We have secured settlement for our client who pursued a clinical negligence claim against his former private orthopaedic surgeon, Mr Sait. This is one in a series of case studies relating to procedures performed by this surgeon at Fawkham Manor Hospital.
The claim consisted of two main allegations: that Mr Sait (i) failed to obtain our client’s informed consent to treatment for his bilateral knee pain; and (ii) performed keyhole knee surgery that was very unlikely to confer upon our client a material improvement in his symptoms.
In January 2016 our client visited his GP complaining of pain in both knees. He had a history of left knee problems and arthritis had been identified during previous keyhole surgery in 2004. His GP referred him to Mr Sait for assessment and an opinion on the management of his knee symptoms.
Initially Mr Sait recommended a manipulation of our client’s knees, which he performed a week or so later. This procedure is performed while the patient is placed under general anaesthetic and the knee joints are then manipulated by the surgeon with the aim of loosening the knee and relieving symptoms of pain and stiffness (which was not a symptom about which our client complained). A steroid injection was also administered at this time.
Our client had a good temporary response to the steroid injection but his pain returned within a couple of months. At a review in March 2016, Mr Sait recommended and subsequently performed keyhole surgery on the right knee. During this procedure the patient is anaesthetised. The surgeon then enters the patient’s knee via very small incisions, and uses surgical tools to cut away built up soft tissue or perform minor soft tissue repairs. Our client’s symptoms were slightly improved after this procedure but, again, only temporarily and they returned approximately three months later.
By August 2016 our client’s knee pain had deteriorated. He returned to his GP who agreed to refer him for a further surgical opinion. Our client was unable to see Mr Sait for further management; it is understood that Mr Sait had been suspended from treating patients at Fawkham Manor Hospital by this time.
Our client was instead referred to another orthopaedic surgeon, Mr Moftah, who advised that his knee symptoms indicated a need for a total replacement of the right knee, which was then performed in February 2018. Thankfully our client experienced a very good outcome from this surgery, with no long-term symptoms or side effects.
Penningtons Manches Cooper was instructed. After obtaining and reviewing a copy of our client’s medical records, we obtained evidence from an expert knee surgeon. That expert was supportive of negligence in our client’s care; following this opinion, we sent a formal letter before claim to Mr Sait’s legal representatives.
It was alleged that Mr Sait was negligent in (i) performing a manipulation of our client’s knees in January 2016, which was inappropriate and would likely not have improved his symptoms; (ii) performing keyhole surgery that was very unlikely to improve our client’s knee symptoms in the long-term and was therefore inappropriate; and (iii) failing to obtain our client’s informed consent to both procedures.
It was alleged, based upon our expert’s opinion and our client’s evidence, that had our client been properly informed and advised by Mr Sait, he would not have undergone either the manipulation of his knees in January 2016 or keyhole surgery in March 2016. He would have avoided general anaesthetic on both occasions and the risks associated with general anaesthesia.
Mr Sait denied all of the allegations made against him in full. He argued that the manipulation procedure was a reasonable option to offer our client and was not inappropriate. He put forward that the keyhole surgery was an appropriate treatment and argued that our client’s symptoms could have been attributed to a meniscal tear, although there was no evidence of this. He also stated that on each occasion our client was appropriately advised of the alternative treatment options available, as well as the associated advantages, disadvantages, risks and benefits of each option.
Our expert remained robustly in support of our client’s case and did not accept the arguments presented by Mr Sait’s legal team. Court proceedings had already been issued because Mr Sait had delayed significantly in providing his response to the allegations. Upon receipt of our expert’s ongoing support for our client’s claim, court proceedings were subsequently served upon Mr Sait.
Mr Sait formally denied the allegations against him and the claim proceeded a reasonable way through the court timetable with both parties maintaining their respective positions. The parties disclosed documentation relevant to the claim and exchanged witness evidence. Prior to exchanging the expert evidence relating to whether the treatment and management were negligent with Mr Sait’s legal team, the solicitor for Mr Sait advanced an offer to settle the claim.
Given our client’s good response to his knee replacement surgery, with no ongoing symptoms, it was considered that the claim was of modest value. We advised our client that the defendant’s initial offer of £7,500 undervalued his claim and the offer was rejected. However, as our client was keen to achieve a settlement, he instructed us to advance an offer to settle the claim for £10,000.
After some ‘off the record’ conversations with Mr Sait’s legal team, this was ultimately accepted in full and final settlement of our client’s claim.
We are pleased to have been able to achieve a reasonable settlement for our client to compensate him for the additional pain he experienced as a result of the alleged negligence. The settlement achieved was within the range we advised our client would be reasonable and was an acceptable settlement in light of the fact that our client wished to complete the claim as quickly as possible. The parties adopted a pragmatic approach to settlement and ultimately a reasonable compromise was agreed.
Should you have concerns over the management of knee symptoms or injuries, either in an NHS or private setting, please do not hesitate to contact a member of the clinical negligence team.