Failure to Refer Patient to Trans Ischaemic Attack Clinic Resulted in Severe Stroke


I was instructed to pursue a Clinical Negligence claim originally by the Deceased to bring a claim on her behalf against Wrightington, Wigan and Leigh NHS Foundation Trust after a failure to refer her to a TIA Clinic, following a Trans Ischaemic Attack in June 2014, which subsequently resulted in her suffering a severe stroke a month later.


Settlement was achieved without the need to issue proceedings.

What Happened

In early June 2014, the Deceased (aged in her early 80s at the time of the negligence) was taken by emergency ambulance to the Emergency Care Centre at Royal Albert Edward Infirmary with a suspected stroke. She was prescribed Aspirin and diagnosed with a suspected TIA (Transient Ischemic attack). A plan was made to refer the Deceased to a TIA Clinic.

However, no referral or follow up was made and sadly in August 2014 the Deceased suffered a further episode. An ambulance was called and the Deceased was taken to Wigan Hospital and subsequently transferred to the Royal Albert Edward Infirmary. Following a CT scan it was confirmed that the Deceased had suffered a thrombotic stroke. It was noted that there was ‘evidence of mild diffuse cerebral atrophy and moderate background microvascular disease’. No acute infarct or intracranial bleed was seen, there was a left frontotemporal low density in the region of the insula extending to the lateral posterior aspect of the left basal ganglia in keeping with the recent infarct.

The Deceased was given 300mg Aspirin for 14 days and transferred to the Acute Stroke Unit. As a result of the stroke the Deceased lost the ability to communicate and the majority of the function down her right side. The Deceased was kept in hospital for at least three weeks, where upon she was then discharged and transferred to a care home for rehabilitation.

Following the stroke, the Deceased suffered a number of falls which set her back. First she injured her knee and a few months later she fractured her arm. In November 2015, she suffered a further fall which resulted in a broken hip, requiring a hip replacement. Sadly the Deceased passed away in December 2015.

As a result of the negligence, she suffered significant disability for the remaining approximately 15 months of her life, losing her previous independence and requiring nursing in a care home. On the balance of probability, those falls would not have occurred but for the Defendant’s negligence and the Estate was accordingly entitled to be compensated for the injuries the Deceased suffered in those falls.

Further, as a result of the Defendant’s negligence the Deceased suffered a shortened life and died in December 2015.

Supportive expert evidence in the form of a Breach of Duty report was obtained from a Consultant in Emergency Medicine.

Supportive causation evidence was also obtained from a Consultant Neurologist.

A Letter of Claim was served on the Defendant in March 2018. A Letter of Response was received in July 2018, which made an admission of liability.

Support was provided to the family during the claim and In May 2019, settlement negotiations took place and in June 2019, the Claim was settled on behalf of the Deceased’s Estate.

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