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Our clinical negligence team has achieved a favourable outcome for a client by securing substantial compensation, following an inaccurate diagnosis and the failure to treat compartment syndrome.

The client approached Duncan Lewis Clinical Negligence director Rebecca Thomas and her team after he received a response to his written letter of complaint from the NHS hospital. Duncan Lewis acted under a Conditional Fee Agreement (CFA).

Background

The client, who was 17 years old at the time of the incident suffered from intermittent cramping in his right leg whilst playing in a rugby match. After the match finished, his mother telephoned 111 and he attended his out of hours GP surgery who advised him to go straight to A&E. On examination in the A&E department at Epsom & St Helier Hospital, it was noted that he had palpably tense lateral compartments “worse on stretching peroneals”. There was also noted to be reduced sensation on the superficial peroneal nerve distribution. Other nerves were noted to be normal. The initial diagnosis was recorded as lateral compression hematoma with nerve compression on a background of Chronic Exertional Compartment Syndrome (“CECS”).

The client underwent an x-ray, which was reported as normal. Blood tests were obtained, and the client was given pain relief in the form of codeine and morphine. The client’s case was also discussed with the Orthopaedic SHO, who reviewed him. The Orthopaedic SHO examined the client and recorded the following: “evolving lateral compartmental syndrome”. The client was admitted to a ward and was kept nil by mouth on the basis that he may go to theatre that morning as compartment syndrome is a medical emergency and surgery is required to prevent ischemia and necrosis.

A Consultant Orthopaedic Surgeon reviewed the client the following morning and after examining the client, he disagreed with the previous diagnoses of compartment syndrome. Rather, he considered that there was a haematoma that should be treated with elevation, ice, analgesia, and physiotherapy. The client was treated as recommended by the Consultant Orthopaedic Surgeon for a period of six days and during this time, he developed foot drop. On the 7th day after admission, a CT was taken of the lower right leg. After review, the client underwent exploratory surgery and a fasciotomy of the right peroneal compartment. The wound was left open to allow for a second look on the following day. It appears that it was at this point that the client was informed that he was, in fact, suffering from compartment syndrome.

The client underwent further surgery eight days after he was first admitted to the hospital. Following the procedure, the client was informed that the dead necrotic muscle had been excised. He was also told of the risk of permanent foot drop.

A cast was fitted and he was discharged with wound follow up at the Hospital. He was also referred to the Plastics and Orthopaedics teams at St Georges Hospital. It was not until five months post discharge that he began walking without aids. Unfortunately, the Plastics and Orthopaedic team at St Georges Hospital informed the client that the nerve damage in his right leg was such that nothing further could be done other than physiotherapy. He was also informed that no reconstructive surgery would be of benefit. The client suffered from anxiety and depression and was prescribed antidepressants. He considered that the incident affected his performance in his A-levels and was self-conscious of the hospital provided orthotic. While the client was able to play rugby post-incident, he could not play to the same level as he could prior to the negligence.
After obtaining supportive expert evidence, a letter of claim was sent to the Trust. Both liability and causation were disputed. As the defendant maintained their stance, proceedings were issued and served. Shortly after service of proceedings, the defendant made a Part 36 Offer. This is a form of offering that is used to settle all or a portion of a dispute between parties in civil litigation. This offering is governed by Part 36 of the Civil Procedure Rules (CPR). Following negotiations between Rebecca Thomas, whom represented the claimant, and the defendant, the claim concluded successfully with acceptance of the defendant’s further Part 36 Offer.

Rebecca Thomas is a Director of Clinical Negligence and Personal Injury at Duncan Lewis. She supervises a team of solicitors, trainees and paralegals who are all dedicated to obtaining the best possible outcome for our clients. In addition, Rebecca is responsible for risk assessing all of the clinical negligence and personal injury claims handled by the firm.

For advice or assistant on a clinical negligence matter, contact Rebecca Thomas via email at RebeccaT@duncanlewis.com or via telephone on 020 3114 1309.

Duncan Lewis Solicitors

Duncan Lewis' Personal Injury team offers no win no fee or fixed fee agreements, representing clients nationwide and is rated 'excellent', 'experienced and knowledgeable' by the independent legal directory, The Legal 500 UK. The personal injury team acts for clients across England and Wales and regularly acts on behalf of victims of fatal injuries and for clients who have suffered injuries that have had a detrimental impact on their lifestyle and ability to work.

We are proud of our reputation for being caring and considerate in their dealings with personal injury clients – and our specialist accident and injury lawyers are trained to go the extra mile to ensure all decisions in the claims process are made in the best interests of the client. We make sure all services reflect this attitude across the entire personal injury department – you can be assured of high quality representation in your personal injury claim at all levels, from our administration staff to our highly experienced personal injury lawyers.