Ms V (Petra’s client) had complained to her GP about painful bunions and she had been referred to a podiatry service, where she was seen by an advanced podiatrist.  He noted that Ms V suffered daily pulsing and throbbing pain in her foot that was relieved upon removing her shoes.  Ms V was keen to undergo surgery and was put on a waiting list.

Bunion surgery performed

Approximately 5 months later Ms V had a left rotational Scarf and Akin procedure and when she attended clinic a couple of weeks later, she was told that x-rays showed good alignment and it would be appropriate for her to do exercises at home.  However, she found these exercises very painful and her foot began to swell.  The pain was so bad that Ms V was unable to return to work approximately 2 months after the operation.  She returned to work 2 weeks later than planned but was in so much pain that she had to stop work after 5 days.

Clinic suggests painful symptoms are caused by ‘fracture’

She attended the foot clinic again and was told she had probably suffered a stress fracture and was given an aircast boot and crutches – although x-rays did not confirm the fracture.  She was told not to work for 6 weeks and given antibiotics – despite there being no evidence of infection.

Ms V wore the boot 24 hours a day, which relieved her pain, but when she took it off for bed (as advised by a clinician), she noticed that her foot swelled and was painful.  She was then told only to wear the boot when she went outside but found the pain when she was not wearing it unbearable and she couldn’t continue the exercise she had been given previously due to the pain.

Chronic regional pain syndrome denied

When Ms V returned to work 6 weeks later, she had to reduce her hours to 4 hours a day and she was in agony when she returned from work each day.  She could barely stand and the pain disturbed her sleep.  A clinician at Nottingham University Hospital foot clinic told her she was suffering from chronic regional pain syndrome, but when she started physiotherapy, the physiotherapist disputed this.  Ms V obtained a medical report from a specialist who said that the pain was due to the original operation and that the metalwork should be removed.  Ms V visited her GP who referred her to an orthopaedic surgeon who agreed with her medical report and she underwent further surgery at Queens Medical Centre in Nottingham.  Her symptoms improved for a while, but pain returned and she now takes ibuprofen to control it.  She also wears special footwear.

Hospital denies liability

Ms V contacted Graysons to see if she could claim compensation and Petra took up her case.  She contacted Nottingham University Hospitals NHS Trust claiming that the procedure was not performed to an acceptable standard due to the choice of rotational osteotomy and the fact that the 1^st metatarsal head was not lowered. This led to unavoidable pain and suffering and degenerative changes in Ms V’s 1^st mtp joint. The hospital denied breach of duty and causation. Petra attempted to reach a settlement without the need for litigation, however, all attempts at settlement were rejected by the defendant and proceedings were issued.

This was a procedurally complex case which was listed for trial on the 6 December 2016, however Ms V was delighted that the hospital settled 6 days before trial for £18,000.

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