Successful claim against Royal Surrey NHS Foundation Trust for negligent A&E treatment after dog bite

Our clinical negligence team has recently achieved a settlement for a client who received inappropriate A&E treatment after sustaining a dog bite injury.

The claimant in this matter attended her local A&E department for treatment shortly after being bitten by a dog. During her initial attendance the wounds were X-rayed and dressed but not washed. The claimant subsequently developed a significant infection which required months of treatment to resolve through multiple hospital admissions for surgical wound wash outs, hand therapy and eventually, fusion of the MCP joint in her thumb due to cartilage damage caused by the extent of the infection. The claimant also suffered arthritis as a result of the infection. The injury sustained had a significant impact on her home and work life. 

A report from an expert in emergency medicine confirmed the care provided on the day of the injury did not meet the standard expected of a reasonable emergency medicine practitioner. Not only did the expert advise that the wound ought to have been thoroughly washed to remove contaminants, but the location of the claimant’s wounds also mandated a referral to orthopaedics for a surgical wash out given its depth and proximity to a joint and associated risks. 

Medical evidence from experts in microbiology and orthopaedics was then obtained to assess the likely trajectory of the infection and the claimant’s treatment but for the failings on behalf of the A&E team. This evidence confirmed that with appropriate treatment on her first attendance the claimant would have, on balance, required one surgical wash out procedure on the day of the injury following which the infection should have resolved with no significant issues, or the need for further treatment.
 
The claimant would therefore have avoided months of additional pain and treatment including two further hospital admissions for surgical wash out procedures, hand therapy, fusion surgery and subsequent rehabilitation as well as the arthritis associated with the infection. 

Once medical evidence was obtained, a letter of claim was sent to the defendant trust. The subsequent letter of response admitted all the allegations made in respect of breach of duty and causation. The parties therefore agreed various extensions to the limitation period to avoid the costs associated with the issuing of proceedings whilst the claim was quantified. This took additional time as the claimant required a further procedure to remove metalwork from her hand that had been required to stabilise the damaged joint.

Once the claimant’s treatment had concluded, final medical evidence was obtained and a schedule of loss prepared. The parties were then able to enter into settlement negotiations and agree a settlement before the need to issue court proceedings arose.

Laura Hanvey, an associate (FCILEx) in the clinical negligence team, comments: “This case highlights that even simple oversights in medical care, such as failing to wash a wound, can have awful consequences. The case is also a good example of how early admissions of liability can help manage the costs of clinical negligence claims. Although the claim took a while to settle after the admissions were made, due to the complexity of the medical evidence required and further treatment required by the claimant, the agreement between the parties to extend limitation meant no unnecessary costs were incurred in issuing court proceedings while evidence to quantify the claim was gathered. This also meant that the claimant could undergo further treatment in the knowledge that her claim would be successful and the only issue still to address was the final value. 

“Whilst this still involved significant input from the claimant in drafting the schedule of loss, no further work was needed on liability witness evidence or defendant expert reports which saved the claimant having to repeatedly recall any distressing events related to liability.”

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