Case Report - Z v S

Accident date: 18 May 2012

Settlement date: 20 March 2018

Gross settlement: £10,000.00

The Claim

The Claimant, a child, pursued a claim for medical negligence against his GP, as a result of the delayed referral and thus diagnosis of the condition of posterior urethral valves and subsequent treatment.


A letter of claim was sent to the Defendant on the basis that the Defendant failed to record or report the result of urine samples correctly on two occasions, resulting in a failure to refer the Claimant to a paediatric nephrologist on each occasion. The Medical Defence Union provided their letter of response confirming that breach of duty was admitted but causation was disputed, and therefore liability was denied.

They alleged that the condition was congenital and thus the Claimant would have experienced damage to his kidneys from birth. They also suggested that the delay in resection of the posterior urethral valves was not likely to have played a significant part in the degree of kidney function abnormality and the subsequent delays did not make any material difference to the final kidney and bladder function.


The Claimant suffered with symptoms of urinary incontinence, offensive smelling urine and intermittent pain since around the age of 4. The issue was initially raised with his GP in March 2010. The Claimant was taken to the GP a number of times, there were episodes of suspected UTI and urine samples were taken. No action or referral was forthcoming though until he was eventually referred to hospital for further investigation over 2 years later. By that time he was suffering from abnormal bladder function and chronic renal failure secondary to late diagnosis of posterior urethral valves.

The Claimant's solicitors obtained causation and condition and prognosis reports from a medical expert supporting the claim. Although the expert maintained that he considered the delay in referral had contributed to the decline in kidney function, ultimately, he conceded that the he could not say that it had made any measurable difference in his condition, level of function or future course of treatment as a result of the negligence.

Given the Defendant's expert's opinion and the risks involved, the Claimant sought to reach settlement on the basis of the symptoms suffered and social embarrassment caused as a result of the poor bladder control during the period of delay. The Claimant was 5 years of age, attending school, it was therefore very embarrassing for him and caused anxiety. He wet his pants regularly, so needed to change clothes and he still wore a nappy at night. The Claimant also suffered episodes of stomach pains and urine infections during the period of delay.

Following disclosure of the Claimant's witness statement and settlement negotiations, the Defendant made an offer of £8,000.00. The Claimant's solicitor negotiated an increased figure and the Claimant's Litigation Friend accepted a Part 36 offer of £10,000.00 on behalf of the Claimant which was subsequently approved at Court.

Solicitor for the Claimant: Helen Reynolds for Spencers Solicitors

Insurer for the Defendant: Dr Grace Cheung for MDU Services

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