Damages after surgeon failed to order correct components for hip replacement surgery

We have secured settlement for a client whose orthopaedic surgeon failed to ensure that the correct components used to complete his revision hip replacement surgery were available. The negligence in his case caused surgery to be abandoned and led to increased pain for our client and the need for additional surgery. The mistake which occurred was completely preventable.

Our client was an NHS patient and attended Frimley Park Hospital for a revision of his right total hip replacement, which had been implanted in 2001. Before the operation took place he met the surgeon to discuss the operation. Our client noticed that it was the same surgeon who had performed the original surgery in 2001. The surgeon knew – because he wrote in our client’s medical records – that our client had originally been fitted with an Ultima TPS hip. It was recorded in the medical records that the surgeon proposed replacing the old TPS femoral head component (the ball of the socket joint) with a matching ceramic component. Our client consented to surgery, which was performed in October 2015.

Our client approached us because, after the operation, he was told by the surgeon that there had been a problem. He was informed that the femoral head component that the surgeon had tried to use to complete the surgery did not fit on the femoral stem. The operation had been abandoned and our client was in no better position than he had been in before the surgery had taken place.

We accepted instructions and when we reviewed our client’s medical records and the note of the operation, we found that the surgeon had tried to implant a new component that was for a completely different hip joint. He did not have any alternative components available to him in the operation theatre and, therefore, the surgery had to be abandoned.

After the operation our client’s right hip was very painful. He was told by his surgeon that he needed another operation to complete the hip replacement but he would have to wait for his hip to heal. The second surgery was not performed until the middle of January in 2016 and it was a further five months before he was able to return to work as a postman.

We instructed an expert orthopaedic surgeon to review the records and report on the standard of care that had been provided to our client. He agreed that the surgeon knew – or should have known - before the date of the operation in October 2015 - that our client had an Ultima TPS hip joint. He should, therefore, have had available to him in the operation theatre a femoral head component that would fit onto the femoral stem, or have available to him sufficient components to be able to revise the entire hip joint. The surgeon’s failure to competently prepare for surgery and make sure that the right equipment to complete the surgery was available to him was negligent. Had the surgeon ordered the correct component, it was likely that our client’s surgery would have been completed on the same day and he would have had a good outcome. He would have avoided the additional operation in January 2016 along with the prolonged recovery, and he would have been able to return to work sooner.

We also instructed an expert psychiatrist whose evidence was that the negligence – which caused our client an extended period of isolation – led to him suffering a mild psychiatric injury which required treatment.

We wrote to the NHS trust setting out the formal allegations of negligence that the medical experts supported. The Letter of Response, which we eventually received a number of months after it was due, admitted negligence in our client’s care. The NHS trust acknowledged that the surgeon should have made sure that the correct components to complete the surgery were available to him. It was admitted that the negligence caused our client to require an additional hip operation caused him a prolonged recovery and caused him to suffer lost earnings. The defendant did not accept that the negligence had caused our client to suffer a psychiatric injury.

Some protracted negotiations then took place over the value of the claim. The solicitor for the hospital made a number of low offers which were not reflective of our client’s injuries but, by disclosing our expert evidence, we were ultimately able to achieve a good settlement for our client.

Analysis

Despite orthopaedic surgeons working in busy units, appropriate care needs to be taken when the surgeon is ordering the components that he will need to complete the procedure. In this case the surgeon recorded in the medical records – and he therefore knew - which components he needed to order for our client’s surgery, but ordered the wrong components.

Our client’s surgery was elective and the surgeon had time before the date of the procedure to order and check that the correct components would be available to him on the date of surgery. He didn’t and this was an incident that was completely avoidable.

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