A County Durham NHS trust has paid £240,000 to a patient whose foot was amputated after a fractured ankle became infected. The man, who has not been named, fell in his kitchen in May 2020 and was taken to University Hospital of North Durham.
Initial Treatment and Deterioration
Doctors initially treated the fracture conservatively, applying a cast and later a 'moon boot'. However, regular X-rays showed the injury was worsening. By October 2020, five months later, the patient required complex ankle fusion surgery. After discharge, he experienced 'electric shock'-like pains, which he described as 'unbearable' by February 2021, leading to readmission.
At that point, doctors discovered an MRSA infection in his left ankle that had spread to his leg and shoulder. Life-saving surgery was necessary, and amputation was the only option. The patient said: 'I was devastated and confused, as I couldn’t understand how my ankle had deteriorated to a point that I needed such drastic life-saving surgery.'
Legal Case and Settlement
The patient pursued a legal case through Hudgell Solicitors. Lawyer Joshua Armstrong alleged that 'fixation' surgery should have been performed during the first hospital admission. The trust had been advised to postpone non-urgent elective treatment due to the Covid-19 pandemic.
County Durham and Darlington NHS Trust denied that the fusion surgery caused the infection but accepted a breach of duty of care for using a 'moon boot' in July and failing to follow MRSA decolonisation guidance in February 2021. An out-of-court settlement of £240,000 was reached.
Impact on Patient
The patient stated: 'This has been life changing for me. I struggled with the changes and no longer being able to do the things I could do before... I’ve also suffered from phantom limb syndrome... My life can never be the same.'
Mr Armstrong expressed disappointment that the trust initially denied negligence: 'We received robust supportive medical opinions from independent experts... that the orthopaedic care was substandard from May 2020 onwards... and that the fusion surgery itself introduced the infection that ultimately led to the amputation.' He added that the settlement would help the patient 'put in place care packages that he so desperately needs to improve his quality of life.'
Trust Response and Improvements
A trust spokesperson said the incident had been 'carefully reviewed' and steps taken to strengthen patient safety, including improved MRSA screening processes and increased screening rates. They also strengthened antimicrobial stewardship by introducing a specialist pharmacist for antibiotic support. The spokesperson stated: 'Every patient deserves safe, high-quality, compassionate care. We are determined to learn from this experience, continue improving our services, and do everything we can to prevent similar incidents in the future.'
