…but for the negligence of D, C would have avoided suffering a stroke due to the beneficial effects of Heparin treatment, which the D should have given her starting just before 02:00hrs on 25 September 2015 and continuing until she was provided with therapeutic anti-coagulation using Warfarin or alternative modern pills. [4]
On 24 September 2015 C suffered symptoms [30]
A&E notes: 01:35hrs: “Rt leg problem. Leg went very cold and white in colour. Called 111 and then sent up here for assessment. HPC: Rt leg paraesthesia & pallor since this PM. Intermittent episodes with 5 minute intervals. Associated paraesthesia. No pain or weakness. Denies any other CVS , CNS symptoms. Is normally on aspirin but had forgotten to take it for last 5/7 due to stress.
Past medical history: AF (atrial fibrillation); pacemaker;
Plan: D/C home; GP to FU in 5-7 days & advise on further management & FU if
needed. Advised to return to ED if any pallor, coldness, pain or paraesthesia of Rt LL. Advised to restart aspirin.” (End of note timed at 01:44hrs). [34]
in the evening of 27 September 2015. C suffered a stroke at home [38]
D conceded breach of duty. [54]
Heparin would have prevented new clot formation, prevented mother clot
propagation (of the existing clot) and would have enabled C’s body not only
to reduce the size of the mother clot in C’s LAA but also to make it less
friable, more stable and more organised, so that on the balance of probability no embolus would have been fired off on 27 September 2015 and C would not
have suffered a stroke. [162]
judgment for C [163]
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