Boyes Turner’s medical negligence solicitors secured a £75,000 settlement for the family of a man who suffered a below-knee amputation after negligent hospital treatment of his broken ankle and diabetic foot ulcer. The claim was made by the injured man’s son, who took over the claim as executor of his father’s estate when his father died from unrelated causes during the investigation of the claim. Delayed removal of plaster cast after ankle fracture leads to pressure ulcer Our client was admitted to hospital after attending A&E with a left distal tibia/fibula fracture (broken ankle). During his month-long stay in hospital his fracture was treated conservatively (without surgery). His lower leg was placed in a below-knee backslab, and x-rays and a CT scan confirmed that he had a mildly displaced left fibular head (knee) fracture and spiral fractures running through the distal tibial and fibular diametaphyses of the ankle. The backslab was then replaced with a total contact cast, which was changed just before his discharge from hospital. The total contact cast was due to be removed a month later at his next fracture clinic appointment, but no plaster technician was available to remove the cast, and it remained in place for another three weeks. When the total contact cast was finally removed in the orthopaedic clinic, the orthopaedic surgeon found an area of ‘threatened skin’ over the patient’s heel and the tissue viability nurse (TVN) noted a 2cm area of black necrosis. He was given an aircast boot to use when walking and advised to remove the boot and reduce the pressure on his heel when he was sitting down. Patient with diabetes and a necrotic ulcer required urgent referral to the MDT foot care team Soon afterwards, he was admitted to hospital with a necrotic ulcer on the back of his heel. He was discharged two days later, again with an aircast boot. He was referred to the district nurses but was discharged without being seen by the acute foot care team when he was unable to accept an appointment at the clinic. His ulcer appeared to be healing when he was next seen at the fracture clinic. He was subsequently discharged from the vascular clinic and a referral was made to the diabetic foot care team. He was then readmitted to hospital after a podiatrist noted that his wound had become painful and was bleeding. An MRI scan revealed that he had osteomyelitis (serious bone infection). He was started on antibiotics but, after a short stay, was discharged. His ulcer continued to deteriorate and he underwent a through-the-knee amputation as a result of peripheral vascular disease. He never regained his mobility, and died from unrelated causes nearly two years later. Claim leads to out-of-court compensation settlement We helped our client’s son and executor pursue an amputation claim for compensation from the hospital. His father had already been receiving care for various health conditions at the time of the negligent treatment, so the claim was limited to his pain and suffering and additional care caused by the negligent treatment and his amputation. We served a letter of claim on the defendant NHS trust based on their negligent treatment of our client’s diabetic foot ulcer, which included delay in removing his total contact cast, failing to refer him urgently to the multi-disciplinary foot care clinic, failing to provide him with urgent vascular intervention, surgical debridement of his necrotic tissue and continued IV antibiotic therapy to treat his osteomyelitis. Our client had a limb-threatening diabetic foot emergency but did not receive specialist MDT foot care or follow-up community foot care in accordance with NICE guidance. Our experts believed that with timely removal of the total contact cast and correct subsequent treatment our client’s necrotic ulcer, bone infection and amputation would have been avoided. The defendant NHS trust responded with an admission of liability, and a £75,000 offer of settlement, which his family accepted. The case concluded without the need for court proceedings. If you or a family member have suffered severe injury as a result of medical negligence or have been contacted by HSSIB/MNSI or NHS Resolution you can talk to a solicitor, free and confidentially, for advice about how to respond or make a claim by contacting us.
