Partner of seriously ill elderly woman who died after being discharged from Royal Infirmary awarded £187,000 damages for junior doctor’s negligence

A judge in the Court of Session ruled that the doctor breached his “duty of reasonable care” to the seriously ill patient and that the failure to advise the deceased that she should be admitted to hospital was “negligent”.

Lord Pentland heard that Jean Graham died on 8 January 2013 at Glasgow Royal Infirmary at the age of 77.

The pursuer George Andrews was her partner, the couple having living together for around 20 years prior to her death.

He raised an action for damages as executor-nominate and as an individual by way of reparation for the deceased’ death, which he claimed was caused by negligence on the part of Dr Mohamed Izzath, a junior doctor then employed by the defenders, Greater Glasgow Health Board.

Mr Andrews alleged that Dr Izzath was “negligent” because he failed to advise the deceased that she required to be admitted to the Acute Assessment Unit (AAU) of Glasgow Royal Infirmary when she was under his care there on 6 January 2013 - instead advising the pursuer that she would be “all right in two or three days”.

The pursuer argued that Dr Izzath ought to have recognised that the deceased might be suffering from a serious medical condition, namely upper gastrointestinal bleeding.

He told that court that he “begged the man to give her a bed”, but the doctor turned away.

The pursuer maintained that if the deceased had been admitted to hospital on 6 January 2013 she would probably not have died.

But the defenders contended that Dr Izzath was not negligent, although they conceded with the benefit of hindsight that the deceased should have been admitted to hospital on 6 January 2013. 

The health board also claimed that even if the deceased had been admitted to hospital at that time, she would nonetheless still have died.

However, having heard evidence from the pursuer, Dr Izzath and Dr Stephen Cleland, the on duty consultant with whom Dr Izzath discussed the deceased’s case before she was discharged, Lord Pentland ruled in the pursuer’s favour.

The judge observed that the evidence of the parties’ principal experts on the liability issues, consultants Mr Neil Nichol and Dr Paul Leonard, both agreed that in the light of the deceased history, her presentation at the AAU, the recorded observations following her arrival there, and Dr Izzath’s findings on examination, the junior doctor should have have advised her that she should be admitted to hospital.

In a written opinion, Lord Pentland said: “Looking at the expert testimony as a whole, I am satisfied that the weight of the evidence strongly supports the view that the deceased should have been admitted to hospital on 6 January 2013. I am left in no doubt that Dr Izzath should have suspected that the deceased had a serious intra-abdominal abnormality. I consider that in failing to do so, Dr Izzath fell below that standard of care reasonably to be expected of an ordinarily competent doctor in the circumstances.”

The experts pointed to the fact the deceased was an elderly patient, had attended that GRI for a second time on consecutive days, had been referred by a GP with suspected melaena and not because of gastroenteritis, had a history of black vomit and black stools, which were strong indicators of upper gastrointestinal bleeding - all of which amounted to a “powerful case” for admission to hospital, the judge said.

He continued: “I conclude that the right inference to draw from the totality of the evidence is that Dr Izzath did not advise the deceased that she should have been admitted to hospital. In my opinion, he was negligent in having failed to give the deceased that advice. I am satisfied that had he done so, the deceased would have accepted his advice. She would, therefore, have been admitted at about 19.05 on 6 January 2013.”

The fact that Dr Izzath discussed the deceased’s case with a more senior doctor, Dr Cleland, before she was discharged did not absolve him of liability.

“It is well-known that a learner driver must show the same standard of care as any other driver. The same principle applies in the case of a junior doctor,” Lord Pentland said.

He added: “I find that Dr Izzath did not carry out a sufficient assessment of the deceased to exclude the possibility that she was suffering from a serious intra-abdominal abnormality. The reports of black diarrhoea and black vomiting, together with her symptoms of abdominal pain and the other features highlighted by Mr Nichol should have caused Dr Izzath to advise the deceased that she should be admitted to hospital. 

“I am satisfied that any reasonably competent hospital doctor would have done so in the exercise of reasonable care. The fact that Dr Izzath discussed the deceased’s case with Dr Cleland does not have the effect of exonerating him from his failure to exercise reasonable care.”