We have recently settled a claim on behalf of a client arising from the consequences of her local hospital’s failure to identify a left ankle fracture. The claim was very complex as our client also had an underlying connective tissue disease.
The ankle fracture was undiagnosed for six years. As a result of the delay, she had to undergo a number of surgical procedures. Three attempts were made to deal with the fracture surgically: firstly by fixing the joint and then by fusion. All three attempts failed. Our client often had to move around using crutches or a self-propelled wheelchair.
On referral to a specialist ankle and foot centre, the damage to our client’s left ankle joint was so severe that amputation was considered. The final attempt at fusion involved using an exterior frame to hold the left ankle in place while it healed. Our client had to endure several months of wearing the frame which led to more mobility problems and she had to learn how to tighten the screws on the frame to help the ankle to heal. Thankfully, the surgery was successful, but her left leg is now shorter than her right and she has no flexion in the left ankle. She has suffered permanent damage and can only put pressure on her left foot for very short periods of time. She is now a full-time electric wheelchair user with significant care and assistance needs.
The defendant admitted breach of duty and some causation in its letter of response. Proceedings were issued and the parties agreed that each party would serve their causation and quantum evidence sequentially.
Our client’s underlying condition and the effects of her ankle injury both involved aspects of orthopaedic and rheumatology care. As a result, the task of evaluating the consequences of her injury, and distinguishing these consequences from the effects of her underlying condition, was challenging. We asked our orthopaedic and rheumatology experts to work together to produce a joint approach to causation. They looked at which injuries were derived from the left ankle injury and which were from the underlying connective tissue disease. The experts also advised on how our client’s injuries would develop in the future and how her underlying condition would have developed had she not been injured.
We instructed experts in nursing and care, occupational therapy, accommodation and orthotics to assist us in quantifying the claim.
To add to the complexity of the claim, following the issue of proceedings, it became clear that the result of having to endure several years of using crutches and, latterly, transferring to and from her wheelchair, had resulted in further deterioration in our client’s condition. Her left shoulder, as well as her right foot where an earlier fracture had been left untreated, were particularly affected. As her injuries developed, we had to return to our orthopaedic and rheumatology experts to ask them to re-evaluate the claim. The damages claimed in the final schedule of loss were substantial. The main areas of dispute centred around the age at which, had she not been injured, our client would have needed a wheelchair indoors and outdoors; when she would have needed full-time care; and her accommodation needs.
The claim settled at mediation two months before trial for £2 million. Our client is now in the process of purchasing a suitable home. The award will also allow her to fund the care that she will need both now and in the future.