Nigel Spencer Ley achieves multi-million pound settlement in short bowel syndrome claim

Published: 25/04/2024 | News

C. v. Southampton Hospital

In 2015 Mrs. C was aged 39 and the mother of two young children.

She had suffered from problems with her hips since childhood, and had later developed back pain. These conditions had forced to retire from nursing some years earlier and limited her mobility: she used crutches inside the house and a wheelchair outside. Following the birth of her child she also developed recurrent hernias. Notwithstanding these problems, she led a full and independent life: she was able to care for her two children and to do the shopping; she had an active social life; she went on cruises with her family.

Following surgery to repair a hernia in August 2015 she developed an internal haematoma, and was admitted to the Defendant hospital for surgery to drain the haematoma. Following this surgery she developed bowel obstruction with complex volvulus (twisting of the bowel). There was a delay of several days in diagnosing her condition. By the time she came to surgery most of her bowel had become unviable. At the first operation 2.5metres of bowel was removed. At a second operation the following day, a further 40cm of bowel was removed.


Since this time the Claimant has suffered “short bowel syndrome”. She is unable to eat and digest food normally and is reliant on parenteral nutrition: she is feed by a central vein feeding line and has a high output jejunostomy.

The effect of this condition on her general health has been devastating: she has developed chronic pain and depression. Following a fall in 2018 she has been confined to bed. She is now dependent on 24-hour nursing care (provided by NHS Continuing Care). She is unable to care for her children, and has no quality of life. No significant improvement in her condition is anticipated, save that it is possible that with intensive physiotherapy she may be able to leave her bed and mobilise in wheelchair. Her life expectancy is impaired: on the Claimant’s case she will live to her early 60s, on the Defendant’s case she will only live to age 54 (she is currently aged 47).


In response to a letter of claim, the Defendant admitted that there had been a negligent delay, and that but for the delay a smaller amount of bowel would have needed to be removed. The Defendant made an offer of settlement of £120,000. Proceedings were issued in 2020. The admission was repeated in the Defence, however the Claimant was put to proof of the consequences of the delay in surgery.

In 2022 the Claimant served a Schedule of Loss valuing the claim at £14million (on a lump sum basis). The bulk of the claim related to care and case management (£10m+). The Defendant responded with a Counter Schedule valuing the claim at £2.7million. While virtually every head of loss was disputed, the Defendant’s principal argument was that as a result of her pre-existing health problems Mrs. C was likely to have become progressively more disabled and would have required substantial care in any event as she became older.


Following exchange of medical evidence and the preparation of joint statements, a settlement meeting between the parties took place in September 2023. Given the uncertainty over her life expectancy, the Claimant sought damages on a periodical payments basis. No settlement was reached, however the issues between the parties were narrowed.

A further attempt at settlement was made during a counsel-to-counsel discussion in March 2024. A settlement was reached consisting of damages of £2.55million (gross of CRU and interim payments) and periodical payments of £375,000. The Claimant gave a Peters Undertaking to cease to claim NHS funding for her care within three months of the consent order.

On a lump sum basis, depending on how long Mrs. C survives (but ignoring indexation of the periodical payments), the value of the settlement was between £4.8m and £8.1m.


Nigel Spencer Ley is ranked as a Leading Junior in the field of clinical negligence in both Chambers UK and Legal 500. He has a particular specialism in claims involving wrongful birth, viral encephalitis, Cauda Equina Syndrome, spinal injury and missed or delayed diagnosis of cancer. For more information, please contact our Clerking Team.