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22 May 2020

Delayed Diagnosis of Necrotising Fasciitis

In this case, the Claimant, who as a result of the Defendant’s negligence, suffered a delay of some 24 hours in the diagnosis of the flesh-eating disease, necrotising fasciitis, which was a significant delay in consideration of the Claimant’s pre-existing diabetes which was known to exacerbate the disease. It was alleged that the delay could have been avoided but for the negligence of the Defendant.

The negligence of the Defendant Trust had long lasting impact on the Claimant, who suffered awful physical injury as well as psychiatric symptoms. As a result of the negligence, the Claimant was diagnosed with post-traumatic stress disorder and her time in hospital affected her everyday life. The Claimant developed extreme anxiety as a result of the Trust’s negligence and became very worried of contracting another infection as her doctors were unable to give explanation of how the necrotising fasciitis was caused. 

Circumstances surrounding the claim arose when the Claimant consulted her GP with extensive painful red areas to her groin (extending across her right flank) and flu-like symptoms. The Claimant’s GP conferred with a colleague about the presenting symptoms and it was decided to urgently refer the Claimant to Hospital. The Claimant’s GP specifically mentioned in their letter of referral the possibility of an abscess of necrotising fasciitis. The admitting Dr noted the possibility of necrotising fasciitis in the admission note but no imaging was taken on the day of the Claimant’s admission to hospital.

It was not until the next day when a junior doctor reviewed the CT scan imaging at 6:30pm and identified necrotising fasciitis and the Claimant was noted for surgical review as she required urgent debridement of the diseased flesh. She underwent surgery to remove the dead tissue, skin, fat and necrotic purulent gas gangrene and to clear bleeding tissue.

The Claimant was then admitted to intensive care but developed then pneumonia. The Claimant remained in hospital and received regular dressing care with the assistance of tissue viability nurses and physiotherapy to help with her mobility and recovery. 

She remained in hospital for nearly 3 weeks. Furthermore, as the skin in the area of the wound site became tight and as the Claimant tired more easily, she was unable to work long hours which led to her losing her position in her previous job role as a care assistant.

 In a medical report, our expert physician alleged on behalf of the Claimant that the Defendant Trust was in breach of duty by delaying the imaging requested by four doctors to rule out an abscess or necrotising fasciitis once the Claimant had been admitted until eventual diagnosis some 24 hours later. This breach occurred as no reasonable and competent body of medical practitioners would have failed to have taken imaging of the Claimant on the day of her admission to hospital. Further, the Trust fell below a reasonable standard of care when they failed to send the Claimant for a CT scan in a reasonable time period. 

As a result of the Defendant’s negligence, the Claimant was left with permanent extensive scarring across the right side of her lower abdomen, groin, thigh and medial pubic area. It was also noted that the Claimant suffered loss of sensation to the skin in this area which would be unlikely to return.

In relation to the causation aspects of the claim it was alleged, that as a result of the breaches, the Claimant would have been seen by a surgical team sooner and operated on 24 hours earlier compared to the treatment she received. If this course of action had occurred, on the balance of probabilities, there would have been a reduction in the tissue loss removed in the Claimant’s debridement surgery and this would have likely resulted in a shorter hospital stay with less morbidity and complications.

In short, it was argued that, although the Claimant would have suffered from the horrible condition  necrotising fasciitis in any event, the delay in diagnosis made matters much worse.

 A Letter of Claim was served by us on behalf of the Claimant and the Trust admitted negligence. The matter eventually settled when the Defendant put forward an offer in the sum of £60,000.00 and this was accepted by the Claimant.