Settlement of claim for delayed diagnosis of DVT

We settled a claim against Wexham Park Hospital for a failure to promptly diagnose a DVT. Our client was playing football when he suffered a gastrocnemius muscle tear in his right calf, causing him immediate pain and discomfort. He rested overnight, but was no better the following day so attended A&E at Wexham Park Hospital where he was told he had torn the muscle and needed to rest his leg.

His symptoms of pain and swelling continued and he visited GPs a number of times over the following few weeks.  One GP arranged an X-ray that showed no abnormality, but still the symptoms persisted.  By six weeks after the original injury he had deteriorated and began to develop discolouration.  The GP found the pulse in his foot was weak so telephoned a vascular surgeon at Wexham Park and explained the background and symptoms.  The surgeon advised by telephone that it was unlikely our client had suffered vascular injury. 

The symptoms persisted despite orthopaedic management and physiotherapy and around three months after the original injury our client sought a second opinion from an orthopaedic surgeon. The surgeon was immediately concerned that our client was suffering DVT.  This was confirmed by subsequent investigations. 
 
We were approached to investigate the standard of care our client had received.  We obtained and reviewed his medical notes and records which we felt supported a case against the hospital.  We then sought expert opinion from a vascular consultant as to when the DVT was most likely to have started, when it could have been detected by investigation, whether the advice from the vascular team to the GP had been appropriate and what impact any delay in diagnosis of the DVT would have had. 
 
Our expert advised that the DVT probably occurred within a month of the original footballing injury and was therefore likely to have been present at the time when the GP consulted the vascular surgeon at Wexham Park.  He considered that it was negligent for the vascular consultant to advise our client's GP that no vascular injury had occurred without performing any examination or investigation. The vascular consultant should have identified that the symptoms the GP described indicated possible vascular injury, including DVT, and should have insisted that our client attended the hospital urgently for investigation. 
 
Our expert considered that investigation at that stage would have identified DVT which could then have been treated.  Instead, our client was put at significant risk of further injury for over two months before the DVT was investigated and diagnosed and the GP, orthopaedic and physio teams all relied on the vascular team’s advice.  As a result of that delay our client suffered more extensive damage than would have occurred with acceptable treatment and a prolonged period of quite severe symptoms. 
 
We wrote to the defendant to set out the allegations of negligence in light of our expert evidence, but the NHS Litigation Authority responded to deny any liability.  We therefore issued and served court proceedings and made an offer to settle our client’s claim which the defendant accepted.

Return to case studies