Whilst surgery may often be the most effective treatment for a medical condition, patients and their doctors all accept that surgical procedures inevitably have an element of risk. Surgeons and anaesthetists must assess each patient’s risk before they have an operation, taking into account the patient’s condition and the type of surgery that is being proposed. The patient should also be informed of known risks, such as common and serious complications of the recommended surgical procedure and reasonable alternative treatments, to enable them to give informed consent when deciding to undergo the recommended surgical procedure. If a patient suffers harm as a result of negligent surgical technique they may be entitled to compensation. Even where unavoidable complications happen, these must be properly managed for surgical and post-surgical care to be of an acceptable standard. Where avoidable injury is caused by failure to manage a surgical complication or post-operative deterioration in the patient’s condition properly, the injured patient may be entitled to make a claim for compensation. What is post-operative care? Post-operative care is the care that is given to a patient after surgery and anaesthesia. Post-operative care begins immediately after the surgery has taken place and continues during the patient’s stay in hospital and continues through additional follow-up after discharge. The aim of post-operative care is to support a patient’s recovery, manage their pain, prevent complications and to intervene quickly if signs of deterioration occur. The type of post-operative care that is required will depend on the type of surgery that has taken place, as well as the patient’s individual needs and risk factors based on their general state of health, their age and other factors, such as their past medical history. The post-operative or recovery period after surgery is a particularly risky time for a patient as their condition may change rapidly. In addition to potential complications arising from their recent surgery and its wound, they may be immobile and heavily medicated, leaving them totally dependent on their nurses and doctors to observe and monitor their condition and respond to changes in their condition with safe and timely post-operative care. What post-operative complications cause serious injury? There are many life-threatening complications which can occur in the post-operative period. They include: Shock (a rapid drop in blood pressure): There are many causes of shock, but they include blood loss, infection, spinal injury or anaphylaxis (severe allergic reaction). Treatments include giving IV blood or fluids, stopping the blood loss, maintaining a patient’s airway and administering medication to increase blood pressure. Shock is a medical emergency. Delayed treatment for shock can lead to cardiac arrest, organ damage and hypoxic brain injury. Haemorrhage (excessive bleeding caused by damage to a blood vessel): The bleeding may be internal (such as within the brain, chest or abdominal cavity) or external (such as bleeding from a wound) but it must be identified and treated urgently. A patient may require emergency surgery to identify the source of the bleeding and carry out a repair. A blood transfusion may also be necessary. Uncontrolled haemorrhage can cause fatal injury. Infection: Bacteria may cause infection at the site of a wound, or internally, at the site of the surgery. Once infection is detected, treatment with oral or intravenous antibiotics, fluids and further surgery may be required. If an infection goes untreated, it can spread rapidly to other parts of the body, including the bloodstream, and may develop into sepsis which is a medical emergency. Blood clots: After surgery, patients are at a higher risk of developing blood clots and venous thromboembolism (VTE), such as deep vein thrombosis (DVT) or pulmonary embolism (PE). The blood clot forms in a vein but may then break off and travel to other parts of the body causing serious injury, such as pulmonary embolism (lungs), thrombosis and amputation (leg), heart attack, or stroke (brain). Anticoagulants (blood thinners) may be prescribed to prevent further clots forming, and thrombolytic drugs given to dissolve those clots which have already formed. Surgery may also be required. When does negligent post-operative care lead to a claim? With appropriate care, many post-operative complications can be avoided. For example, the risk of injury to blood vessels can be reduced by use of an appropriate surgical technique, blood clots may be prevented with the use of compression stockings, and infections may be avoided with appropriate wound care. A doctor may be negligent if they fail to recognise the patient’s increased risk of a particular complication and take sensible steps to reduce the likelihood of that problem occurring. Some complications cannot be avoided, but serious injury should be prevented by healthcare teams ensuring that patients are carefully monitored post-operatively to ensure that problems are detected and dealt with promptly. What is the National Early Warning Score (NEWS) system? The National Early Warning Score (NEWS) system helps healthcare clinicians monitor and recognise deterioration in a patient’s condition. NEWS works by giving a score to six different physiological markers (respiration rate, oxygen saturation, systolic blood pressure, pulse rate, level of consciousness or new confusion, and temperature). The score indicates how far each of the six markers of the patient’s condition deviates from normal. To be effective, NEWS observations should be taken regularly, scores must be calculated correctly, and appropriate action must be taken promptly when changes in the NEWS scores suggest a deterioration in a patient’s condition. What types of medical negligence claims arise from negligent post-operative care? Boyes Turner’s medical negligence solicitors are experienced in handling serious injury claims arising from mistakes in post-operative care. Examples of some of our successful claims involving post-operative negligence include: Settlement of £1.5m lump sum plus lifelong PPO care payments of £225,000pa for a man who was left with tetraplegia when he fell from a hospital chair where he had been left to sleep after readmission with complications after spinal surgery. The fall caused a cervical spinal cord injury but his complaint of paralysis was ignored and he was hoisted into a bed and left without neurological examination or urgent cervical decompression. £750,000 settlement for a woman who suffered multiple amputations and psychological injury, after negligent treatment for post-operative sepsis and necrotising fasciitis. Her deteriorating condition was treated with inadequate antibiotics and when further surgery revealed a perforated bowel, signs of sepsis and necrotising fasciitis were mistaken for post-operative bruising. She developed septic shock, multi-system organ failure, ischaemia, brachial thrombosis and extensive peripheral vascular compromise which led to gangrene in her hands and feet and multiple amputations. £450,000 settlement for a 70-year-old man with a medical history of thrombosis and popliteal vascular disease who suffered a thrombosis, and lack of blood flow (ischaemia) to his foot requiring a below-knee amputation as a result of negligent post-operative management of his anti-coagulation medication. £200,000 settlement for the widow of a man who suffered a fatal stroke after air was allowed to enter his central venous catheter (central line) during post-operative hospital care. £185,000 settlement for a young woman who developed pressure sores as a result of negligent post-operative nursing care. £105,000 settlement for the widower of a woman who died from undiagnosed post-operative internal bleeding. Despite her known risk of bleeding, she was given an insufficient amount of fresh frozen plasma during surgery. Without post-operative surgical review her internal bleeding was not identified until it was too late to save her. £62,500 settlement after negligent post-operative care at a private hospital caused peritonitis, additional surgery and extensive scarring from wound dehiscence. If you or a member of your family have suffered severe injury as a result of negligent surgical or post-operative hospital care, or HSSIB/MNSI or NHS Resolution has contacted you, you can talk to a solicitor, free and confidentially, for advice about how to respond or make a claim by contacting us.
