November 2021

Aortic dissection medical negligence claims

Posted on 18 November 202128 March 2025 by Sarah O'Sullivan

Aortic dissection is a serious condition that can impact at any age.

It is essential that aortic dissection is detected early, as when treated quickly there is a very good chance of survival. Sadly, when delays in diagnosis happen it can lead to catastrophic outcomes.

Jacob Hassan was a father of two, who died after having an aortic dissection aged 62.

Jacob, a keen cyclist who regularly cycled 100 miles a week, had worked as a GP for over 30 years before taking early retirement. He lived in Cambridge with his wife, Sharon, and loved visiting his grandchildren in Indonesia and Australia.

His death followed a trip to A&E after Jacob had experienced intense chest pain. He was discharged with a diagnosis of “non-specific chest pain” without being offered the scan that would have saved his life.

What is aortic dissection?

Aortic dissection occurs when there is a partial tear in the aortic wall. The aorta is the main artery that carries blood away from the heart. If a tear develops, it can allow blood to leak into the aortic lining, which can create a false channel between the inner and outer layers.

Many of the symptoms of aortic dissection are similar to those of other heart problems like heart attacks. Usually, the first sign of an aortic dissection is abrupt and severe chest, back or abdominal pain. The sensation is often described as ripping or tearing.

How is aortic dissection diagnosed?

Aortic dissection is not common and it can also be difficult to diagnose. That’s why it’s so important to have a specialist CT scan. In Jacob’s case, this could have been performed on-site to provide a quick and definitive diagnosis. When diagnosed and treated quickly, the survival rate for aortic dissections is better than 80%.

According to the Aortic Dissection Charitable Trust, however:

33% of sufferers are misdiagnosed
2,000 people die each year from aortic dissection in the UK

Like Jacob, most patients with aortic dissection suffer sudden severe chest pain, which can settle completely after a few hours. Routine tests carried out in the Emergency Department can come back normal. Only a specialist CT aortogram can conclusively say one way or the other whether a patient has an aortic dissection.

Case study of failure to diagnose aortic dissection

Jacob’s story is tragic and his death avoidable.

On a cycle ride from Cambridge, Jacob had to pull over because he was breathless. For an experienced cyclist like Jacob, this was an unusual occurrence. That same evening, he complained of chest pains, telling his wife Sharon to call an ambulance.

By the time he arrived at Addenbrooke’s Hospital’s A&E Department his chest pain was intense. The triage nurse noted the pain was stabbing in nature and radiated to the back – both classic symptoms which should have alerted staff to the need for a CT scan.

Jacob was given painkillers and a chest X-ray but was discharged without being offered a CT scan. A common scenario with aortic dissection is that it can be dismissed because patient doesn’t seem ill enough.

The pain subsided but Jacob continued to lack energy over the next few days. Then, one evening, his wife Sharon returned home to find Jacob collapsed and unresponsive. He died later that night.

Classic signs of aortic dissection missed

The decision to discharge Jacob without offering him a CT scan, despite his unexplained chest pains, was a tragic mistake. According to the coroner, a CT scan would have led to a diagnosis of aortic dissection and saved Jacob’s life.

The Coroner’s Record of Inquest noted that “The presentation of chest pain being severe, sharp, and radiating to his back was indicative of acute aortic syndrome… and should have triggered CT aortography at the hospital which would have confirmed the presence of such a dissection.

“This would have necessitated emergency cardio thoracic surgical intervention and on balance, Jacob would have survived such a procedure.”

Cambridge University Hospital NHS Foundation Trust failed to offer a CT scan and there was also a communication issue with the A&E department not being able to access to the electronic notes of the ambulance crew.

Seeking justice and raising awareness

With the help of Partner Tim Deeming in our medical negligence team, Sharon Hassan is proceeding with her case.

Once the Coroner commenced the inquest investigations, independent experts confirmed Jacob’s death could have been avoided if the cause of severe chest pain had been thoroughly investigated.

Through the case we aim to raise awareness of the effectiveness of CT scans in identifying aortic dissection.

As Sharon said: “Unless the Health Authority has a system to offer a scan to all those presenting with chest pain that cannot be explained by a heart attack, pneumothorax or pulmonary embolism, tragedies will continue” she said. “I just want to ensure no family has to go through what mine has.”

Tim Deeming, Partner acting for the family added: “It’s vital we raise awareness through shared knowledge. As a lawyer supporting families who have had such challenging circumstances, it is through shared experiences we can improve services and learn.”

“It’s about systems and it’s about support… we hope wider training can be provided about Jacob’s circumstances and we want to create a legacy so that CT investigations for aortic dissection are considered basic and fundamental to rule out.”

