VTE, thrombosis and embolism compensation claims

A blood clot which forms in a vein, where it blocks or restricts the flow of blood, is called a venous thrombosis. When part of the blood clot breaks off and moves through the bloodstream to block a blood vessel in another part of the body, this is known as venous thromboembolism or VTE.

DVT or deep vein thrombosis is a type of venous thromboembolism (VTE). Deep vein thrombosis or DVT means that a blood clot has formed in a deep vein, such as in the lower leg.

DVTs can sometimes be caused by long periods of immobility, such as sitting for hours on a long-haul flight or extended bed rest in hospital after surgery. Untreated DVT can lead to serious complications, including amputation or pulmonary embolism (PE).

Pulmonary embolism or PE is another type of VTE, which is caused when the breakaway blood clot causes a partial restriction of the blood flow or complete blockage in one or more of the arteries of the lung. Pulmonary embolism (PE) is often caused by clots which have been carried by the bloodstream from a deep vein thrombosis (DVT) in the leg.

If PE is diagnosed and treated early, the patient should make a full recovery. Delays in treating PE can lead to death or disability from heart failure, arrhythmia and cardiac arrest, and lung damage (pulmonary infarction).

Cerebral venous sinus thrombosis (CVST or CVT) is a very rare form of VTE which occurs when a blood clot blocks the large vein which drains blood from the brain. If untreated, CVT can cause brain injury from bleeding (haemorrhage) and swelling within the brain and stroke.

Air embolism, also known as gas embolism, is a dangerous condition in which a bubble of air has entered the blood circulation and blocks a vein or artery. Air embolism can be caused during surgical and anaesthetic procedures, dialysis, injections, use of intravenous cannulas or by trauma to the chest.

Air embolism blocks the blood vessel with an air bubble, unlike VTE blockages which are caused by blood clots, but has similar consequences for the patient, including stroke, heart attack, respiratory failure or death.

VTE, thrombosis and embolism injury and medical negligence claims against GPs, emergency services and hospitals often arise from one or more of the following negligent mistakes:

• failure to properly assess the patient’s risk for VTE;
• failing to carry out a full examination or consider the patient’s full medical history;
• failing to recognise signs, symptoms and complications of VTE;
• delayed or incorrect diagnosis and treatment of VTE;
• delayed referral of the patient to hospital;
• medication errors;
• delays, misinterpretation and reporting errors relating to tests, scans, and x-rays;
• ventilation errors;
• injection and cannulation errors;
• monitoring errors;
• surgical and post-operative errors;
• informed consent, safety-netting and follow-up errors;
• failing to follow national guidance.

Our personal injury team can help clients with VTE (such as pulmonary embolism) claims arising from major trauma caused by workplace, RTA or other accidents.

Medical negligence claims arising from mistakes in the prevention, diagnosis, and treatment of VTEs, thrombosis and embolisms often involve severe injury to the patient or long-term disability from:

• cardiac arrest and heart failure;
• lung damage and respiratory disability;
• amputation;
• brain injury and stroke;
• PTSD psychological injury;
• fatal injury or maternal death.

VTE affects people of any age, gender, race or ethnicity. Up to 60% of all VTEs are associated with hospital care. Guidance by the National Institute for Health and Care Excellence (NICE) requires hospitals to assess each patient’s individual risk of VTE on their admission to hospital and reassess their risk whenever their clinical condition changes.

The risk of thrombosis is increased by:

• long stays in hospital, long-term bed rest or immobility;
• surgery, especially on the pelvis, abdomen, or hip/knee replacement surgery;
• traumatic injury or major trauma;
• broken bones or injuries to a vein;
• cancer and its treatment;
• during pregnancy, birth and postnatally;
• contraceptives, especially those containing oestrogen (estrogen);
• HRT or hormone replacement therapy;
• family history of blood clots;
• being overweight (obesity);
• dehydration;
• smoking.

During and after pregnancy, the mother has a higher risk of developing venous thrombosis than someone of the same age who isn’t pregnant. The risk of pregnancy-related VTE is higher where the mother:

• has had a previous thrombosis;
• has an increased risk of blood clots from a condition called thrombophilia;
• has a family history of venous thrombosis;
• is over 35 years of age;
• is overweight ( BMI over 30);
• has pre-eclampsia;
• has just had a caesarean section;
• lost more than 1000ml (one litre) of blood during childbirth or has had a blood transfusion;
• has had more than two children;
• is immobile for long periods of time;
• is a smoker.

Venous thromboembolism (VTE) is the most common cause of maternal mortality. Reports by MBRRACE-UK and HSIB have suggested that the deaths of many of these mothers could have been avoided with better maternity care.

Maternal death can be caused by VTE at any time during pregnancy, birth and for up to six weeks postnatally. Regular VTE risk assessment is an important part of maternity care. Midwives are required to assess the pregnant mother’s individual risk of VTE at the mother’s first (booking) appointment and at 28 weeks, as well as on admission to hospital at any other time during the pregnancy. A further assessment of the mother’s risk of venous thromboembolism should take place after the birth and on any postnatal readmissions to hospital.