Delayed diagnosis and treatment of renal tract obstruction

Davies and Partners settled a claim relating to a negligent delay in diagnosis and treatment of renal tract obstruction.

Mr G suffered from a history of bladder problems related to his Multiple Sclerosis for which he has required catheterisation. This resulted in intermittent urinary tract infections. Mr G was admitted to hospital as an emergency with a urinary tract infection and constipation. Urosepsis was suspected but no radiological imaging of the kidneys was made during or following this admission.

Mr G was again admitted to the Royal Berkshire NHS Foundation Trust, two years after the initial admission for urinary tract infection, with abdominal pain, nausea and fever. Urospesis was again suspected and an ultrasound was undertaken. This demonstrated mild to moderate right hydronephrosis. A referral to the Urologists was recommended. This referral did not take place. Following a letter from Mr G’s GP he was admitted to hospital. He had a diagnosis of recurrent urinary tract infections and a urethral stricture. He underwent a Cystoscopy and bladder washout. There was no mention of the hydronephrosis identified on the recent USS.

A CT Scan was requested and reported a ureteric stone with hydronephrosis and inflammatory soft tissue around a dilated upper ureter and debris within ureter. Mr G underwent a right nephrostomy, a right antegrade ureteric stent was inserted to drain urine past the obstruction and he later underwent a right ureteroscopic laser fragmentation of ureteric stone and change of ureteric stent, which was later removed. Further investigations and treatment were undertaken. A DMSA Isotope Renogram showed no function in the right kidney and Mr G’s right kidney was subsequently removed.

Davies and Partners were instructed by Mr G to investigate and pursue a claim on his behalf in relation to delay in diagnosis and treatment of stone disease and renal tract obstruction under the care of Royal Berkshire NHS Foundation Trust.

As a result of delay in diagnosis and treatment Mr G suffered from urosepsis, recurrent right kidney stone disease and ultimately right kidney failure requiring multiple procedures followed by removal of his kidney which would have been avoidable. Mr G remained at significant risk of developing a serious disease and/or deterioration in his remaining kidney function such that dialysis would be required in the future in circumstances where it would have been avoided. This was a lifelong risk

The Defendant Trust admitted breach of duty in their Letter of Response. Judgment was subsequently entered with damages to be assessed. The Trust offered to settle in the sum of £63,500. Proceedings were issued and settlement was agreed and approved by the Court for £200,000.

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