Trust Apologises After Internal Investigation Finds “Questionable Series Of Clinical Decisions” In Man’s Care

A patient has spoken of his concern after a review into upper limb operations was launched by a West Midlands hospital trust. 

Walsall Healthcare NHS Trust has apologised to Gary James after an internal report found there had been a “questionable series of clinical decisions” in his care. 

Gary, of Willenhall, underwent a partial right elbow replacement before having a full joint replacement, both at Walsall Manor Hospital. 

Two years after the full replacement he underwent two further operations - including one in which his elbow fractured - as he remained in pain and struggled to extend his arm. 

Medical negligence lawyers investigate man's elbow surgeries at Walsall Manor Hospital

After instructing expert medical negligence lawyers at Irwin Mitchell the 58-year-old has spoken for the first time about the “years of pain” he has suffered and to raise awareness of the issues he’s faced. 

It comes after a serious incident report by Walsall Healthcare NHS Trust found a number of issues in his care. 

These included “inappropriate” decision making in not promptly referring the father-of-two to a specialist centre under British Elbow and Shoulder Society (BESS) guidelines before any surgery was performed.  

The size of joint implanted during Gary’s full elbow replacement was also “incorrect” and “may have contributed to further complications”, the report added. 

Investigation into upper limb operations launched

Gary was told last year that the Trust launched an internal investigation and the Royal College of Surgeons had completed an audit into upper limb procedures such as shoulder and elbow replacements – including Gary’s. 

It is not known how many cases formed the review, whether it is still ongoing or what the outcome was.  

Medical negligence lawyer calls for lessons to be learned 

Ryan Blake, the specialist medical negligence lawyer at Irwin Mitchell representing Gary, said: “Gary had suffered years of discomfort and pain in his elbow and hoped that a referral to hospital would be the start of him receiving the care he needed to solve his issues. 

“Unfortunately the first-hand account we’ve heard from Gary and the worrying issues the Trust has identified during its own investigation indicate this didn’t happen.

“Gary has faced an incredibly difficult few years and still experiences pain and mobility issues with his elbow that affect his life.  

“While we welcome the Trust’s wider internal investigation into upper limb operations, patients like Gary will no doubt have a number of concerns about their care. 

“We call on the Trust to learn lessons from the issues it has identified in Gary’s case to improve patient care for others. It’s also vital that patients who are part of the review receive the support and answers they deserve.”

Walsall Manor Hospital elbow surgery - our client's story

Gary, a production manager who is married to Kim, 55, was referred to Walsall Manor Hospital in 2013 after experiencing five years of pain and discomfort in his elbow. 

Following a consultation he underwent partial replacement surgery that December. The following year he underwent another procedure designed to reduce pain he continued to experience. 

Gary continued to experience pain and attended another consultation at Walsall Manor in 2016, undergoing a full joint replacement in June. He continued to complain of pain. Two-stage revision surgery took place six weeks apart in October and December 2018.

An X-Ray after the surgery in October 2018 highlighted his joint had fractured during the operation. However, this was deemed to “have healed well” by the time of the second procedure, the report said.

Patient who continued to be in pain wasn't promptly referred to a specialist

Gary continued to experience pain and difficulty extending his arm. He has been told he may need further revision surgery and has been referred to a specialist orthopaedic hospital and is awaiting a further review. 

The serious incident investigation report found there was an absence of promptly referring Gary to a specialist under BESS guidelines in 2013.

The time between Gary’s first and second revision procedures in 2018 was “not enough to ensure” his fractured had suitably healed and ensure the further surgery would not worsen his condition, the report also found. 

Patient reveals concern over his care

Gary said: “I’d suffered with a pain for a number of years following a fall but I just put it down to being active. I have a physical job and enjoyed going to the gym and boxing. 

“I coped the best I could and would often take painkillers. However, it got to the point where I couldn’t go on and sought medical help. 

“I had no reason to dispute anything I was told and thought surgery would be the best option and solve my problems. 

“However, it didn’t seem to work and the pain continued despite physio and trying to let my elbow heal. There just seemed to be a lot of visits to hospital complaining about my elbow and that it wasn’t improving.

“It got to the point where I sought a second opinion. When the specialist told me he thought there was an issue with my elbow I couldn’t believe it.  

“I’ve had years of discomfort and pain and still struggle to bend my arm. You don’t realise how much you need your elbow until you struggle to move it. 

Man's recovery still uncertain after upper limb operations

“I can’t fault the care I’ve received since I was referred to a specialist. However, I still don’t know how much of a recovery I will make and it’s frustrating that I’ve been told that I’ll probably need more surgery. 

“I feel that I deserve answers as to why this has been allowed and hope that by speaking out it raises awareness to others who may be in a similar situation.” 

Find out more about our expertise at helping people following problems with surgery at our dedicated medical negligence section. Alternatively to speak to an expert contact us or call 0370 1500 100.