Press behaving badly...why all is not as it seems in the Leslie Ash case
February 2008
Last month the settlement of Leslie Ash’s claim against Chelsea and Westminster NHS Foundation Trust after suffering a MSSA infection in 2004 was trumpeted by the media as a landmark case. Our Infection specialist, Sian Morgan, sets the record straight.
Ms Ash was admitted to the Chelsea and Westminster in 2004 having suffered a punctured lung and two broken ribs. She underwent surgery and received a spinal epidural anaesthetic. She appeared to be recovering well but two days post-operatively reported a small “spot” at the needle site on her back to a nurse. That nurse apparently squeezed what was a small abscess filled with pus and advised Ms Ash that she would be fine. Shortly afterwards she was discharged home.
Some two days later Ms Ash woke up to find herself paralysed from the chest down. The actions of the nurse in squeezing the abscess had caused MSSA bacterium present in the wound site to be sealed in. The bacterium found its way into the bloodstream and the infection seeded in the spine causing paralysis. Spinal infection is a rare, but not unheard of, complication of surgery.
Ms Ash has been left with permanent weakness down one side causing her difficulties walking. She uses a stick and, at times, a wheelchair. He claim for negligence comprised, amongst other items, a large claim for future loss of earnings. She claimed that her mobility problems, coupled with general frailty left her unable to work as an actress. She received £5million in damages in an out of Court settlement.
So, now to debunk the hyperbole……
“The 47 year old actress caught a strain of MRSA” The Daily Mail
Reality: Ms Ash was infected with MSSA – meticillin susceptible staphylococcus aureus. MSSA is not a strain of MRSA. Rather, MRSA – that is meticillin resistant staphylococcus aureus – and MSSA are different strains of staphylococcus aureus bacterium.
“She contracted MSSA from an epidural needle which came loose” The Daily Mail
Reality: The MSSA was found to be present at the epidural needle site but loose needles do not in themselves cause patients to acquire infections.
“The NHS Trust admitted it was in breach of duty over some treatment but disputes other allegations” The Sun
Reality: Correct. The Trust accepted that the infection could have been treated more appropriately but did not accept that Ms Ash acquired her infection through any breach of duty of care.
“Leslie Ash this month won £5million in damages from Chelsea and Westminster NHS Trust – the highest compensation ever awarded for contracting a hospital infection” Law Society Gazette
Reality: Wrong. Allegations of acquisition may have been made, but the settlement was reached not because Ms Ash contracted MSSA. Compensation was agreed because the MSSA was not appropriately treated.
“In July 2006 Kitty Cope, 87, won a landmark case against the Princess of Wales hospital in Bridgend, South Wales, after her lawyers argued that it had breached health and safety rules. Previously claimants had to prove that the NHS was negligent, which was far more difficult” Times online
Reality: Wrong. The Kitty Cope case was not a landmark case and the law has not changed to make claims easier. Breach of COSHH (Control of Substances Hazardous to Health) Regulations was argued, but the applicability of the Regulations was never accepted by the Hospital. Furthermore, the case settled out of Court for other reasons and no legal precedent was set. Since then, the Courts have considered the applicability of COSHH in Ndri -v- Moorfields Eye Hospital NHS Trust [2006] EWHC 3652 (QB) but held that the COSHH regulations do not apply to patients. In order to obtain damages for injuries caused by a Hospital Acquired Infection, patients still need to prove that either they acquired the infection through the Hospital’s negligence (which is exceptionally difficult to achieve) or that their infection was improperly treated as in the reported case and this hampered their recovery.
It is understandable why public reaction to Ms Ash’s award has been mainly negative. Despite the best efforts of the NHSLA, the Trust and Ms Ash’s solicitors, ‘the man on the street’ only hears two things from the press: MRSA and £5 million. We clearly have some way to go in educating the public, and in some cases, the press, on why clinical negligence claims are settled and the way that damages are calculated. Ms Ash’s case was not settled because she acquired an infection nor because she is a celebrity. Furthermore the figure of £5million was not plucked out of the air. The sooner we get that message out there, the better.
