What was the case about?
We were instructed by Mrs S who was aged 79 years at the time she had surgery and 80 at the time of settlement. Mrs S had been complaining of pain in her left shoulder. X-rays confirmed she had osteoarthritis in the joint and she was referred to the upper limb clinic at the hospital. Initially she was treated conservatively with steroid injections for the pain. However this did not assist and a shoulder replacement surgery was recommended. The surgeons operating note showed no complications were encountered during the surgery. The plan was for her to have a post operative x-ray, for her arm to remain in a sling for a number of weeks and for her to undergo physiotherapy. Mrs S returned back to the ward later during the day of surgery. Her family were told that all had gone well with the operation and that she should be home in a few days. The following day Mrs S who had not been told she had to have a post operative x-ray, complained of incredible pain, an ability to move her left arm and tingling in the fingers of her left hand. She was advised this was normal following this type of operation and was prescribed increased pain killers. This continued for 2 days. She was eventually seen by a member of the orthopaedic clinical team who immediately noticed she had not had a post operative x-ray. She was sent straight away for an x-ray which revealed a fracture of the left humerus. She was taken to theatre and underwent open reduction and internal fixation of the fracture. Some 12 months following the surgery Mrs S was still left with considerable pain but now in the upper arm and lower arm and this was considered to be due to the plate used to fix the fracture irritating the nerve. Her only option was to undergo further surgery to remove the plate. Mrs S continues to receive pain management treatment.
What did we do and how did we help our client?
When Mrs S instructed us she had already been through the NHS complaints procedure and remained still uncertain of how her arm had become to be fractured. She had even been told by the hospital that she probably had caused it herself by severely banging her arm some time after the shoulder replacement surgery. This she could not accept because she knew that due to the level of pain she had she had not moved her arm significantly. In addition to being very disappointed with the outcome from the surgery due to the continuing pain she was left with a feeling of not trusting her local hospital because she could not accept their explanation as to how the fracture had been caused. We obtained public funding on her behalf. We obtained copies of her medical records and then instructed independent expert orthopaedic opinion. The independent opinion concluded that in all probability the fracture was caused at the time of the initial operation when reaming the bone to insert the prosthesis. This is a recognised complication of surgery. There was no indication to suggest the surgery had been performed below a reasonable standard of care. Indeed, the consent form Mrs S had signed included the risk of peri-prosthetic fracture, although Mrs S could not recall being advised of this. The criticism of the hospital though was the failure to perform the post operative x-ray which should either have been done at the time Mrs S was in the operating theatre following the initial surgery or at the latest the next day. Mrs S had experienced some 3 days additional pain and suffering whilst the fracture remained undiagnosed and untreated.
We negotiated a settlement, without the need to issue Court proceedings, in the sum of £3,000 plus payment of legal costs.
Mrs S was satisfied with the explanation she had received, as a consequence of bringing the legal claim, as to how the fracture had occurred.
For further information please contact Sarah Huntbach (sarah.huntbach@anthonycollins.com)