Facts
Kay's son was admitted to hospital with meningitis. By mistake, he was given a penicillin overdose. It was thirty times the norm. He went deaf. No case had ever been recorded where penicillin had caused deafness. Often, meningitis itself caused deafness. The first instance found in favour of the plaintiff, but this was overturned by the Court of Appeal. In the House of Lords the plaintiff argued, the overdose increased the risk of neurological damage. Deafness was damage of the same type, therefore the defendants should be liable. Lord Keith demonstrated grasp of medical knowledge by describing the facts somewhat more elaborately.
"Meningitis is a disease which causes inflammation of one or more of the three membranes which envelop the central nervous system consisting of the brain and spinal chord . The three membranes are the dura mater, the arachnoid and the pia mater. Between the arachnoid and the underlying pia mater is the subarachnoid space, which is filled with cerebro-spinal fluid (CSF). The general practitioner had treated the respiratory infection with ampicillin administered orally, but due to vomiting its therapeutic effect may have been to some extent frustrated. On admission to hospital Andrew was found to be seriously ill. He was treated with benzyl penicillin and sulphadiazine administered intravenously. A specimen of CSF was taken and sent for analysis. On the following day, 29 November, the laboratory reported that two cultures of pneumococci had been cultivated from the specimen. This led to a confirmed diagnosis of pneumococcal meningitis, a most virulent form of the disease. The consultant paediatrician in charge of the case, Dr McClure, instructed that 10,000 units of penicillin be injected intrathecally, that is to say by way of lumbar puncture into the subarachnoid space containing the CSF. The reason for this procedure was to bring about that the penicillin might most readily reach the infected meninges and attack the bacteria which were causing the disease. The injection was carried out shortly after noon on that day by Dr Adam-Strump, a senior house officer. By mistake he injected about 300,000 units of penicillin instead of 10,000 units. This rapidly produced toxic effects. The child went into convulsions and later developed a degree of hemiparesis, that is to say paralysis on one side of his body. Dr Adam-Strump realised his mistake immediately, and remedial measures were urgently instituted. These were successful in saving the child's life and by 1 December the immediate ill effects of the overdose appeared to have been surmounted. A rapid recovery from the meningitis also followed. He was discharged from hospital on 24 December. His parents before then had begun to suspect that he was suffering from deafness. This proved to be indeed the case. He was suffering and still suffers from profound bilateral deafness."
Read more about this topic: Kay's Tutor V Ayrshire & Arran Health Board
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