After suffering a stroke, ZB* was largely mobile and independent. In the years that followed, ZB’s health deteriorated as he began suffering from nausea, reduced appetite, reduced mobility, and acute pain.
After experiencing issues with his chest for two years and having multiple chest x-rays, which showed fluid on the lungs and pleural effusions and thickening, in 2017, ZB received a delayed diagnosis of drug-resistant spinal tuberculosis (TB).
The hospital trust missed multiple chances to test and diagnose TB, including in 2015 when a CT scan showed a spinal lesion in the L1 vertebral body, which was left untreated for two years. Had the lesion been biopsied, ZB would have been diagnosed as early as October 2015. Unfortunately, the TB was left untreated for a number of years, despite there being radiological evidence of the infection.
Spinal Tuberculosis
Tuberculosis, or TB, is an infection caused by a strain of bacteria from the mycobacterium tuberculosis group. Most TB in the UK is pulmonary (meaning it affects the lungs). However, TB can be present in other areas of the body, including the spine. Spinal tuberculosis is strongly suspected when CT or MRI imaging studies of the spine reveal collapse of vertebrae and paraspinous abscesses. The diagnosis is then confirmed through biopsy or through laboratory culture of the material drained from a paraspinous abscess. If diagnosed early enough, spinal tuberculosis responds to antituberculosis medication alone.
Challenges faced by the family
ZB suffered from extreme pain when coughing, unexpected weight loss and back pain. ZB had been experiencing issues with his chest for two years. He underwent multiple chest X-rays and tests, which showed fluid on the lungs and pleural effusions and thickening, all of which are markers for tuberculosis. A CT scan also showed an abnormality in his L1 spinal disc, which was not investigated further.
ZB was required to transfer to a care home when he could no longer manage his complex care needs with assistance from family members. ZB required extensive care and assistance, became immobile, incontinent of both urine and faeces and required a hoist for all transfers.
How we helped settle the claim
Jenny Tetlow, a lawyer in our NHS negligence team, instructed medical experts, who confirmed that had the spinal lesion been identified following the CT scan in 2015, ZB would not have suffered such a drastic decline in his quality of life. Compensation was claimed on the basis that had the spinal lesion been diagnosed following the CT scan, this would have prompted MR imaging and biopsy of the spine, leading to an earlier confirmed diagnosis and treatment of TB.
At this stage, ZB could have been treated with a 12-month course of antibiotics and would have avoided the narrowing of his spinal canal and the need for decompression surgery. Despite being a complex case due to ZB’s past medical history, Jenny managed to secure the client a damages award of £85,000 on the basis that had the TB been picked up sooner, ZB would have avoided the unnecessary surgery and the consequent significant decline in mobility and function.
*Details anonymised
