Claim for Damages Following Hip Surgery

Lanyon Bowdler Solicitors acted for a claimant who brought a claim for damages for personal injuries and consequential loss arising from alleged clinical negligence. This was with respect to the treatment and advice the claimant received at The Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Trust whilst the claimant was under the care of her consultant with respect to her hip, including surgery.

The claimant’s consultant performed a periacetabular osteotomy. Periacetabular osteotomy involves performing several bone cuts and repositioning the bone at the end of the femur in the hip socket. Since the operation the claimant has suffered from serious disability. She could not walk any distance without discomfort and had to use a stick. She did very little gardening and struggled with housework and was in constant pain. She contacted us many years after the operation when she failed to have her questions adequately answered by the Trust and by then she thought she should never have had the operation.

The initial allegations of negligence summarised were as follows: -

1. Misdiagnosis of underlying symptoms;
2. Offering an operation to the claimant which she would say should not be performed on patients as old as she was and which carried a very high risk of complications;
3. Having recommended the operation to the claimant, failing to obtain properly informed consent;
4. Failing to offer alternative treatment;
5. Performing the periacetabular osteotomy.

The defendant initially argued that the claim was statute barred and brought out of time , but withdrew the limitation defence following representations from Lanyon Bowdler.

It was the claimant’s case that had she not had the operation her pre-operation symptoms (which were not major) would have continued until the age of about 60 and she would have had a total hip replacement which on the balance of probabilities would have been successful and would have left her pain free. She would then, about 10 years later, have undergone a revision hip replacement which would also have been successful and left her pain free.

As a result of the operation the claimant was significantly disabled. She continued to work but with difficulty and her ability to carry out normal household tasks greatly diminished. She would not be able to have a hip replacement operation because of the non-union of the pubis. The medical evidence obtained was that she was likely to be wheelchair bound later in life. This is something that would not have happened unless and until the second hip replacement had failed in 20 – 25 years time. The medical expert was of the view that she would need single level accommodation and that she would require significant care and attention. An Occupational Therapist visited the claimant’s property and stated that her present accommodation met neither her present nor her future needs. The claimant was described as a stoical individual

The main thrust of the claimants case was that she was not adequately consented. The case was strenuously defended throughout and listed for trial for four days at Birmingham District Registry.

This was an extremely complex case in relation to negligence and demonstrating that the negligence caused the injury. Periarticular osteotomy is a major operation, known to carry very significant risks of serious complications, and which is technically difficult to perform. Expert Orthopaedic Surgeons instructed by Lanyon Bowdler concluded that the claimant should have been warned that the success rate was likely to be low. It is a relatively rare operation carried out by few practitioners.

They also concluded that she was not properly consented. She was not apparently warned of the very high risk of complications including non-union and nerve damage (both of which she had). She was given an unrealistically high chance of improvement of pain in the hip.

With regard to causation, the defendant's own doctors carried out many investigations to attempt to identify the causes of the claimant's increased pain and disability. All accepted that they were a great deal worse than they were before the operation. Having carried out the investigations, the doctors concluded that the problems were the result of the surgery.

The defendant steadfastly refused to make any offers until weeks before trial. Following the rejection of three offers the Trust agreed to pay acceptable damages by way of an out of Court settlement to the claimant. With her damages the claimant was able to buy a bungalow making day to day living easier.