Successful settlement for negligent care during kidney transplant by NHS Trust

Stephanie Prior

Claimant v Royal Free London NHS Trust

Osbornes have reached a settlement agreement on behalf of a Claimant who brought proceedings against an NHS Trust for the negligent care provided to him during a kidney transplant in 2018.

Background

The Claimant, a professional sportsman, was born with Alport Syndrome, a genetic condition, inherited from his mother; characterised by kidney disease, hearing loss and eye abnormalities.

In 2018 Claimant needed a kidney transplant due to his kidney failure, and his 41-year-old father was identified as a match. Claimant underwent a kidney transplant with the kidney donated by his father.

When a kidney is transplanted, there is always a short period when the kidney is deprived of blood and at risk of progressive damage. The risk is high when the kidney is warm as the issue remains metabolically active at this time. To minimise this risk the kidney must be rapidly cooled to reduce metabolic activity and preserve function.

However, Claimant’s father had been diagnosed with sickle cell trait and cold agglutinins, which puts the kidney at high risk of damage during a transplant. For patients with this syndrome, once the Kidney is removed, it should be perfused with large volumes of warm perfusion fluid to remove the donor blood and therefore all the cold agglutinins. After which, it should be cooled in the conventional way.

In this case, one of the operating surgeons was aware of the father’s cold reactive antibody but did not predict it would have a detrimental effect on transplantation. It is unclear if both surgeons were aware of the father’s condition. The surgeons did not flush father’s kidney with warm water; instead, immediately cooling the kidney after removing it from his body.

The kidney failed to function following the surgery, and the Claimant was informed that had they of known of the cold reactive anti agglutinin they would have first performed the warm flush, before the cold-water flush.

Claimant required a further living donor kidney transplant, which finally took place at the end of December 2020.

As a result of the failed surgery, the Claimant suffered a hiatus in his sporting career, and would have returned to full fitness by mid-2019. He would not have required additional treatment including the need for re-transplantation. He also would not have suffered an anticipated reduction in life expectancy.

Procedure

A Letter of Claim was sent to the Defendant in May 2021.

The allegations against the Trust included, but were not limited to:

• Failure to warn the Claimant about his father’s blood conditions
• Failure to discuss the presence of donor cold agglutinins and sickle cell trait with a consultant haematologist before transplantation.

• Failure to consider or mitigate the risk of agglutination and haemolysis related to the donor cold agglutinins and sickle cell trait respectively or to warn the father or Claimant of the possibility of associated complications

A Letter of Response was received from the Defendant in January 2022. The Trust admitted failure by the renal team to discussing the presence of cold agglutinins in the father’s blood with the haematology department. They admitted that had such a discussion taken place, it would have resulted in an alteration to the conventional perfusion method (i.e. the donor kidney would have been perfused in warm fluid first). This, in turn, would have avoided the failed kidney transplant.

Following the Trust’s admission of liability, an offer was put forward by the Defendant in the sum of £140,000. Osbornes put forward a counteroffer of £165,000, and the Defendant’s thereafter put forward a counter-offer of £160,000 plus reasonable costs, which was accepted by the Claimant.

The Claimant was pleased with the outcome of the medical negligence claim, which will hopefully compensate for the years of his career missed due to his ill-health and the impact it has had on his career going forwards.

Claimant’s Solicitor

Stephanie Prior, Partner, Osbornes Law

Counsel

Chris Stephenson

Defendant’s Solicitor

Tania Kahlon, Bevan Brittan

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