Medico-legal
Drilling down into orthopaedic claims Gemma Taylor and Andy Norman The MDU recently analysed more than 400 claims notified to us in a recent five-year period by members working in independent orthopaedic practice and the issues that lie behind such claims.
Gemma Taylor was a GP partner before working for Bupa as a lead physician. She joined the MDU in 2017 and is now a high value medical claims handler, having gained qualifications in legal medicine and insurance.
W
e successfully defended 78% of the cases in this review, without paying compensation to the patient. However, a claim for clinical negligence can be brought many years after the incident occurred, often without warning. Our expert claims handlers and medico-legal advisers understand how stressful this can be and the importance of mounting a robust defence of your position. Compensation is awarded with the aim of returning the patient to the position that they would have been in had the negligence not occurred. If the injury suffered is such that the person can no longer work and requires a significant level of care, then considerable damages will be paid. The size of damages does not reflect the magnitude of the clinical error, but the injury to the patient.
Andy Norman has worked in personal injury litigation, before specialising in clinical negligence litigation initially with NHSR and at the MDU as a senior claims handler.
Reasons for claims The majority of claims files that the MDU received were due to one of four reasons: post-operative complications, delayed diagnosis, intra-operative complications and consent. Below we look at some of the most common allegations for each area.
Post-operative complications Post-operative complications featured in almost half of the claims examined. Allegations included: • Long-term pain. • Poor healing and wound infection.
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• Radial nerve damage and significant loss of function due to inadequate nerve protection during surgical fixation of the humerus. • Femoral nerve damage following knee surgery leading to reduced mobility. • Non-union of fractures due to poor surgical technique; for example, malpositioning. • The use of wrong-sized implants and the failure of surgical components post-surgery. • Inadequate post-operative wound management; for example, an above-knee amputation following total knee replacement. • Post-operative wound infection. In some cases, this led to the failure of joint replacements leading to revision surgery.
Delayed diagnosis Allegations of delayed diagnosis or referral featured in around 15% of cases. Diagnoses that were allegedly missed or delayed included: • • • • • • • •
Tendon ruptures Sarcoma Meningitis Vascular necrosis Ligament/cartilage tears Osteomyelitis Dislocations Nerve damage
Intra-operative issues Ten per cent of claims alleged poor operative technique, during the course of a procedure. Such allegations included:
