Vascular surgery cases
K v. Ealing General Hospital NHS Trust
On 23 March 1999 K, aged 35, attended the A&E Department at
Ealing General Hospital following the sudden onset of a tingling
sensation in her left arm associated with the veins in the arm
becoming very prominent. She was seen and examined by an SHO in
A&E who concluded that K had a musculo-skeletal problem and
advised Brufen and rest. In fact K was suffering from axillary vein
thrombosis probably attributable to an oral contraceptive.
On 23 March 1999 K, aged 35, attended the A&E Department at
Ealing General Hospital following the sudden onset of a tingling
sensation in her left arm associated with the veins in the arm
becoming very prominent. She was seen and examined by an SHO in
A&E who concluded that K had a musculo-skeletal problem and
advised Brufen and rest. In fact K was suffering from axillary vein
thrombosis probably attributable to an oral contraceptive.
The following day, K described her signs and symptoms to a
physiotherapist who diagnosed a blood clot and not a trapped nerve.
T consulted her GP who diagnosed an axillary vein thrombosis and
referred her back to Ealing General Hospital. After a delay of
several hours she was admitted and anticoagulant therapy
commenced.
K was seen by a vascular surgeon on 7 September 1999 and he
advised intravenous thrombolysis of a blockage of the left axillary
vein followed by resection (i.e. removal) of her first left rib to
prevent recurrence of the thrombosis.
He carried out the operation under general anaesthetic on 30
September 1999. However, instead of removing K’s first rib he
removed her second rib in error.
The first rib was therefore removed by way of a second operation
later that day.
The surgery led to recurrent pain in the left pectoral muscles
and recurrent aches and pains over the left posterior neck and
shoulder muscles along with discomfort on the left shoulder and
back, decreased sweating in the left axilla, a 5.5cm scar on the
left axilla and restricted upper left chest function.
Proceedings were issued on 18 March 2002 supported by a positive
report from a consultant surgeon. He was critical of the failure in
the A&E Department to make the correct diagnosis and contended
the delayed diagnosis had a marked effect on her loss of
respiratory function.
In addition, the expert was highly critical of the decision to
undertake surgery at all and critical of the wrong rib being
removed and that a second operation took place when K was not in a
position to provide informed consent.
Richard Earle listed the case for
trial on 6 March 2006. Following discussions between the surgeons
(instructed by both parties), the Defendant maintained its stance
that the surgery was carried out appropriately and it was not
unreasonable to mistakenly remove the second for the first rib.
On the morning of the trial the Defendant made an offer of
£75,000. Following negotiations at the Court door the case was
settled in the sum of £125,000 damages.
The case was taken with the benefit of Legal Aid.