Unpredictable complication of surgery

Medical history

A 53-year-old postman underwent bilateral total hip replacement at a private hospital. After recovering from the anaesthetic he had what appeared to be a left brachial plexus palsy. This diagnosis was at first confirmed by another consultant orthopaedic surgeon with particular experience in brachial plexus injuries, but the diagnosis was then questioned when the patient was examined by a consultant neurologist. It was the neurologist's opinion that the patient had suffered a stroke, which was confirmed by a CT scan.

The claim

The patient made a claim for compensation, based entirely on allegations about faulty positioning on the operating table - a view supported by his expert.

Expert opinion

The MDU obtained independent expert opinion from another neurologist, an anaesthetist and an orthopaedic surgeon. The neurologist confirmed that it was his opinion that the patient had suffered a stroke. Both the anaesthetist and the orthopaedic surgeon confirmed that the operation had been carried out in an entirely appropriate and standard manner. While it is well-recognised that short periods of hypotension may occur during the cementing of a prosthetic joint, there was no evidence of any period significant enough to affect a fit and relatively young man with no previous history of cardio-vascular disease. The MDU's experts all agreed that the patient had been a victim of an unavoidable and unpredictable complication, occurring without clinical negligence.


The allegations about a brachial plexus injury were resisted with the support of the neurological evidence. The patient's concurrent cerebrovascular accident was specifically identified in the defence of the claim. Nevertheless, it was nearly five years after formal legal proceedings had been issued before the patient finally discontinued his action on advice from his own experts. Because the claim had been funded privately, rather than by legal aid, the two medical defence organisations concerned were able to recover their legal costs.

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