A case in clinical negligence involving an orthopaedic/knee injury. Following referral for specialist investigation, including MRI scanning, the only abnormality deemed present was a possible medial meniscal tear with no medial compartmental osteoarthritis present. The claimant was referred for an investigative arthroscopy.
She was consented for arthroscopy and possible repair of any medial meniscal tear, if found. Post arthroscopy it emerged that during the procedure the clinician decided to perform a new procedure – “micro-fracture”. The Claimant had not been consented for this procedure and post surgery was given no advice on appropriate rehabilitation – use of walking sticks, crutches, immobilisation, and specialist physiotherapy.
The knee deteriorated with increased pain and instability. Proceedings were issued for the failure to properly consent in relation to micro-fracture, the surgery undertaken in any event contra indicated (the width of the area affected far exceeding the maximum prescribed for micro-fracture) and failure to properly rehabilitate.
Limited admissions were made by the Defendant, albeit the main battleground centrered on causation – which symptoms/disability related to the condition that existed pre-surgery and those which were caused by the substandard care received.
With expert input in orthopaedics and radiology, it was established that the more serious injury was that caused by the contra indicated surgery, that the damage was likely to be permanent and that in addition to unnecessary/additional pain, suffering and lost amenity, the Claimant would be unable to return to her work as a Mental Health Nurse in a secure unit, thereby incurring significant loss of earnings post-surgery, to retirement.