Significant settlement obtained for BA pilot against orthopaedic surgeon Tony Andrade

Our specialist medical negligence team has achieved £450,000 in compensation for a client following negligently performed lower limb surgery.

The client was a long-haul pilot for British Airways. In 2017 he attended a surgeon with a complaint of groin pain, which had become a nuisance when he sat in the cockpit during flights for his work. After some investigations, it was suggested that he might need surgery to his hip and he was referred to the defendant, Mr Andrade.

He first attended Mr Andrade in March 2018. X-rays were taken of his hip and Mr Andrade recommended keyhole surgery to repair some torn soft-tissues lining the hip joint. That procedure was performed without complication, but our client continued to have pain in his hip and groin. At that point, Mr Andrade noted that our client’s leg was slightly rotated. He advised that the rotation of his leg may be creating increased stress on his hip, causing his pain. He recommended de-rotation surgery. Our client was a young parent. His wife was pregnant and was due to have their second child within a few months. Mr Andrade told him that the procedure was straight forward and he would recover quickly, being able to walk after two weeks. Our client was reassured by the straightforward nature of the surgery and the quick recovery and agreed to the procedure.

Mr Andrade divided our client’s tibia and fibula, rotated our client’s foot and ankle, and secured the tibia to his ankle with a fixation plate and screws.

After the procedure, our client’s outcome was materially different to what he expected based upon Mr Andrade’s advice before the surgery. He felt that his leg did not look right, with the angle of his foot appearing odd. He had a lot of pain and struggled to put any weight through his right leg without significant discomfort. Mr Andrade initially reassured our client but after he returned on two further occasions, Mr Andrade accepted that the osteotomy had failed and needed to be revised.

Further surgery was subsequently performed. Following this, our client experienced a significant infection to his ankle, which required two wash-out procedures over the next few months. Even then, our client’s ankle was not correctly positioned and was painful. He sought opinions from several expert foot and ankle surgeons, who advised that the biomechanics in his right foot had been altered.

Our client attended significant rehabilitation but his long-term outcome was materially impacted. He experienced weakness, fatigue and pain in his ankle, which increased with use. His tolerance for standing and walking was reduced, and he could no longer run or exercise as he once did. His work as a pilot was also affected significantly. His ongoing symptoms meant that his ankle was very sore and painful after returning from a long-haul flight and there were numerous opportunities for overtime that he wasn’t able to pursue because of his ongoing and permanent symptoms.

Our specialist orthopaedic team were instructed to investigate the standard of care that our client received. Supportive evidence was obtained from an expert trauma surgeon, who was of the opinion that our client was incorrectly advised pre-operatively and his informed consent to treatment was not obtained. Moreover, the expert was critical of the way in which the surgery was performed. Mr Andrade used only a small fixation plate, and held our client’s bones together with just four screws. The advice to mobilise on, in effect, a fractured ankle soon after surgery meant that the surgery would never have succeeded and our client would always have needed revision surgery. If the surgery had been performed using a more robust fixation plate and screws, with appropriate advice not to weight bear post-operatively until there were signs of healing on X-ray, then our client would have had a good outcome, without needing revision surgery or suffering infection. He would have had no symptoms in his ankle and his work would not have been affected.

Allegations of negligence were served on Mr Andrade. No Letter of Response was provided and eventually court proceedings were issued against him. In his Defence he denied the allegations that were supported by our expert, and argued that he had properly advised our client and had performed surgery to an acceptable standard.

The claim proceeded part-way through the court timetable, until Mr Andrade’s solicitor proposed the parties attend a settlement meeting. The claimant agreed, and we were able to achieve a settlement that reflected our client’s injuries and financial losses.

Arran Macleod, a senior associate in the medical negligence team, comments: “This case involved complex issues of liability and causation because of the fairly novel nature of the surgery, as well as issues relating to consent. Valuing the claim was also complicated, because of the nature of our client’s work and remuneration structure. It was important that we obtained evidence from an expert forensic accountant to carefully review and analyse our client’s earnings records so that we could seek proper compensation to reflect his earnings losses.”