Penningtons Manches' clinical negligence team has just settled a claim against Wexham Park Hospital for a failure to promptly diagnose a deep vein thrombosis (DVT). Our client was playing football when he suffered a gastrocnemius muscle tear in his right calf, causing him immediate pain and discomfort. He rested overnight but, as he was no better the following day, he went to Wexham Park Hospital A & E where he was told he had torn the muscle and needed to rest his leg.
His symptoms of pain and swelling continued and he attended a number of times on his GPs over the following few weeks. One GP arranged an X-ray that showed no abnormality but the symptoms persisted. Six weeks after the original injury, his condition had deteriorated and began to develop discolouration. The GP found the pulse in his foot was weak so telephoned a vascular surgeon at Wexham Park and explained the background and symptoms. The surgeon advised by telephone that it was unlikely our client had suffered vascular injury.
The symptoms persisted despite orthopaedic management and physiotherapy and around three months after the original injury our client sought a second opinion from an orthopaedic surgeon. The surgeon was immediately concerned our client was suffering DVT. This was confirmed by subsequent investigations.
We were approached to investigate the standard of care our client had received. We obtained and reviewed his medical notes and records which we felt supported a case against the hospital. We then sought expert opinion from a vascular consultant as to when the DVT most likely started, when it could have been detected by investigation, whether the advice from the vascular team to the GP had been appropriate, and how the delay in diagnosis of the DVT may have affected our client.
Our expert advised that the DVT probably occurred within a month of the original footballing injury and was therefore likely to have been present at the time when the GP consulted the vascular surgeon at Wexham Park. Our expert considered that it was negligent for the vascular consultant to advise our client's GP that no vascular injury had occurred without performing any examination or investigation and that the vascular consultant should have identified that the symptoms described by the GP indicated possible vascular injury, including DVT, and should have insisted that our client attended the hospital urgently for investigation.
Our expert considered that investigation at that stage would have identified DVT that could then have been treated. Instead, our client was put at significant risk of further injury for more than two months before the DVT was investigated and diagnosed. The GP, orthopaedic and physio teams all relied upon the vascular team’s advice. As a result of that delay, our client suffered more extensive damage than would have occurred with acceptable treatment and a prolonged period of quite severe symptoms.
We wrote to Wexham Park Hospital to set out the allegations of negligence in light of our expert evidence but the NHS Litigation Authority responded to deny any liability. We therefore issued and served court proceedings and made an offer to settle our client’s claim which the defendant accepted.
Andrew Clayton, associate in the clinical negligence team at Penningtons Manches LLP, who managed this case commented: “This was a case where the GP correctly identified the possibility of a vascular problem but, when he consulted the vascular team at Wexham Park, they ruled out such an injury without even seeing our client. Because of their failure to properly assess our client’s symptoms, he suffered a significant and unnecessary delay in diagnosis and treatment. Luckily this has not affected his long term outcome but the care provided was disappointing and it was fortuitous that he did not suffer further complications of an undiagnosed DVT – which could have been severe. It was also disappointing that we had to start through a court timetable before the Trust was willing to deal with the case.”