The clinical negligence team at Penningtons Manches has recently settled a claim against Frimley Health NHS Foundation Trust after a patient suffered a nerve injury following the use of nerve blocks prior to her knee surgery, which she had not consented to.
The patient underwent a knee operation on 12 September 2014 at Frimley Park Hospital.
Prior to this surgery, the patient had received correspondence from an anaesthetist explaining that she had experienced a spinal headache following a nasty reaction to an anaesthetic during a previous gynaecological surgery. The anaesthetist advised the patient to provide a copy of this letter to any future anaesthetist to make them aware of her problems relating to spinal anaesthetic.
On the day of the patient’s knee surgery, she provided the letter to the anaesthetist as instructed. The anaesthetist informed her that he had been planning to give her a spinal epidural but the patient explained that she was concerned about having a reaction to this and therefore only wanted a general anaesthetic as she knew that she had not had a reaction to this in the past. She signed a consent form for the general anaesthetic before undergoing the knee surgery.
After her operation, the patient was assessed and initially her observations seemed fine. However, a few hours later she was unable to wriggle her toes and her leg was completely numb. The feeling in her leg returned after a few days, but was then replaced with extreme pain in her foot, causing her great difficulty in sleeping and moving.
At the time, the patient did not understand why she was experiencing these problems with her foot. Her treating surgeon had explained that it may be the result of a block given during surgery, but the patient had mistaken this to mean a physical block or clamp that had been used to keep her leg in place during the procedure.
Unfortunately, the patient’s pain continued and when she returned to see her treating surgeon, she was told that the problems with her foot were actually as a result of nerve blocks which had been administered prior to her surgery as a means of managing her pain. This came as a complete surprise to the patient who had no knowledge that nerve blocks had been administered, neither did she recall ever giving her consent for them to be used.
The patient instructed Penningtons Manches’ clinical negligence team, which carried out investigations as part of the claim. It was alleged that the patient had not given her consent to the nerve blocks and that they had caused her a nerve injury, leading to pain and disability in her foot.
The defendant, Frimley Health NHS Foundation Trust, denied liability on the basis that the patient was informed of the nerve blocks. It acknowledged that the medical records did not provide any evidence that the patient had been advised of the risks associated with the nerve blocks, or that she had been fully informed that they would be used. However, it was asserted by the defendant that it had supportive witness evidence that consent was obtained and a consent form with the patient’s signature on it had made reference to the word ‘block’, indicating that she had consented to their use.
While the defendant was unwilling to admit that there had been a failure to obtain the patient’s consent to the nerve blocks, it did acknowledge that the use of these nerve blocks had caused a nerve injury which had greatly impacted upon the patient’s mobility and recovery after her surgery. The trust was prepared to negotiate a settlement and a resolution for the patient was reached.
Emma Beeson, associate in the clinical negligence team at Penningtons Manches, who represented the client, notes: “It has been extremely frustrating for our client to receive details of the defendant’s denial of liability in light of the fact that she had no knowledge of the nerve blocks administered prior to her surgery in September 2014. It was a complete shock for her to find out that the reason she was suffering from immobilising pain in her foot was due to the fact that she had been given a form of pain relief to which she did not consent.
“While the defendant trust did not admit liability in this case, I hope that its willingness to negotiate with us and reach a settlement indicates that more should have been done to ensure that our client gave her consent to the use of nerve blocks and that this was properly recorded within her notes.
“Our client’s nerve injury has severely impacted her life over the last few years and stopped her from doing a number of things she hoped she would be able to do following her knee surgery, which intended to improve her mobility in the first place.”