It was noted on a pre-operative x-ray that Mrs Patel had a deformity (bowing) of the bottom part of her thigh bone which would make the operation technically more difficult. The operation note referred to the bowing of Mrs Patel's femur and that "notching of femur was inevitable owing to deformity of bone."
Mrs Patel was in a lot of pain after the operation. She was unable to weight bear. A post-operative x-ray of her right knee was taken and reported a fracture in the femur above the knee replacement prosthesis. She underwent a second operation where the fracture was fixed with a pin and plate.
Unluckily Mrs Patel fell two years later, in November 2011, and suffered a further peri-prosthetic fracture of her right femur, just above the metal plate in her thigh bone. She was admitted to the same hospital and underwent surgery to reduce and fix the fracture with a metal plate.
Sam Critchley took up the fight for Mrs Patel, after being personally approached by her niece. We obtained Legal Aid to fund the claim. We secured expert evidence from a leading orthopaedic expert who said the surgeon performed the knee replacement surgery negligently in July 2008 by:
- failing properly to take into account the deformity of the Claimant’s thigh bone;
- failing properly to angle the surgical cuts so as to avoid notching of the bone (making it more likely to fracture); and
- having caused notching to the femur, failing to take appropriate steps to achieve secondary stability of the femur and prevent subsequent fracture by using a different component to bypass the defect and achieve stability or by applying a supplementary plate to protect the femur.
The hospital strongly defended the claim. They said the surgeon did take account of the bone deformity and performed the operation correctly. The Defendant argued that the operation was technically very difficult because of the femur deformity and some notching of the bone was necessary and unavoidable.
The Defendant also argued that the complication of peri-prosthetic fracture - which was communicated to the claimant during the consenting procedure - was inherent in the nature of the claimant's condition and complexity of the knee operation and there was no failure to take appropriate steps to prevent subsequent fracture.
The Defendant specifically denied that the fracture two years later was in any way related to the surgery. They blamed the second fracture on the Claimant's fall and bowed femur and argued that after a successful total knee replacement there is a high risk of fracture.
Mrs Patel continues to suffer from marked pain and discomfort in her right knee, including when sitting and at night. Her knee gives way when she walks and her walking distance is now restricted. She mobilises with a stick. These problems are compounded by the fact that the Claimant suffers from widespread osteoarthritis, affecting her hands, shoulders and her left knee. What was most upsetting for the Claimant is that she was unable to return to work. She has worked all her adult life and this gave her independence. As a result of the negligent surgery the Claimant developed moderately severe depression.
The Defendant argued that her inability to work and daily restrictions were due to her underlying osteoarthritis and nothing to do with the alleged negligence. They argued she had not been working before the operation in July 2008 and would never have returned to work in any event.
We served court proceedings in May 2012. A full Defence was received in September 2012. A trial date was fixed for March 2014 and we settled what was a hard fought case, two months before trial, in January 2014. Samantha secured £200,000 damages for Mrs Patel which went some way in removing the anxiety that she faced of an uncertain future and retirement.
Mrs Patel said, after the case:
"I was so very happy with the job that Samantha did on my case. She got more for me than I could have hoped for. Thank you"
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