A claim in damages arising out of substandard clinical care whilst the patient underwent vascular surgery in the First Defendant’s Hospital, before being transferred into community care at home with the Second Defendant’s community nurses, and then into the care of the Third Defendant’s Hospital. As a result, the patient suffered grade 4 pressure sores to sacrum and feet.
Not to be disclosed.
The patient attended the First Defendant’s Hospital in February 2016 and was diagnosed with a blood clot in his right leg. It was suspected that this had been caused by a stroke/heart attack.
The patient was advised that they could either operate on the leg to try and remove the clot, or they could amputate the leg. The decision was taken to try and save the leg. The operation was initially successful and for the duration of his stay in Hospital, and despite some resistance to aspects of his nursing care, there is regularly documented wound care and pressure area care up to the date of his discharge from Hospital in April 2016 into the care of the District Nurses.
The care plan included the use of a suction pump/aspirator for the surgical wound to keep it dry and free from infection and, as he was largely bedridden, care for his pressure areas.
Unfortunately, there was a delay with delivery of the VAC Pump, it was not used regularly and then at all after it was delivered, and his pressure areas were not regularly checked and care for.
The patient’s surgical wound subsequently became infected and grade 4 pressure sores developed on his lower back and the heel and toe of his foot.
The patient was re-admitted to the Third Defendant’s Hospital in July 2016 with infection in his right leg and the pressure sores. He required an amputation of his leg because of the infection but, tragically, the amputation was not enough to prevent the infection from taking hold again; it subsequently spread to his vital organs, and the patient on 9th February 2017. The cause of death was stated to be urosepsis.
The case, which came to us in February 2019, is brought by the deceased’s daughter as executor of the estate.
We gathered all the records and had a tissue viability of TVN support a claim for breaches of duty by the Second Defendant which caused the pressure sores to the back and feet, as well as experts in plastics and vascular surgery to understand any causal link between the substandard care and the amputation and death.
Limitation was upon us, so we had issued proceedings against all three Defendant Trusts as we served a Letter of Claim upon the Second Defendant, and Letters of Notification upon the First and Third Defendants whilst we investigated any allegations to be brought against them and any additional allegations against the Second Defendant around the leg amputation.
Solicitors were instructed for all three Defendants who asked that we extend time for service of the Particulars of Claim so that our pre-action investigations and exchanges were allowed to continue.
The Defendants served a Letter of Response denying liability.
One of the more noteworthy arguments advanced was the suggestion that, because domestic carers from the local council were attending the patient’s home 4 times a day and were also supposed to be checking pressure areas, the community nurses were entitled to assume that was being done, and that they did not need to check the pressure areas themselves.
Following the condemnation of the denial from the Claimant’s nursing expert, the claim was robustly maintained, following which there were offers of settlement from the Defendants and an eventual settlement agreement reached.
For us, the outright failure of the nurses to pay any heed to the pressure areas of a bedridden patient, is almost as inexplicable as their suggestion that the duty to do so could be delegated to others.
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