Seven figure settlement for delay in diagnosis of ADEM

Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory condition that affects the brain and spinal cord. It can develop after a minor infection, such as a cold, when the immune system attacks the protective covering of the nerves.

In this case, the client’s claim related to a delay in starting intravenous methylprednisolone pulse (IVMP) therapy, a treatment used to manage inflammation. Two hospital trusts admitted that they failed to ensure that a specialist neuroradiologist’s interpretation of the client’s brain MRI scan was properly recorded and passed on to the treating team.

The trusts also admitted that clinicians failed to consider ADEM appropriately and arrange a spinal MRI scan promptly. As a result, the client’s treatment was delayed by four weeks.

The delay in treatment resulted in significant spinal injuries. The client continues to experience restricted mobility and fatigue, alongside altered sensation in the upper limbs.

The client also has bladder and bowel dysfunction and short-term memory difficulties.

Although the trusts admitted that they had failed to provide appropriate care, they argued that earlier treatment would not have improved the client’s eventual recovery. They believed it would only have helped the client reach their current condition and prognosis sooner.

However, the medical evidence obtained for the claim suggested that, although ADEM would still have caused some ongoing symptoms, the client would have made a substantially better recovery if treatment had started four weeks earlier.

The client’s spinal injuries have had a lasting impact on mobility and everyday functioning. Ongoing fatigue, altered sensation and bladder and bowel difficulties have added to the challenges of living with ADEM.

The client’s short-term memory difficulties have also formed part of the wider impact of the injuries.

The lasting nature and range of these symptoms meant the claim needed to consider more than the initial delay in treatment. It was important to establish how the delay had affected the client’s recovery and what support they would need in the future.

The case involved complex medical questions. Although the trusts admitted that treatment had been delayed, they disputed whether starting treatment earlier would have led to a better outcome. The team on the case needed specialist evidence to challenge this position.

They instructed experts across relevant medical and rehabilitation disciplines, including neurology, neuroradiology and rehabilitation medicine. The case also involved experts in neuropsychology, colorectal surgery and urology, as well as specialists who could assess the client’s care and accommodation needs.

ADEM is rare in adults, and there were no controlled research studies available to show what the client’s outcome would have been with earlier treatment. This made it particularly difficult to establish the difference the delay had made.

To address this, the team instructed a neurologist who specialised in demyelinating diseases such as ADEM. This specialist expertise helped the team challenge the trusts’ reliance on a general neurology opinion and support the argument that earlier treatment would have led to a substantially better recovery.

The case settled before trial, with the team securing a seven-figure settlement for the client.

The compensation will help fund appropriate therapies, aids and equipment, as well as medical treatment and suitable accommodation. It will also provide for the client’s ongoing care needs.

The settlement recognises the lasting impact of the client’s injuries and will help provide funding for the support they need going forward.

What the client said

“You guys have all been super awesome. I’m not sure a simple thank you is enough! For now though, thanks to all of you who’ve been so amazing to deal with. Special thanks to Rhea and Laura! Both amazing people. And of course, to Abi and Victoria. You’ve both been super lovely people to know and to have in my life. It’s been a real honour to have you fighting my corner!”

A delay in diagnosis or treatment can have serious consequences, particularly when it affects a complex condition such as ADEM. Establishing how that delay changed a person’s recovery can also be difficult, even when medical negligence has been admitted.

At Fletchers, we understand the importance of investigating the medical evidence carefully and understanding how an injury affects your life and future needs.

If you believe you or a loved one has suffered harm because of delayed diagnosis or treatment, we can help you understand your options.

Find out more about our medical negligence claims service.