Patient left with uneven leg length due to surgical negligence

24 April 2024

Our client had a total right hip replacement but when physiotherapists helped her to stand the next day, one leg felt longer than the other. Her surgeon later confirmed it – following the surgery her right leg was 33mm longer than her left.

The story

Our client had a total right hip replacement but when physiotherapists helped her to stand the next day, one leg felt longer than the other. Her surgeon later confirmed it – following the surgery her right leg was 33mm longer than her left.

The details

Our client underwent a total right hip replacement as an NHS patient because she had developed painful osteoarthritis that was affecting her mobility.  The day after the operation, she was assisted to stand by the physiotherapists and immediately felt that her right leg was significantly longer than her left leg.  She was reassured by the physiotherapists and accepted their advice that things would improve with exercise. When she saw her surgeon for a post-op review, the sensation of the right leg being longer that the left had not improved.  The surgeon measured her legs and confirmed that there was a 33mm leg length discrepancy. He explained that he had used the smallest prosthesis available to him, but that the stem of the prosthesis had not gone as far into the femur as it should have done. His solution was to offer our client a left hip replacement to correct the imbalance, however as our client had no symptoms of arthritis in her left hip, she declined the offer of further surgery and instructed Shoosmiths to investigate a potential claim for clinical negligence.

How we helped

Alex Haider, Senior Associate, obtained a report from an independent consultant orthopaedic surgeon which identified several breaches of duty on the part of the operating surgeon. In particular, the report noted that the surgeon had failed to properly plan the hip replacement and that, if he had, a more appropriately sized prosthesis could have been obtained.  The independent surgeon also reported that our client did not require a left hip replacement and that it was inappropriate for her to have been offered one.

A letter of claim was sent the defendant hospital and NHS Resolution (NHSR) began investigating. Once their investigation was complete, NHSR admitted liability and asked us for settlement proposals.

While NHSR had been investigating the claim, Alex obtained further expert evidence about our client’s condition and prognosis to assist with the valuation of the claim. The orthopaedic expert assessed our client and advised on future treatment options including a raised left shoe, and revision surgery to remove the prosthesis and fit one of a more suitable size. We also obtained a report from a spinal surgeon because our client had developed significant lower back pain because of the change in her gait.  The spinal surgeon also assessed our client and arranged an MRI scan of her spine. He advised that if the discrepancy in leg length was not corrected it was likely that she would require future spinal surgery.

Fortunately, despite her mobility issues, our client had been able to remain in employment.  She had previously worked in an office setting but because of the Covid pandemic she was able to take a position that allowed her to work from home and meant she only suffered a modest loss of earnings.

Initially our decided that she did not want to have revision surgery and wanted to try adapted footwear.  Although the footwear did help, she felt self-conscious wearing it and became reluctant to go out of the house. She also felt self-conscious going out because she had a pronounced limp and had to use a walking stick. A report from a consultant psychiatrist concluded that our client had developed agoraphobia and a depressive disorder and recommended appropriate private treatment.

Our client eventually decided that she wanted to explore the option of surgery, so an interim payment was obtained from the defendant to cover the cost of a private consultation with a specialist to discuss the potential benefits and risks of further surgery. She decided that she would like to have revision surgery but wanted to defer it until her current contract of employment had come to an end.

Settlement negotiations started and our client decided to agree a settlement of more than £85,000, including future treatment costs and associate losses at the time of future treatment.

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Disclaimer

This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024

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