Negligence case: BHB's $500,000 legal bill
The Bermuda Hospitals Board has been ordered to pay estimated legal costs of $500,000 after it lost an appeal in the Privy Council against a patient who won damages for negligence suffered at King Edward VII Memorial Hospital.
The board's insurers will foot the bill. The patient in question, Kamal Williams, a father of two from Southampton, said he felt “bullied” by the BHB but yesterday's outcome vindicated his decision to fight the case through the courts.
The BHB, which receives close to $150 million from the public purse annually, was ordered more than two years ago to pay $60,000 to Mr Williams in compensation for the life-threatening illness he developed after his appendix burst in May 2011.
The patient suffered damage to his heart and lungs owing to avoidable delays in operating at the hospital to remove the appendix. BHB paid the compensation but chose to appeal the court ruling to “gain legal clarity”.
Acting on the advice of medical malpractice lawyers, it took the case to the Privy Council in London, Bermuda's highest appeals court where a panel of Britain's top judges ruled in favour of the patient yesterday.
Speaking afterwards, Mr Williams, a risk analyst, told The Royal Gazette: “I am relieved and happy. Any intelligent person would have seen that it would come to this conclusion.”
He added: “People should challenge the hospital or any large entity when they feel like they have been wronged.
“They [the BHB] gambled and lost as a result of what I believe was bad advice from their insurer. This could have been settled early on, yet they continued to challenge me.
“I feel like I have been bullied, but they picked the wrong person to pick a fight with, as I don't like bullies and I stood up for what I believe in.”
Mr Williams, who is married, with two young children, has already donated $5,000 from his compensation to teenage brain cancer survivor N'Keema Virgil.
He now plans to use the rest towards his children's education.
As The Royal Gazette has previously reported, Mr Williams spent an agonising 12 hours waiting for surgery, after being taken ill with crippling stomach pains.
His operation was delayed for hours because of a string of problems at the hospital, including delays in running tests and obtaining results.
In the meantime, toxins spread throughout Mr Williams's body, triggering a heart attack and breathing difficulties.
He spent a week in the intensive care unit on a life-support machine, but has since made a full recovery.
Mr Williams sued the hospital, winning $60,000 at the Court of Appeal in Bermuda in 2013. The BHB appealed to the Privy Council, arguing that the Court of Appeal had made an error in law.
It did not ask that the patient should be stripped of his compensation. Yet, in an effort to clarify the law in Bermuda, it asked the Privy Council to agree that he deserved only $2,000, as it could not be proved that the delays caused the serious medical complications.
Yesterday, Lord Toulson, in a written ruling on behalf of five Privy Council judges, said the hospital board's negligence had indeed “materially contributed to the injury to the heart and lungs” of the patient.
Greeting the news, Mr Williams's lawyer, Jai Pachai, said the BHB contested liability despite expert medical evidence to the contrary.
“I would estimate that for this case, in which Mr Williams has received damages of approximately $60,000, legal expenses on all sides have easily exceeded $500,000,” Mr Pachai said.
“Of course, most of Mr Williams's fees have been paid by the hospital's insurers. It is a testament of Mr Williams's strength of principle and character that he has persevered with this case for a period of nearly four years.
“It is also unfortunate that the hospital, which is subsidised by the people of Bermuda and its insurers, are so intent on contesting such obvious claims instead of considering them on an objective basis and achieving a fair and reasonable resolution.”
Mr Pachai suggested that the “massive legal expense” associated with the case “will no doubt be reflected in the BHB's future premiums”.
The BHB had told the Privy Council that the Court of Appeal ruling could set a dangerous and expensive precedent if allowed to stand.
Britain's publicly funded National Health Service also wrote to the Privy Council judges, urging them to heed that concern.
Nick Rigg, communications manager for the NHS Litigation Authority, said yesterday: “We are actively considering the implications of this ruling for the NHS.”
Kamal Williams, 39, arrived at King Edward VII Memorial Hospital at 10.15am on May 30, 2011, suffering from severe stomach pain.
Screaming in agony by 11.44am, Mr Williams was seen by doctors four times before a CT scan was ordered at 1.10pm to check for appendicitis.
Further delays ensued. A technician in the diagnostic imaging department said Mr Williams would have to wait in a long queue of patients needing scans. The on-call radiologist had gone home early from work on the day in question as he was himself feeling ill. He did not answer a page from the doctor looking after Mr Williams as a result.
The scan was finally performed at 5.12pm and was sent to an overseas radiology contractor in Australia at 6.27pm for interpretation, due to the radiologist having gone home.
The results from this “out of hours” service in Australia did not arrive back in Bermuda until 7.19pm. Mr Williams was diagnosed with acute appendicitis and taken to the operating room at 9.30pm. Surgery began 45 minutes later, 12 hours after he first arrived at the hospital.
The surgeon discovered the patient had a perforated appendix and associated sepsis (toxins that had spread through his body). He was suffering heart and breathing problems.
He was admitted to the Intensive Care Unit and spent seven days on a life support machine.
Mr Williams took the Bermuda Hospitals Board to court and the case ended up at the Court of Appeal in November 2013, where the judges said Mr Williams should be paid $60,000 compensation, plus $14,400 for loss of earnings.
In November 2015, the BHB challenged that ruling at the Privy Council in London. The outcome — against the BHB and in favour of the patient — was announced yesterday.
The full ruling can be read here
