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Clinical negligence case study – delayed diagnosis

Multi-million pound settlement for a case previously abandoned

This case relates to a delay in diagnosing and treating meningitis and sepsis that settled at a capital equivalent value of £16m.

We are pleased to report that one of our major partner law firms in London, Hodge Jones & Allen (HJA), has recently settled a multi-million pound case.

Case Details

This challenging case involved a young child and a delay in diagnosing and treating meningitis and sepsis. The negligence had already occurred some 7 years before we were asked to insure the matter. When presented to us in 2015, the case was in a distressed state, having been abandoned by other London solicitors after a negative expert’s report and a cancelled Legal Aid Certificate.

However, HJA approached us with a positive input from a KC and we were encouraged to offer ATE cover. The critical issue in the case was the impact of delay of some 8 hours after attending at A&E and the commencement of strong antibiotic treatment.

Once the breach of duty was established, the case turned on the impact to the outcome caused by the delayed diagnosis and treatment – every hour of delay contributed to a very serious outcome, which involved a life-saving amputation of lower limbs and fingers.


Judgment was entered in 2020 and the following two years have involved intensive use of various experts in assessing the level of damages, which has recently been agreed at the capital equivalent value of £16m; one of our largest settlements to date.

The Practitioner’s view: comment from Emma Wray, HJA partner and instructed solicitor:

“Initially this seemed to be a case worthy of investigation, but on obtaining the records and noting the previous involvement of solicitors and the negative advice from Counsel we immediately advised Temple, having obtained a brief advice from leading Counsel. Temple, nonetheless, agreed to insure the claim, and we agreed to regularly update them with progress.

Cases involving a delay in diagnosis of infection such as this are notoriously difficult, but we started from the premise that the expert instructed by previous solicitors (who agreed there had been a missed opportunity to give antibiotics 3.5 hours earlier than they were administered) had strayed outside his expertise when commenting on causation. Evidence from a microbiology expert supported causation and was bolstered by further evidence from a pediatric intensive care expert.

At this stage, we were ready to serve draft Particulars of Claim to stand as a Letter of Claim, following which admissions were made. Proceedings were issued, judgment was entered and we then embarked on the lengthy and complex process of quantification.

This case stands as a good illustration of the need for individual risk assessment of cases to be shared between solicitor and insurer, and for insurers to trust the judgement of legal advisers. We are grateful to Temple for their support throughout.”

Please call Matthew Best on 01483 514804 or email with your observations on this topic or to discuss your ATE insurance requirements.

Click here to find out more about ATE insurance for delayed diagnosis /misdiagnosis cases

Matthew Best Cert CII

Head of Personal Injury & Clinical Negligence
Read articles by Matthew Best Cert CII

Matthew Best Cert CII

Matt has an insurance background and joined Temple in 2011 having worked for 4 years in a leading insurance company where he was dealing with personal injury work. Matthew was promoted to Underwriting Manager and subsequently Senior Underwriting Manager taking on overall responsibility for Temple’s personal injury and clinical negligence underwriting department.

In 2022 Matt joined the board of directors as Director of ATE Partnerships. Matthew has cultivated fantastic relationships with our business partners for many years. His ability to build a clear understanding of their requirements and more importantly what is required to fulfil such requirements means he is ideally placed to support the strategic direction of the company.

Matt remains the head of the personal injury and clinical negligence department and is committed to all Temple’s business partners in order to deliver the highest level of service they expect. He is also responsible in making sure that Temple’s ATE and disbursement funding products remain competitive, but most importantly that they are fit for purpose for solicitors and their clients.


Read articles by Matthew Best Cert CII