Medical negligence advice and help

Our medical negligence solicitors are devoted to achieving the support our clients and families need. If you or your family has been affected by potential concerns regarding your medical care, we can support you on your journey.

NHS Litigation Reform: Tees Law submits evidence

Posted on 9 November 202130 March 2025 by Sarah O'Sullivan

In September 2021 the Government’s Health & Social Care Committee launched a new inquiry to examine the case for the reform of NHS litigation.

Our Tier 1 Medical Negligence team represents patients who have suffered avoidable harm as a result of medical accidents. The team, led by Executive Partner Janine Collier, has extensive lived experience of NHS Litigation and is passionate about improving patient safety and giving clients a voice.

Janine and her team have put forward their evidence to the inquiry as they have significant concerns and wish to ensure that patients who have suffered avoidable harm whilst under the care of the NHS are appropriately represented, their voices heard and that access to justice is not compromised.

A need to focus on culture, not costs

The NHS is the largest employer in the UK and one of the largest employers in the world. The cost of NHS litigation must be seen in this context.

Over the past four years, total payments and administration costs under NHS Resolution clinical schemes have remained steady at between roughly 1.5% and 1.6% of the total NHS budget. This is a very low percentage compared to other organisations, where indemnity costs range from 1% to 15%, with almost all over 2%.

The main way to reduce cost – both human and financial – is to reduce avoidable harm.

There is evidence of a “defensive culture”, “dysfunctional teams” and “safety lessons not learned” across the NHS and until this is addressed, lessons will not be learned, change will not be implemented, errors will continue to be not just made, but repeated. The H&SC Committee’s own report into Maternity Safety published in July identifies a culture of blame within NHS Trusts.

Our medical negligence team’s view is that it is morally unacceptable to look to introduce any kind of legal reform which impedes access to justice or appropriate compensation for those who have been injured at the hands of the NHS through no fault of their own. This includes, but is not limited to, a possible introduction of fixed recoverable costs, which would have a disproportionate effect on the most vulnerable in our society.

The full version of our evidence to the inquiry can be viewed here. The outcome of the inquiry is expected in 2022.

Capital Gains Tax on property

Posted on 1 November 202128 March 2025 by Sophie Soraf

Latest update following the budget announcement

In the Autumn Budget 2021 the chancellor avoided making increases to capital gains tax on property.

Instead he offered some good news by extending the reporting and payment deadline for UK residents disposing of UK residential property that results in a CGT liability. You now have 60 days from completion of the disposal to deliver a CGT return and pay any tax due. The deadline has also been extended to 60 days for non-UK residents required to report a direct or indirect disposal of UK land and make a payment of tax.

The change takes effect for disposals that completed on or after 27 October 2021.

What is Capital Gains Tax?

Capital Gains Tax (CGT) is a tax on the profit you make when you sell or ‘dispose of’ an asset that has increased in value since you purchased it. To clarify, you are not taxed on the full amount you make from the sale, only the profit or ‘gain’.

What does it mean to ‘dispose of’ an asset?
Disposing of an asset refers to more than just selling it, and can include:

Gifting or transferring it to somebody else
Exchanging it for another asset
Receiving compensation (e.g. an insurance payout) due to the loss or damage of the asset.

If you are organising your finances, it can be a good idea to talk things through with a wealth management expert. Tees has independent financial advisers you can ask for advice.
When do I have to pay Capital Gains Tax on the property?
You will usually be taxed on the sale of a property if it is a second home or buy-to-let property, or if you have let out part of your main residence. CGT also applies to the sale of commercial premises, land and inherited property. Certain costs, such as legal and estate agency fees, stamp duty or surveying costs, are deductible when calculating your ‘gain’.

However, under most circumstances, you won’t usually be taxed on the sale of your main home due to a tax relief called Private Residence Relief (PRR).

Call our specialist solicitors on 0808 231 1320

What is Private Residence Relief and how do I know if I qualify?
PRR will exempt the gain from CGT when you’re selling a home you have lived in as your main residence for the entire period of ownership. You must meet this and all other PRR criteria to be eligible for the relief. There are a number of scenarios that may limit your entitlement to PRR, including;

Letting out all or part of your main residence (not including having a lodger who shares the house with you)
Using part of your main residence for business purposes only
Generally, the grounds must not exceed 5,000 square metres
You must not have bought the property simply to sell it on for profit.
What are the Capital Gains Tax rules for second homeowners, and what has changed?
People selling a second home or buy-to-let property must pay CGT on any profit they make from the sale after the deduction of any allowable expenses and allowances. The taxable gain is treated as the “top slice” of your income and basic rate taxpayers will be taxed at a rate of 18%, while higher and additional rate taxpayers will be taxed at 28%. As the gain is the top slice of your income it is possible for some of the gain to be taxed at 18% with the rest a 28%.

