The clinical negligence team at Penningtons Manches Cooper has achieved a £500,000 settlement for a patient who suffered significant and debilitating injuries following total hip replacement surgery at a London North West University Healthcare NHS Trust hospital.
At the time of the claim, the claimant, Mrs M, was a very fit and active 79-year-old. She was offered a total left hip replacement to manage her severe osteoarthritis in her left hip, having trialled an unsuccessful period of conservative management with physiotherapy. Mrs M was advised to undergo a total hip replacement with a cementless cup and cemented femur prosthesis.
The procedure was performed at the North West London hospital and was overseen by a consultant orthopaedic surgeon. A specialist registrar was responsible for a section of the operation which involved reaming the acetabulum to prepare Mrs M’s hip for the placement of the prosthetic cup. Concerns were raised during this process that the acetabulum was being over-reamed and the consultant assumed control over the remainder of the surgery, during which a 52mm cup was placed into Mrs M’s hip despite the acetabulum only being reamed to 48.2mm. As a result, Mrs M suffered a major peri-prosthetic fracture of the pelvis. This was not appreciated intra-operatively, nor on the post-operative x-ray which was only reviewed after several days. In addition, fixation screws used to secure the prosthesis were misplaced within Mrs M’s hip.
Following the surgery, it was noted that Mrs M’s left leg was shorter than her right leg and was externally rotated, suggestive of left hip dislocation. The peri-prosthetic fracture was still not appreciated by the defendant, which subsequently arranged for Mrs M to be transferred to another hospital for open reduction manipulation under anaesthetic in an attempt to relocate her hip. During this procedure, the peri-prosthetic fracture was finally recognised and it was noted that the fracture had also caused loosening of the prosthetic cup. The manipulation under anaesthetic was therefore futile and Mrs M was transferred for complex reconstructive surgery. A CT scan of Mrs M’s hip revealed a complete disruption of the left total hip replacement, a complex left acetabular fracture involving the floor, anterior and posterior columns, and detached fracture fragments.
Prior to the negligence, Mrs M was an active member of her local golf club and church. She was a fiercely independent lady who took pride in her home and family life. As a result of the failed hip replacement, Mrs M suffered significant and permanent injuries. She continues to experience pain and significantly reduced mobility, requires the assistance of walking aids and is now dependent on others for most day-to-day activities. She also needs single-storey accommodation and adaptations to her home to support her impaired mobility.
Penningtons Manches Cooper was instructed to investigate a claim against London North West University Healthcare NHS Trust. An internal serious untoward incident report prepared by the defendant identified several failings by the hospital. Following receipt of supportive expert orthopaedic evidence, a pre-action protocol letter of claim was served on the defendant. Liability was subsequently admitted in full by the trust.
Despite the early admission of liability, the defendant was slow to progress the claim to a full and final settlement. Ultimately, proceedings were issued to expedite the claim given the claimant’s age and urgent need for funds to support her care package. Following judgment being entered in favour of Mrs M, the case was eventually settled out of court for £500,000. Mrs M and her family were extremely pleased with the settlement achieved and believe it will vastly improve her quality of life.
Lyndsey Banthorpe, an associate in the clinical negligence team who acted on this claim, said: “Such irreparable and permanent injuries are devastating to see, particularly so when inflicted upon such a charming and effervescent lady as Mrs M. Her injuries will have a lasting and profound effect on her way of life and I am pleased that we were able to achieve a settlement that recognises her continued tenacity in spite of her physical limitations.”