Mrs Fox attended St George's Hospital concerned that she may be having a miscarriage. She was examined and told that a miscarriage was likely and to 'let nature take its course'. During her admission, she was told off by midwives for getting out of bed to ask for an update and was told to rest and use the call bell if she needed anything.
Thankfully, Mrs Fox was not having a miscarriage and she was discharged home. At discharge, she asked if she could return to work, but was told to continue resting as she had been in hospital. She therefore spoke to her GP who signed her off work for two weeks. The hospital failed to advise her of the risk of a Deep Vein Thrombosis (DVT), that her risk was significantly increased compared to the general population given her pregnancy and as she was within 30 days of a hospital admission. She should have been told to mobilise and stay well hydrated.
A couple of weeks after discharge, Mrs Fox began to suffer from pain in her calf and attended the A&E department at St George's where she was diagnosed with a DVT. She was prescribed therapeutic doses of Low Molecular Weight Heparin for six months.
During labour, Mrs Fox began to suffer from severe back pain. This improved post-birth but worsened again after a few weeks. She spoke to her GP who referred her for physiotherapy, which didn't help. She later had a scan that showed she had in fact suffered three insufficiency fractures in her spine. She was subsequently referred to Croydon University Hospital where she was seen by an orthopaedic surgeon.
The surgeon told her that she likely had a rare form of osteoporosis called Pregnancy and Lactation Induced Osteoporosis (PLO). The Surgeon told her she could undergo a balloon kyphoplasty which involved inserting cement into the fractures. She was told to 'think of the procedure as more of an injection than an operation', and that she would walk out of the hospital the same day pain-free.
Mrs Fox was told she could have the operation the next day or face a delay since the surgeon was then going on holiday. She agreed.
The surgeon however failed to obtain her informed consent since he did not inform her about the option to undergo conservative treatment with a back brace and medication to improve her bone mineral density, which had a similar recovery to surgery. The Surgeon also failed to perform further imaging and discuss her case at a multi-disciplinary team meeting to confirm whether surgery or conservative treatment was the correct approach.
Following the balloon kyphoplasty, she awoke in incredible pain. Despite this, the team at Croydon began physiotherapy and encouraged her to mobilise. After three days, she was sent for a further scan which showed a fourth spinal fracture. She remained an inpatient at Croydon for another week before discharge home with an ill-fitting back brace.
Mrs Fox subsequently sought a second opinion and transferred her care to the Royal National Orthopaedic Hospital. A rheumatologist was surprised a kyphoplasty had been performed and that the team at Croydon had not referred for assessment before surgery.
Mrs Fox has had a slow recovery. While her fractures have healed, she now suffers from chronic pain, considered to be multi-factorial in cause. She also suffers from depression and PTSD, for which she continues to have psychiatric treatment. Her chronic pain prevents her from working as she did before the negligence, and her earnings potential has dropped significantly.
Once instructed, Jamie obtained reports from an obstetrician, haematologist, rheumatologist and neurosurgeon, who concluded that the advice to rest post-discharge was negligent and materially contributed to Mrs Fox developing a DVT, and that the therapeutic doses of LMWH required thereafter materially contributed to the development of PLO.
The neurosurgeon was also critical of the failure to obtained informed consent for the balloon kyphoplasty and the failure to obtain further imaging and discuss the case with the multi-disciplinary team. He also considered that the additional fracture was caused at some stage during or shortly before the balloon kyphoplasty, and would have been avoided had she been given the option to have conservative treatment.
Jamie subsequently sent Letters of Claim to St George's Hospital and Croydon University Hospital. Liability was denied by both defendants. Formal court proceedings were issued and served. Jamie obtained further reports from a consultant in pain medicine, a psychiatrist and a care/OT expert which allowed him to quantify the claim.
At mediation, Jamie was able to secure a seven-figure settlement for Mrs Fox. The settlement serves as acknowledgement that she did not receive appropriate treatment and will hopefully allow her to move on with her life.
Following settlement, Mrs Fox said:
"I will be forever grateful to Jamie Green for his tenacity, perseverance and unfaltering belief throughout the past 6 years. He is an incredible champion; sensitive, available, kind but also measured in his approach. He has been with me every step of the way and I always felt listened to and understood.
It has been an incredibly long journey and although it does not take away the pain and I will never get back the loss of the time with my little boy, a huge weight has been lifted and we can now look to the future with renewed hope. Thank you Jamie, from our whole family and from myself, I'm so grateful."
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