Spotlight on Venous Thromboembolism (blood clots)

A blood clot is a semi-solid mass of blood cells and other substances that form within blood vessels. It can block a vein or an artery, preventing blood from reaching organs, with potentially devastating consequences. It is vital that symptoms of a clot are recognised and treated quickly otherwise they can be life threatening or cause permanent damage. Unfortunately, misdiagnosis and delays in diagnosis are not uncommon and these, along with other failures in the management of blood clots, can lead to claims for medical negligence.  

Clots can form in any part of the body.  The term Venous Thromboembolism (VTE) is used to describe two interrelated conditions - Deep Vein Thrombosis and Pulmonary Embolism. Shockingly, according to Thrombosis UK, VTE is the most common cause of preventable hospital deaths.

Deep Vein Thrombosis (DVT)

DVT is a blood clot that occurs in one of the deep veins of the body, most commonly one of the larger veins in the leg such as the femoral vein.

It is very important that a DVT is diagnosed and treated as soon as possible. The longer a DVT is left untreated, the worse the outcome can become. Untreated, a DVT can block or restrict blood flow to the arteries in the limb, making amputation necessary. Part of the clot can also break away potentially resulting in a pulmonary embolism.

Pulmonary Embolism (PE)

A pulmonary embolism happens when a clot becomes lodged in an artery in the lungs preventing or restricting blood flow.

PE is the most serious condition within the spectrum of VTE and has a high mortality rate. Prompt recognition of PE is paramount.

Research recently published in the Health Sciences Review suggests that, in an emergency department setting, more than 27 percent of patients with PE are initially misdiagnosed and half of all those in inpatient settings are misdiagnosed.

To prevent PE, initially a DVT must be recognised so treatment can be administered to reduce the risk of the clot breaking into the blood stream.

Symptoms
 

A blood clot / DVT may cause throbbing or cramping pain, swelling and redness and warmth in a leg or arm. A PE may result in sudden breathlessness, sharp chest pain and a cough or the coughing up of blood.

Do I have a claim?
 

Blood clots are more likely to occur in sedentary situations, for example, following surgery. Indeed, Thrombus UK says that 55 to 60 percent of VTEs happen during or after hospitalisation.

According to guidelines set by the National Institute for Health and Care Excellence (NICE) all patients over 16 who are admitted to hospital should be assessed for their VTE risk and preventative measures taken where needed.

It is important to ensure that patients stay hydrated and are active whenever possible. Where there is an identified risk, blood thinning medication (anticoagulants) might need to be prescribed. Particularly, this may occur where a patient has other VTE risk factors, for example being overweight, a smoker, or having certain conditions such as Crohn’s disease. Pressure stockings may also be recommended to assist with blood flow.

Claims for medical negligence can arise where an inadequate assessment of risk leads to a preventable blood clot. An example would be a failure to prescribe blood thinners post-surgery for someone at risk or a lack of suitable advice. A failure to diagnose a DVT in time may also result in a claim where a PE is subsequently suffered.

VTE Case studies

• One of our solicitors acted for a man in his 40s who suffered from unexplained calf pain. On attending his GP and A&E he was advised that the symptoms were due to sciatica. He had no history of back problems whatsoever. This was a snap diagnosis with no proper investigation or examination of his vascular system. His condition worsened over time and eventually he was unable to walk. When admitted to hospital his foot was found to be cold and pale. A femoral artery blood clot was found but by this time it was too late to operate to save the leg and he had to undergo an amputation. The claim settled after issue of court proceeding for a seven-figure sum.
• One of our solicitors also acted for a chemotherapy patient who suffered with similar symptoms. Despite the well-known strong association between some chemotherapy drugs and deep vein thrombosis his condition was not diagnosed quickly and after waiting 13 hours to be seen in A&E he had to  undergo an above knee amputation as a result of NHS negligence. The claim settled without the need for court proceedings for a very significant sum.

How we can help

We specialise in VTE claims and understand how devastating the impacts can be. We provide our clients with the highest level of support from the outset and work with leading experts, including those in the field of vascular surgery, to assess a claim. We ensure that any package of compensation obtained is maximised and that consideration is given to all future needs and losses. Where a claim is brought on behalf of someone who has died, compensation can be obtained for a loss of dependency, both emotionally and financially.

FURTHER INFORMATION

If you have any questions regarding this blog, please contact James Bell or a member of the Medical Negligence and Personal Injury Practice, or call us on 020 7814 1200.

ABOUT THE AUTHOR

James Bell is the head of our Medical Negligence and Personal Injury practice and joined the firm in 2023 from Hodge, Jones & Allen. He has undertaken medical negligence cases for over 20 years.  Throughout his career James has dealt with a very wide range of cases concerning all types of negligence claims – delayed diagnosis cases, birth injuries, anaesthetic injuries, surgical errors,  GP and hospital negligence, all types of orthopaedic claims, including complex hip and knee replacement surgery claims and and all types of cancer cases.