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Error in surgical care led to compartment syndrome

by Andrea Rusbridge

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Our client, Aaj Chocken, suffered compartment syndrome in both of his legs following errors during and in his post-operative care after undergoing facial surgery at John Radcliffe Hospital in Oxford.

He was diagnosed late in life with Crouzon Syndrome. This a relatively rare genetic condition which causes the bone plates in the skull to join together incorrectly, leading to breathing difficulties, headaches and other problems with the ear, nose and throat.

Error in equipment used to prevent blood clots during surgery

Crouzon syndrome is treated with complex surgery to carefully reshape the skull. In Aaj’s case, the surgery was successfully performed, however, an error occurred with the Flowtron boots he had to wear. Flowtron boots are commonly used during lengthy operations in order to prevent blood clots and DVT in the legs while a patient is unconscious. Connected to a pump, they intermittently inflate and deflate to stimulate the flow of blood through the deep veins, pushing blood back towards the heart, mimicking how veins are squeezed by muscles when you walk.

Compartment syndrome

An error in fitting or operating the boots caused compartment syndrome, severely damaging the muscles and nerves. Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells. Compartment syndrome can be either acute or chronic. In this case it was acute.

When Aaj awoke from surgery, he found he was unable to walk. Medical staff were confused by the unexpected pain and loss of use of his legs, suggesting to Aaj in earshot of his family that ‘he was a bit lazy and wasn’t trying hard enough’. There was a delay of several days in diagnosing compartment syndrome and although surgery was eventually performed to reduce the pressure, unfortunately the damage was already done.

In the months following the surgery Aaj’s condition improved to the extent that was able to walk awkwardly on crutches, but he remained in significant levels of permanent pain. It’s remarkable and to his credit that he returned to work, even though he had to take two buses to work each morning to support his young family. However, as more time passed his mobility deteriorated and he became reliant upon a wheelchair to get around and high levels of painkillers to manage his pain.

Turning to Shoosmiths for help

The family turned to Andrea Rusbridge, a partner specialising in medical negligence claims at Shoosmiths, to investigate the care which he received at John Radcliffe Hospital. The NHS Trust quickly admitted they had been negligent in allowing compartment syndrome to develop.

The claim then looked into compensation for his lost earnings as he was forced to retire early as well as the adaptations and support he needed now and, in the future, such as personal carers, an adapted home with full wheelchair access and the ongoing medical treatment and therapies he would require.

Psychological as well as physical damage

Aside from his physical injuries, Aaj also suffered psychologically. Andrea comments:

"The family had been very active, outdoor people, frequently going camping and cycling together. One of the most distressing things for Aaj was the fact that a he could no longer engage in any sports with his children."

While litigation was ongoing, Shoosmiths researched what might be available to help improve his mental well-being and his relationship with his kids, eventually introducing him to the Phoenix Wheelchair Basketball club, which the firm has supported since 2012. The entire family have enthusiastically embraced the sport and, of course, the cost of any wheelchair basketball equipment was also included in his claim.

A settlement to help rebuild his life

This was a complicated case due to Aaj’s unusual injuries, the scale of the effect on his life and how his disabilities developed during the claim, progressively becoming worse. We achieved substantial interim payments before the claim finally settled so Aaj could begin putting support and adaptations in place to improve his life as soon as possible.

Many family friends provided supporting evidence for the claim about how Aaj had been affected. They invariably commented on how he had always been a hardworking, conscientious man who was a much-loved member of his church community.

Aaj comments:

"I was at a low ebb with everything that had happened. I couldn’t work. I couldn’t provide for my family, but the settlement has helped a lot, putting the care in place that lets me have as normal a life as possible. The continuing support and encouragement I got from Shoosmiths also gave me tremendous confidence to try new things and keep going. I’m extremely grateful to Andrea and all her team for helping me put my life back together."

A substantial settlement was reached which included annual payments for the rest of Aaj’s life to ensure he would always have the funds to pay for the care and treatment he would continue to require. Andrea Rusbridge concludes:

"It was an absolute pleasure to work with Aaj and his family. My team and I were delighted to be able to help him regain some of his independence and secure his and his family’s future."


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