From 6 April 2020, UK residents selling a home that is not their main residence will have 30 calendar days from the date of completion to notify HMRC of the gain on a new CGT return and pay any CGT owed. This is a significant shortening of the previous deadline; those selling a property liable to CGT prior to the start of the 2020 tax year had until the self-assessment tax return deadline of 31 January following the end of the tax year of sale to notify HMRC and pay any tax due. To highlight the magnitude of the change, taxpayers could have had up to 22 months to make their payment under the old system against just one month now.

As an example, if a property was sold on 5 April 2020, the taxpayer wouldn’t need to notify HMRC and pay CGT until the date their 2019/20 tax return was due, i.e. 31 January 2021. However, if that same property was sold on 6 April 2020, the taxpayer would only have until 6 May 2020 to complete the necessary paperwork and make their payment – a reduction of nearly nine months.

What changes have there been to Private Residence Relief?
There are special rules governing the sale of a home the taxpayer has not always lived in. In circumstances such as these, you may not qualify for full Private Residence Relief, but there may be certain periods that will qualify.

Prior to the 2020/21 tax year, provided the property had been your home at some point in your period of ownership the last 18 months before the property is sold were always eligible for the relief (whether or not the property was your main residence at that time). For sales on or after 6 April 2020, however, this relief period reduced to nine months. For people purchasing a home prior to selling their old one, this effectively halves the grace period within which you can live in your new property without paying CGT on your former home. In practice, this means taxpayers must ensure their old property is sold within nine months to avoid a potential CGT charge. This final period is extended to 36 months in certain limited circumstances, most typically where the taxpayer moves directly from the property in to a care home.

You may also get relief for any periods of absence adding up to three years, or four years if you had to live away from home in the UK for work. You’ll get relief for any period of time you were living outside of the UK for work. You must have lived in your home before and after your absence to qualify, unless work prevented you from doing so.

What about Lettings Relief?
Another important change from 6 April 2020 is the loss of lettings relief in all but extremely limited circumstances. Where a taxpayer previously qualified, this relief previously exempted up to a maximum of £40,000 of a gain from CGT in instances where a former main residence had been subsequently let out. The loss of this relief could cost some taxpayers up to an additional £11,200 in tax. Unfortunately this previously generous relief is now unavailable in most circumstances.

What qualifies as my ‘main residence’ for Capital Gains Tax purposes?
What makes a main residence is a complicated issue in tax law, very simply put it is your home. Home is of course, much, much more than simply where you live and will be relatively easy to identify in most circumstances.

If you own more than one home, you are able to nominate which property you would like to be your main, tax-free residence. This doesn’t have to be the one you live in all, or even most, of the time. You may wish to nominate the property you expect to make the most profit on when you sell it. Once you have purchased a second home, you have two years within which to nominate your main, tax-free residence.

It should be noted that if you are married or in a civil partnership, you can only nominate one property between you.

What will I need to do?
If you sell a UK residential property and a chargeable gain arises you’ll need to report the gain to HMRC on a CGT return and pay the tax within 30 days of completion. HMRC will issue penalties and charge interest if you needed to report a gain/pay tax and failed to do so.

With such a tight deadline, you’ll need to make preparations in advance to ensure compliance with the new 30-day deadline. Unless you are classed under certain categories for whom the use of digital technology cannot reasonably be expected, you are expected to make your CGT return and payment online via HMRC’s government gateway. If you don’t have a government gateway account, you’ll need to apply for one – a process which can take up to 10 working days, so this will need to be factored in. You’ll also need certain details to hand to fill in the required paperwork – these should also be gathered in advance to prevent delays and any potential penalties. The information you’ll need includes:

The date the property was acquired
Costs of purchase and disposal e.g. purchase price, legal, surveying or estate agency fees (these can normally be found on the completion statement from your solicitor)
Costs of eligible home improvements
Earnings in the applicable tax year.
To calculate your taxable gain you will need to deduct the allowable costs (be careful, not all costs are allowable) from the sale proceeds. You can then deduct any allowances calculated such as PRR. Finally, if you haven’t already used it, you can deduct your annual CGT tax-free allowance of £12,300 (2020/21).

It is this “taxable gain” that will be added to your estimated income in order to calculate the tax payable. You’ll pay CGT of 18%, 28% or a combination of the two on the remainder, depending on your tax band.

If you complete a tax return you will also need to include details of the disposal on the return as normal, paying any tax adjustment through self-assessment as normal.

Tees has a dedicated team of tax accountants that can assist you with your rental and capital gains tax reporting requirements. Please do not hesitate to contact us if you would like assistance with your tax reporting obligations.