Ms Ash was admitted to the Chelsea and Westminster in 2004 having suffered a punctured lung and two broken ribs. She underwent surgery and received a spinal epidural anaesthetic. She appeared to be recovering well but two days post-operatively reported a small “spot” at the needle site on her back to a nurse. That nurse apparently squeezed what was a small abscess filled with pus and advised Ms Ash that she would be fine. Shortly afterwards she was discharged home.
Some two days later Ms Ash woke up to find herself paralysed from the chest down. The actions of the nurse in squeezing the abscess had caused MSSA bacterium present in the wound site to be sealed in. The bacterium found its way into the bloodstream and the infection seeded in the spine causing paralysis. Spinal infection is a rare, but not unheard of, complication of surgery.
Ms Ash has been left with permanent weakness down one side causing her difficulties walking. She uses a stick and, at times, a wheelchair. He claim for negligence comprised, amongst other items, a large claim for future loss of earnings. She claimed that her mobility problems, coupled with general frailty left her unable to work as an actress. She received £5million in damages in an out of Court settlement.
So, now to debunk the hyperbole……
“The 47 year old actress caught a strain of MRSA” The Daily Mail
Reality: Ms Ash was infected with MSSA – meticillin susceptible staphylococcus aureus. MSSA is not a strain of MRSA. Rather, MRSA – that is meticillin resistant staphylococcus aureus – and MSSA are different strains of staphylococcus aureus bacterium.
“She contracted MSSA from an epidural needle which came loose” The Daily Mail
Reality: The MSSA was found to be present at the epidural needle site but loose needles do not in themselves cause patients to acquire infections.
“The NHS Trust admitted it was in breach of duty over some treatment but disputes other allegations” The Sun
Reality: Correct. The Trust accepted that the infection could have been treated more appropriately but did not accept that Ms Ash acquired her infection through any breach of duty of care.
“Leslie Ash this month won £5million in damages from Chelsea and Westminster NHS Trust – the highest compensation ever awarded for contracting a hospital infection” Law Society Gazette
Reality: Wrong. Allegations of acquisition may have been made, but the settlement was reached not because Ms Ash contracted MSSA. Compensation was agreed because the MSSA was not appropriately treated.
“In July 2006 Kitty Cope, 87, won a landmark case against the Princess of Wales hospital in Bridgend, South Wales, after her lawyers argued that it had breached health and safety rules. Previously claimants had to prove that the NHS was negligent, which was far more difficult” Times online
Reality: Wrong. The Kitty Cope case was not a landmark case and the law has not changed to make claims easier. Breach of COSHH (Control of Substances Hazardous to Health) Regulations was argued, but the applicability of the Regulations was never accepted by the Hospital. Furthermore, the case settled out of Court for other reasons and no legal precedent was set. Since then, the Courts have considered the applicability of COSHH in Ndri -v- Moorfields Eye Hospital NHS Trust [2006] EWHC 3652 (QB) but held that the COSHH regulations do not apply to patients. In order to obtain damages for injuries caused by a Hospital Acquired Infection, patients still need to prove that either they acquired the infection through the Hospital’s negligence (which is exceptionally difficult to achieve) or that their infection was improperly treated as in the reported case and this hampered their recovery.
It is understandable why public reaction to Ms Ash’s award has been mainly negative. Despite the best efforts of the NHSLA, the Trust and Ms Ash’s solicitors, ‘the man on the street’ only hears two things from the press: MRSA and £5 million. We clearly have some way to go in educating the public, and in some cases, the press, on why clinical negligence claims are settled and the way that damages are calculated. Ms Ash’s case was not settled because she acquired an infection nor because she is a celebrity. Furthermore the figure of £5million was not plucked out of the air. The sooner we get that message out there, the better.
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