Drain left in knee - negligent surgery

 

  RL

 

 And

 

 East Lancashire Hospitals NHS Trust

         

                                                       

 

CASE REPORT

 

 

Background to the claim

 

In February 2001 76 year old Mr L accidentally hit his left knee with a crow bar, badly damaging it. He already had some degenerative changes in the knee joint caused by osteoarthritis and it was decided that he required a total knee replacement, which was performed in November the same year. The results of the surgery were poor with continuing stiffness and reduced flexion and Mr L underwent manipulation of the knee under general anaesthetic on 2 occasions ( December 2001 and March 2002) Unfortunately this did not lead to any improvement and a revision of the  knee replacement was performed July 27 2002.

 

Following the second operation there was initially some improvement but this did not last long. The joint was very swollen and painful, flexion was much reduced and Mr L had great difficulty walking. He had physiotherapy but this made little difference.

 

In March 2004 further knee X-rays were taken and Mr L was lead to believe that everything was normal. In fact a large segment of wound drain can be seen on these films (expert opinion) but no action was taken.

 

Mr L continued to have problems with his knee until April 21 2006 when further X-rays were performed. These X-rays identified a foreign body in the knee that was identified as part of the drain from the revision surgery of July 2002. Mr L then underwent further surgery to remove the remnant of drain on September 25 2006 after which time the knee began to         improve.

 

Case for the claimant

Mr L claimed that had the wound drain been totally removed, as it should have been, in all probability the results of the surgery would have been reasonably good and he would have been spared 4 years of pain, anxiety and loss of amenity. He would also have avoided a third operation on his left knee.

 

Case for the defendant

The defendant Hospital Trust admitted that the entirety of the drain should have been removed a few days after the revision surgery on July 27 2002 (this is a procedure usually undertaken by a nurse) and that the failure to do so amounted to negligence.

Causation was rather less clear as the results of knee replacement surgery are not always good, particularly if there has been a revision of the original prosthesis. However, it was generally accepted that the results of the 2002 surgery would have been better to at least some degree if the drain had been fully removed.

 

Particulars of Injury

Following the revision surgery in July 2002 Mr L struggled to carry out the tasks he had previously been able to do such as gardening and assisting with household duties. He was also unable to enjoy the leisure pursuits from which he had previously obtained pleasure such as playing golf and hiking.

 

Court Proceedings

Once expert evidence in relation to causation had been obtained and considered, a settlement offer in the sum of £21,000 was made to the defendant Trust on 11^th August 2008. This offer was rejected and the defendant Trust, via the NHS Litigation Authority made a counter-offer of £12,000. Following further negotiations, settlement was agreed at £15,500, representing approximately £5,000 for special damages and £10,500 for general damages.

 

Legal Representatives

 

For the claimant

Sally Leonards

JMW Solicitors

1,Byrom Place

Spinningfields

Manchester

M3 3HG

 

For the defendant

NHS Litigation Authority