We have secured a settlement for our client whose orthopaedic surgeon used incorrect components during her total hip replacement surgery causing her increased pain and the need for additional surgery. The mistake which occurred was completely preventable.
Our client was an NHS patient and attended the BMI Three Shires Hospital under the NHS’s e-Referral Service for a right total hip replacement. Before the operation took place she met the surgeon who discussed with her the risks of surgery and the frequently occurring complications. Our client consented to surgery, which was performed on 19 November 2015.
The operation note recorded that the surgeon implanted an acetabular cup and a delta protruded lip liner with internal diameter 28 mm and used a femoral head component with a 32 mm diameter, ie the femoral head was larger than the cup liner and, as a result, did not sit within the hip socket.
After the operation our client’s right hip was very painful and unstable. Within one week her hip dislocated and she had to attend A&E, where a procedure was performed to re-locate the hip. Our client’s hip continued to be painful and, three days later, dislocated again. Another procedure was performed at A&E but the doctors were, by that point, very concerned by how unstable her hip was. The following day an invasive procedure was carried out to investigate her hip and it was found that the initial surgery had been performed with incorrectly matched components. Our client required a complete revision of the hip replacement which took place a few days later.
We instructed an expert orthopaedic surgeon to review the records and report on the standard of care that had been provided to our client. He agreed that the hip was destined to fail because the surgeon had used the wrong components. Had the correct components been used then our client would likely have had a good outcome. She would have avoided the two hip dislocations and the revision surgery.
The expert also reported on our client’s outcome and prognosis. In his opinion her recovery was prolonged and the soft tissue damage as a result of the need for revision surgery caused reduced hip strength which affected her walking tolerance. It was considered that our client would need a further revision operation in the future.
We invited the BMI Three Shires Hospital to make an early admission of liability in light of this incident being classed as a 'never event'. Liability was admitted but the hospital disputed the impact of the admitted negligence on our client’s prognosis. Some protracted negotiations then took place over the value of the claim. The solicitor for the hospital made a number of low offers which were not reflective of our client’s injuries but, by disclosing our expert evidence, we were ultimately able to achieve a settlement that our client was pleased with.
Orthopaedic surgeons work in busy units but mistakenly using incorrectly matched components should never happen. The fact that the femoral component (the ‘ball’) did not fit within the acetabulum (the ‘socket’) should have been obvious. At the very least the surgeon should have noticed his mistake during surgery and revised the components there and then.
Never events are serious preventable incidents that should not occur under any circumstances. So that these types of cases are prevented, it is vital that surgeons take appropriate care in choosing the components they use during joint replacement surgery and to ensure that the joints they do choose function correctly before completing surgery.