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Case Study

Six figure settlement for below shoulder amputation after restricted blood flow missed by Royal London Hospital

Sam was admitted to the Renal Assessment Unit at Royal London Hospital for an elective procedure for an exchange of a tunnelled dialysis line. Sam was taken to theatre at around 10am and advised it would be a 30 minute procedure, but it took around two hours. Immediately post procedure, Sam felt pain in his chest and left arm, and he brought this to the attention of the nurses.

He was given his usual oxycodone prescription. He explained that the pain in his arm was not alleviated by the painkillers. By the evening, Sam's oxycodone dose was doubled from his usual dosage, and increased to two-hourly. He continued to complain of ongoing pain.

Over the next four days, Sam repeatedly told the nurses and doctors he was in pain. He was seen by a Consultant who dismissed his concerns and advised this was normal. The Consultant did not look at nor examine Sam's arm on several occasions.

On the third day, Sam's scheduled dialysis session had to be terminated early due to the excruciating pain in his arm. By the early evening, Sam was no longer able to move his left arm below the elbow.

The following morning, in addition to the numbness and pain, Sam developed localised bruising to the area. He was taking 6 x 10mg of oxycodone, a strong painkiller, but still remained in excruciating pain.  He now had difficulties moving his arm.

On the fourth day following the procedure, a registrar attended to review Sam. The registrar noted there was no motor function and that Sam had been reporting an increasingly painful left arm. He took a detailed history and Sam explained the symptoms he had been experiencing post procedure. The registrar arranged for a CT angiogram to take place, and vascular referral.

The CT angiogram identified a blood clot and restricted blood flow in Sam's lower arm. He was advised it was unlikely to be salvageable, and the same day was taken to theatre to have surgery. He underwent an embolectomy and fasciotomy procedures. His arm could not be saved and he had an emergency below shoulder amputation the next morning.

Sam spent five days in ITU before being moved to the renal ward where he had a lengthy admission before being discharged home.

Shortly after being instructed, Arti invited the Trust to admit liability for the delay in diagnosis resulting the loss of Sam's left arm below the shoulder. Proceedings were issued and judgment was entered following the admission. The Defendant also agreed to make an interim payment to fund Sam's rehabilitation.

Sadly, Sam passed away two years after the amputation, while the case was ongoing. Arti negotiated a six-figure settlement in the case shortly after Sam's death for his wife and teenage daughter.

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For further information about surgery negligence claims, please call Arti Shah on 0207 861 4139 or email


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