Diabetic Patient Forced to Have Leg Amputated After NHS Negligence

A diabetes sufferer from Berkshire has been forced to have one of her legs amputated after medics failed to give appropriate treatment to infected pressure sores on her heel. While the Royal Berkshire NHS Foundation Trust has apologized to Brenda Curtis, it has not yet issued a formal admission of liability.

Diabetic patient was not seen by a specialist

On 20^th October 2014, Brenda Curtis from Thatcham was admitted to the Royal Berkshire Hospital following a fall at home. The 57-year-old – who suffers from Type 1 diabetes and chronic kidney disease, for which she undergoes heamodialysis three times a week – was diagnosed as having a fractured pelvis as a result of the fall. Three days later while she was still under hospital care, it was noted that she had a grade three pressure sore on her heel.

Pressure sores, also known as bedsores or pressure ulcers, are localized injuries that break down the skin and the underlying tissue, and are caused when an area of skin is placed under extensive pressure. The extra pressure disrupts the blood supply to the skin, with the affected area becoming starved of oxygen and nutrients, with it breaking down and leading to the formation of an ulcer. Such sores can occur over a relatively short period of time and conditions that affect the flow of blood around the body – including diabetes – can also make a person more vulnerable to the problem.

It is estimated that just under half a million people across the UK will develop at least one sore in any given year and it is usually those admitted to hospital with another health condition. The severity of pressure ulcers varies significantly, and accordingly, so does the treatment. For those with a low-grade sore, creams can be applied to help aid the healing process, with the wounds dressed until they recover. However, the more serious cases can require surgery, as with Mrs Curtis, or can even be life threatening due to potential complications, such as gangrene and blood poisoning.

Despite the severity of the sores, Mrs Curtis was not seen by a specialist tissue viability nurse, nor was there any mention of the sore on her discharge letter when she returned home from hospital a week later. Due to the discomfort she found herself in, Mrs Curtin underwent repeated hospital treatment for the sores in the months following her fall. They became infected and in February 2015, she was required to undergo a below the knee amputation.

Severe pressure sores were not treated adequately by hospital staff

Following concerns about the way her treatment was handled, Mrs Curtis wrote to the hospital looking for answers as to why certain decisions were taken and why she was not referred to a specialist once the severity of the sores was discovered. She received a response from the Royal Berkshire NHS Foundation Trust – the trust responsible for the Royal Berkshire Hospital – which contained an apology and acknowledged defects in her care. However, there was no admission of medical negligence.

With the support of her husband, she began legal action against the trust, seeking compensation to help cover the cost of adaptations to their home to make it more suitable for Mrs Curtis following the leg amputation. Mr Philip Curtis commented:

"It was just so shocking how quickly the problems with her heel sores escalated. In four months Brenda had gone from being treated for a fall with a blister on her heel, to having infected pressure sores needing days and days in hospital, and ultimately an amputation.

We feel that the issues could have been better managed. The first discharge letter didn't mention pressure sores at all and there were other things wrong on the letter such as recording the wrong type of diabetes which is extremely worrying. We've just lost all confidence and I want Brenda to get the best possible support and rehabilitation she can so that she can begin to move on from this."

Despite a legal letter setting out the couple’s case being issued to the hospital, no response or admission of liability has been received to date. A spokeswoman for the couple said:

“It's disappointing that despite there being what appear to be clear errors in this case, the NHS Trust is yet to respond to the couple’s letter, dragging the matter out for Brenda and Philip and preventing them from getting the extra specialist support they need to help them come to terms with what has happened.

Any amputation is obviously a major event for those involved and they deserve answers as to what went wrong and why, as well as a fair settlement to help them get the necessary rehabilitation Brenda needs, and any equipment or adaptations for her home which may help her to get around more easily."

A spokesperson for the trust confirmed that an investigation is ongoing, but was unable to comment any further.

Making a negligence claim for poor or inadequate medical care

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