Patient Advised To Have Unnecessary Hip Replacement Surgery When More Suitable Treatment Should Have Been Offered

Summary

We represented the Claimant in relation to her claim in damages arising from injury and loss sustained following a contraindicated total hip replacement.

Settlement

Liability was denied throughout the pre-action and post-issue phases of litigation, and the matter was settled at mediation 6 weeks before a listed 4-day trial.

The amount of settlement is to remain confidential.

What Happened

The Claimant had a longstanding issue with pain and discomfort around the hip region which had been resistant to some consultant-led, conservative treatment. There was uncertainty and doubt around the cause of the pain and whether it was emanating at all from the hip joint itself in the absence of any radiological evidence of a significant arthritic condition. It was for these reasons that the Claimant’s then consultant felt that a total hip replacement was contra-indicated.

The Defendant Surgeon took over the Claimant’s care in 2015 and, despite seeing radiology and MRI evidence of mild/early arthritis in the hip joint, gave the Claimant the impression that a hip replacement would be the only way of resolving the problem.

The Claimant, keen to follow his advice, asked to have her surgery as soon as possible.

The Defendant Surgeon, who was actually also rather uncertain about the cause of the pain, agreed to put her on his surgical list but called for a diagnostic ultrasound injection to be performed first to confirm whether or not the problem was coming from the hip joint.

An appointment for the injection was scheduled by administrative hospital staff but, before informing the Claimant of it, they called her to offer a cancellation slot for her total hip replacement. In doing so, the appointment for the ultrasound injection was cancelled.

The hip was replaced, and, within the Operation Note, the Defendant Surgeon recorded (rather vaguely) that he observed grade 4 arthritic changes in the joint.

Despite the joint replacement, the Claimant continued to suffer the same pattern and symptomology of hip pain.

The Claimant’s Expert Hip Surgeon asserted that:

  • the arthritic changes demonstrated on the pre-operative radiology and MRI where far too mild to explain the level of the Claimant’s symptoms;
  • no reasonably competent orthopaedic surgeon would have considered that a hip replacement should be performed on the basis of the history presented and those radiological and MRI findings;
  • the Defendant Surgeon was clearly still investigating the cause of the symptoms when he scheduled the injection and, having done that, no reasonable surgeon would have gone on to perform the hip replacement without that injection being performed to confirm that the pain was emanating from the hip and that joint replacement was likely to resolve the problem;
  • the injections would not have demonstrated a problem emanating from the hip joint or that a hip replacement was indicated; and
  • the Claimant would/should have been referred for dedicated, specialist-led pain management for future management of her condition.

The Defendant’s position was that:

  • radiological images are not conclusive on the extent of arthritis in the joint.
  • it was the Claimant who cancelled the appointment for her ultrasound injection, and, on that basis, she had made the decision to have her hip replaced without that diagnostic investigation;
  • In any event, the Defendant Surgeon recorded that grade 4 changes were found in the joint which justified the decision to replace the joint.

We resisted the suggestion that grade 4 arthritis would not have shown up on radiology – that level of anthric change presents as bone degeneration which will be seen on radiology.

There was then a factual issue over who cancelled the ultrasound injection – the Defendant suggested that the Claimant had called the Hospital to cancel them because she had been offered the hip replacement cancellation. However, that simply made no sense – there were no letters or calls to the Claimant to inform her of the ultrasound injection operation; the Claimant had no recollection of knowing about the ultrasound appointment (never mind phoning to cancel it!); she understood it to have been recommended to make sure that the hip should be replaced so would not have tried to cancel it; and the evidence produced rather suggested that it was more likely to have been the administrative staff at the hospital who cancelled the ultrasound, perhaps on the basis that an earlier-than-expected surgery slot had been found and, having assumed that the injection was purely therapeutic, considering that the surgery superseded the need for it.

However, and in any event, the Claimant’s case was that having made the decision that further diagnostic investigations were necessary before the hip was replaced, no reasonably competent surgeon would have carried on to  replace the hip regardless of who cancelled the investigative injection. We were very surprised to hear the Defendants try to argue that, in circumstances where the patient has taken the decision to abandon these further diagnostic investigations, the patient is taking the risk that the hip replacement may not be the best option, and it is then reasonable for the surgeon to provide the joint replacement on the basis that informed consent has been given. That seems to us to be an entirely wrong and rather worrying interpretation of the law in this area.

Finally, the suggestion that the alleged subsequent discovery of severe arthritis on operating could be a form of reasonable retrospective clinical assessment used justify replacement of the joint in the presence of an unsupportive contemporaneous clinical presentation, does not even warrant further analysis. It is perhaps sufficient to say that the pre-operative radiology spoke for itself and that the Defendant Surgeon would have been in some difficulty explaining his rather convenient intraoperative finding at trial……and perhaps that is why this matter settled on the lead up to trial after nearly 4 years of unconditional denial.

Contact our hip replacement claims experts today

If your hip joint replacement surgery or hospital care was negligent or you were advised to have an unnecessary hip replacement,  you could be entitled to compensation.  Contact our experts today for advice on how to make a hip injury claim and the potential compensation you could receive. We provide a ‘No Win – No Fee’ claims service so you will not incur any costs if your claim is unsuccessful*.  To start your free no-obligation case evaluation contact us today on 0333 900 8787, email admin@devonshiresclaims.co.uk or complete our online form.

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