Cyclist on how being thrown off her bike by a pothole almost killed her

Kim Howard, with her electric bike in Edinburgh, is recovering after life-threatening brain injuries suffered when she crashed in October 2021.

An American cyclist has been left with a £14,000 NHS bill after suffering life-threatening injuries when she hit a pothole and was hurled from her bike.

Kim Howard required emergency surgery to stop bleeding on her brain and is now being charged by the NHS for the surgery and aftercare.

She suffered potentially fatal injuries after hitting a pothole on the A703 between Peebles and Eddleston where road users have repeatedly raised the alarm about the danger.

Howard spoke of her ordeal as the state of Scotland’s roads comes under increasing scrutiny. An estimated £1.7 billion is needed to repair the country’s roads, and last month The Sunday Post revealed how councils are paying out millions of pounds to cyclists and other road users injured in accidents linked to potholes.

Figures obtained from 27 councils revealed 1,040 personal injury claims in relation to damaged roads between 2017 and 2022 with a total compensation bill of £3.3m.

Kim Howard, who suffered a brain injury when she went over a pothole on her bike

Howard is now considering a compensation claim against Scottish Borders Council after hitting a pothole on her electric bike in October 2021.

She said: “The road is very narrow and is known for its potholes. I went out about 7am for croissants, but the road was busy because it was a mountain bike race day. I saw two drains with potholes beside them and managed to avoid the first but hit the second. The bike then hit the kerb and I landed on the path. I was knocked out and people called an ambulance.”

The book illustrator was rushed to Borders General Hospital in Melrose, where a CT scan revealed a minor brain bleed and an X-ray showed a shattered collarbone. She was released after four days, with her arm in a sling.

Two months later, exhausted from sleep deprivation due to the pain, she fainted at a bus stop in Edinburgh, injuring her head, suffering two black eyes, broken teeth and a bottom lip severed in two that required plastic surgery. She also fell from a set of ladders a week later, on Christmas Eve, attempting to turn off a smoke alarm.

A follow-up CT scan showed a large brain bleed, and Kim was rushed to Edinburgh Royal Infirmary for life-saving treatment. Surgeons drilled holes in her skull to relieve the subdural hematoma (bleeding on her brain). The operation was successful and Kim was released from hospital five days later. She has since been given a bill for £13,808, which she has begun paying at £100 a month.

She said: “I am very grateful for the exceptional care I received. My worry was that I had no insurance, and when I explained this to doctors I was told that as it was an emergency I would not be liable.

“I had suggested I fly home to the States to have surgery, but was told in no uncertain terms I was too ill and that I needed life-saving surgery. I was so shocked to receive this bill when I was told previously I wouldn’t have to pay.”

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Howard, 68, is from the US but lives six months of the year in Edinburgh, where she owns a studio flat. Before the accident, she was illustrating books on the John Muir Way and the Fife Coastal Path. She said: “I am an artist and book illustrator which allows me to me to work anywhere in the world, but my heart is here in Scotland.

“I love the country and I love the people. I’ve hiked here, I’ve kayaked here, I’ve cycled all over. But this has not only shaken me physically, but also emotionally. It is very stressful being asked to pay this amount of money, especially when I was told that I wouldn’t have to as it was an accident and I couldn’t fly home. I really hope NHS Lothian absolve me of this.

“It was a life-long wish to live in Scotland, and it would be a great sadness to me if I had to sell my flat to pay the debt and leave here.”

Jim Densham, Cycling UK’s campaigns and policy manager for Scotland, said the situation posed a genuine risk to cyclists – and was likely to get worse. He said: “Roads across Scotland are covered in potholes, which poses a real risk to many. Hit a pothole when driving and it could be an expensive trip to the garage but if you’re cycling you could end up in hospital or worse. Budget cuts to local authorities risk further underinvestment in road maintenance and means already poor roads will decline further.”

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Dr Tracey Gillies, medical director for NHS Lothian said: “NHS Lothian follows national guidance for overseas visitors who receive treatment. A&E and Observation Ward areas are free of charge to all patients however, charges may apply for further care. Ms Howard has not been charged for emergency treatment but is liable for her follow up treatment and aftercare costs.”

Scottish Borders Council said: “The council receives injury accident records from Police Scotland however, we do not appear to have any record of an accident involving a cyclist on the A703 during that period. It is therefore very difficult to comment further on the specific incident.”