Damages for injuries sustained to radial artery during negligent wrist surgery at East Surrey Hospital

We settled a claim against Surrey and Sussex Healthcare NHS Trust following the alleged negligent mismanagement of our client’s orthopaedic treatment for a wrist fracture in 2002, when our client was nine years old.

We settled a claim against Surrey and Sussex Healthcare NHS Trust following the alleged negligent mismanagement of our client’s orthopaedic treatment for a wrist fracture in 2002, when our client was nine years old. 

Our client sustained an injury to his right wrist in 2001 having fallen from a tree. He was initially taken to Crawley Hospital where he was found to have suffered a displaced fracture of his right radius and a fracture of this right ulna. He was transferred to East Surrey Hospital where he underwent manipulation under anaesthetic. 

His fracture was subsequently found to have displaced again and he was admitted for open reduction and internal fixation (ORIF) surgery in August 2001, during which metal plates were fixed into place. 

The operation was a success and, following a review in May 2002, the fracture was noted to have healed. Our client was admitted to hospital for removal of the metal plate in June 2002. Following the operation, he had swelling and bruising to his right hand and wrist along with tightness in the forearm. Despite this, he was discharged from hospital. Thereafter he presented to the Accident and Emergency department on two occasions, with complaints of bleeding through the wound. He was readmitted to hospital, where it was noted that a haematoma (a collection of blood) had formed around the wound. He was then admitted for further surgery, during which it was noted that the surgeon had cut the right radial artery in three places. 

Upon the client turning 18, we were instructed by him to investigate whether the surgeon was negligent in damaging the radial artery during the removal of the metalwork or whether this would be regarded as a recognised risk of the procedure. Expert evidence was initially obtained from an orthopaedic surgeon, which concluded that, while damage to the radial artery was a recognised complication, there was a distinction between a surgeon damaging the radial artery and cutting the radial artery in three places.  

It was our expert’s view that this surgeon had performed the surgery in a substandard way by failing to identify the location of the radial artery and site the operative field sufficiently far away so that there could be no possibility of damage or, alternatively, failing to identify that he had cut the radial artery and repairing the same. It was the expert’s view that, had the surgeon taken adequate steps to protect the radial artery during the removal of the metalwork, our client would have enjoyed a short, uneventful recovery and would have avoided a wound infection and the need for further surgery. As a result of these failures, he was left with some residual weakness to the right forearm and extensive scarring which constituted a significant cosmetic disfigurement. 

A claim was presented to Surrey and Sussex Healthcare NHS Trust but the trust denied any failings in the client’s care and court proceedings were issued. Throughout the case, the trust maintained that damage to the radial artery was a recognised complication and that the surgeon had not breached their duty of care towards our client. 

Following the issue of court proceedings, we commissioned further evidence from a consultant plastic surgeon and consultant psychiatrist. The plastic surgeon commented that the scarring to our client’s right forearm was far more extensive because of the need for further surgery. The consultant psychiatrist was of the view that our client had suffered a recognisable psychiatric injury as a result of these events. 

Once proceedings were issued, the parties worked their way through the court timetable. The defendant maintained its denial of liability but, just prior to the exchange of expert evidence, the trust made an offer to settle the claim calculated according to its perceived litigation risk. The defendant upheld that this was a case that it would fight all the way to trial  but a settlement was reached after negotiations. 

This case was an interesting example of where a claimant who was a child at the time of the events, due to the Limitation rules, was able to make a decision to look at a case when they became an adult, despite the lapse of a number of years.

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