Andalusian healthcare admits negligence and must pay patient 172,000 euros

At 26 and with a severe disability caused by Lennox-Gastaut syndrome, a patient entered a Malaga hospital in June 2015 for a gastrostomy (a procedure to insert a feeding tube into the stomach). After the surgery, doctors ordered a 24-hour fast. However, "because she needed medication and was in discomfort, a nurse who had not used a feeding tube for a long time gave her the drug mixed with food after just eight hours, despite her family's objections".

From that moment, her condition deteriorated sharply: she suffered a gastric perforation, severe septic shock, several emergency operations and a multidrug-resistant infection acquired in the hospital.

The Andalusian health service (Sas) acknowledged poor medical practice and initially offered 18,078.91 euros in compensation. The family rejected that figure and took the case to court, where a first ruling awarded more than 222,000 euros. The Sas appealed, arguing that the compensation scale was wrong and that the patient's prior condition explained much of the deterioration.

The High Court of Justice of Andalucía (TSJA) resolved the most controversial points of the appeal in a ruling from February. One of the central issues is the tracheostomy (a surgical procedure to create an opening in the trachea and, through a cannula, allow air to enter and exit the lungs).

The ruling acknowledges that the patient had pre-existing conditions, but states that this specific procedure was not necessary before her hospital admission. The ruling concludes that it stemmed directly from the prolonged intubation required due to complications following the perforation and states that it "cannot be separated from the negligent act that triggered the septic condition".

The court also examined the removal of a fallopian tube. It ruled that surgeons had to perform this procedure because of the abdominal infection that followed the initial error. It added that the procedure became "essential due to the progression of the infection, directly linked to the original incident", which justifies including it in the compensation.

The judges also focused on the emotional harm the parents suffered. Beyond their daughter's physical condition, they highlighted the profound change in the family's life. The parents now provide "constant, ongoing and exclusive care", which has prevented them from working and increased their daughter's dependency. According to the court, this situation represents a clear loss of quality of life and deserves separate compensation.

One of the main legal debates centred on which compensation scale to apply. Although the events took place in 2015, before the full implementation of a specific law, the court supported using it as a reference. It stated that this system offers "a more accurate response to the current reality of harm" and avoids outdated compensation levels. It therefore rejected the Sas request to apply stricter criteria.

In its conclusions, the ruling stated firmly that the medical care "did not meet professional standards", confirming the Sas's liability. It also dismissed the argument that the patient's pre-existing conditions should significantly reduce compensation, finding a clear link between the negligence and the worsening of her condition.

The court set the final compensation, deducting the amount already paid. The patient will receive 172,779.79 euros for temporary injuries, long-term physical and psychological harm (including the tracheostomy and loss of a fallopian tube), aesthetic damage and future care costs. Her parents will receive 50,000 euros in total for the emotional harm linked to caring for a highly dependent person. The Sas must also cover legal costs.

The ruling brings to a close a case marked by the admission of medical error but also by a dispute over how to assess its consequences. The court ultimately opted for a broader valuation that reflects the real impact of the harm caused.