Clinical negligence claim settled against Kingston Hospital NHS Foundation Trust for cannulation failings resulting in extravasation injury

Our clinical negligence team has settled a claim for a woman who suffered an extravasation injury following alleged negligent failings by medical professionals during cannulation and the administration of contrast dye for a CT scan.

Following the removal of cancerous tissue in the claimant’s bowel, medical professionals recommended a CT abdominal and pelvis scan to ensure all cancerous tissue had been removed.

Our client underwent the recommended CT scan in July 2019. It took multiple attempts by the medical professionals to site the cannula in her arm, in order to insert the contrast dye for the scan. The cannula was finally inserted into a small vein on her right wrist. Then, contrary to their own hospital policy, the medical professionals left her alone in the scanning room for the CT scan to be performed. As the scan started, our client felt extreme pressure, pain and discomfort in her wrist. She developed immediate and significant swelling from her right elbow and into her right hand, and then quickly lost sensation from her right elbow down to her right thumb and fingertips.

Our client had sustained an extravasation injury which involved 50ml of contrast dye and 10ml of saline being injected into the tissues in her wrist around where the cannula was sited, rather than into the vein.

Following her injury, she had to undergo open carpel tunnel release surgery under general anaesthetic the following day. After the surgery, our client continued to suffer with sensitivity and pain over the scar, with shooting pains radiating up her forearm. She also experienced a complete loss of sensation in the tip of her thumb and index finger and decreased strength in the hand. Further carpal tunnel release surgery was required 15 months later, but even after this, our client unfortunately still has some permanent loss of sensation in two fingers. 

She approached our clinical negligence team due to her concerns about what had happened. We investigated and sought independent expert evidence on the issues.

The independent expert evidence obtained was of the opinion that our client should not have been left alone in the scanning room during the pre-monitoring phase of the scan, as the medical professional should have been checking whether the cannula was correctly sited, so as to minimise the risk of extravasation injury. Our expert was critical of the siting of the cannula in the claimant’s wrist and the size of the cannula for its location in a small vein.

There was also concern over whether the rate of injection of contrast dye had been properly contextualised to appreciate the type and size of cannula being used. It was our expert’s opinion that the method used was not acceptable and led to the extravasation injury.

We presented the claim to Kingston Hospital NHS Foundation Trust but all allegations were denied – the trust maintaining that the methods used were appropriate. Given the dispute and the support of our expert, we issued court proceedings to progress matters. The case remained disputed, but as the court timetable progressed the parties engaged in negotiations and reached a settlement.

Bethan Horsfield-Marrs, associate in the clinical negligence team at Penningtons Manches Cooper, comments: “Unfortunately the failings of the medical professionals during the insertion of one cannula for a single scan had quite a significant impact on our client for a number of years, and this continues to date. Given how central the use of our hands are to daily life, the loss of function and sensation in our client’s hand and wrist naturally had a wide-ranging impact, particularly on her quality of life and ability to work. Despite the lack of admissions by the NHS trust, we persevered for our client, and reached a settlement.”

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