An avoidable deep vein thrombosis, complications from a bunion operation and a question of consenting to risk

Ms P had a bunion operation. She told the Trust before the operation that she had previously suffered from a DVT, but the Trust did not give her anticoagulant medication to prevent a DVT.

Twelve days after the operation, Ms P's calf started swelling and her foot was very painful to the touch. She was diagnosed with DVT and given medication to reduce the body's ability to form blood clots.

Six months later, Ms P needed a second operation after a screw in her foot – inserted during the bunion operation - had fractured. Almost three years later she had a third operation to remove the screw remnant.

Ms P's recovery was long, and she was in pain and immobile.  She lost out on almost a year's part-time earnings and she had to pay for physiotherapy, massage and home help. Ms P also said that the Trust had failed to explain the risks of a prolonged, painful and immobile period of recovery from the bunion operation, and about the possible need for further surgery.

What we found

We partly upheld this complaint. The prolonged pain that Ms P experienced was related to the bunion surgery rather than the DVT. The consent form inadequately described the risks of surgery and the procedure for getting consent was not in line with national guidance. However, taking account of Ms P's evidence, we considered on the balance of probabilities that she would have gone ahead with the operation even if she had known the risks.

Putting it right

We saw that the Trust had already given Ms P a payment to cover the cost of private therapies, two months' lost earnings and a token amount to cover the cost and inconvenience of hospital visits. It acknowledged and apologised to Ms P for not giving her an anticoagulant, given her history of a DVT.

As a result of our investigation, the Trust paid Ms P £320 to cover a further month's lost earnings (the effects of a DVT last, on average, three months rather than two). It also agreed to consider reviewing its consent forms and procedures.