neuropsychiatrist and an expert in care. A Round Table Settlement Meeting took place but the case did not settle. Experts’ meetings took place and our solicitors were able to settle the case for a six-figure sum, just under a month before trial.

Our client has not been to work for several years and it is uncertain whether he will ever return to work. When he had been discharged home from his stay in intensive care, he continued using the non-invasive ventilation at night. His family were concerned about leaving him alone and the doctors agreed that he needed someone with him at all times in case he fell asleep without the mask on. He has only recently been told to stop using the non-invasive ventilation. There was also uncertainty during the case about whether or not our client had capacity. An approval hearing was required for settlement but an assessment has subsequently shown that our client does have capacity.

Dr Mala Sidebottom and Gillian Wickham handled this case and Nigel Spencer-Ley from Farrar’s Building was instructed.

This was a complex case for breach of duty and causation and there were also difficult issues on quantification. However, I am pleased that we have now secured a settlement so that my client can get on with his life. This settlement will allow him to undergo therapy and treatment as well as rehabilitation. There is also provision for case management and ongoing care from family members.

Dr Mala Sidebottom

We would like to thank Moore Barlow for all their support. They kept us up to date at all times and ensured we understood the whole process. We felt very happy with their service, in keeping us informed and supported all the way. We are happy with the outcome.

The client

How Moore Barlow can help

At Moore Barlow, our experienced medical negligence solicitors have specialist knowledge and understanding of the difficulties relating to encephalitis cases and are specialists in this area. We have an excellent track record for succeeding in these cases and are regarded as leaders in the field.

If you think you may have a compensation claim, contact us today.