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This is a real life case study of a joint replacement claim we have recently won. Our medical negligence team summarises the details.
The claimant underwent surgery for a right little finger joint replacement and joint fusion to her index finger. She was provided with very little in the way of post-operative rehabilitation as a result of the lack of instructions in surgeon’s post-operative notes. No post-operative x-rays were taken of the little finger to confirm the positioning of the joint implant or assess the success of the operation.
When the claimant’s cast was removed, she noticed that her little finger immediately fell to the side at the knuckle sitting beyond a right angle to the base of her finger. She was given little guidance in respect of rehabilitation exercises and was provided with a buddy strap and finger splints. Following several months of splinting, the finger remained deviated and was noted to be catching when it was out of strapping.
She sought further medical assistance and was informed that the only option to resolve her issue would be to amputate the finger. However, a further consultation with a consultant surgeon confirmed that the procedure could be performed again, but this time they would fuse the joint rather than replace the joint implant. The claimant was told she would lose movement in the little finger, but it would resolve the deviation and pain issues she was experiencing. The claimant understandably decided that she did not wish to undergo further surgery at the Trust.
The claimant was therefore left with her finger falling at a right angle from the knuckle whenever it was not strapped to her ring finger. This made daily life difficult and painful for her.
Our team was able to assist her on a no win, no fee basis. We obtained her full hospital records and a detailed investigation of the her medical history was carried out, including:
- her attendance at the same hospital several years earlier when she was informed that she would require fusion surgery to the same little finger;
- the consent discussion prior to the joint replacement surgery;
- the standard of the surgery itself; and
- the after care and rehabilitation procedure.
A medico-legal report was obtained from a consultant orthopaedic surgeon specialising in hand surgery which established that, on balance, the hospital trust had:
- failed to obtain informed consent from the claimant ahead of the surgery;
- the surgery was not carried out to a reasonable standard; and
- they failed to manage her rehabilitation procedure due to a lack of instructions from the surgeon.
A further expert report was obtained from a specialist hand therapist to establish whether the standard of rehabilitation care caused or contributed to the failure of the joint.
We sent a Letter of Claim to the Trust setting out the allegations against them. It was argued that if the Trust had informed the claimant of the risk of further deviation or failure of the implant, she would not have undergone the surgery. In addition to this, we argued that the post-operative instructions were substandard, such that the hand therapist did not know what procedure had been performed or how to treat it. The claim was strongly defended by the Trust, leading the claimant to instruct a barrister and issue the claim in court.
Following a case conference with the barrister, the claimant and the experts, it was identified that the strengths of the case were the failings of the Trust in the standard of consent for the procedure, failure to provide adequate post-operative handover and thereafter failure to provide a suitable hand therapy regime.
Having issued legal proceedings the Trust swiftly entered into settlement negotiations, leading to a compensation package being agreed in an out of court settlement.