Substantial damages recovered for injuries suffered as a consequence of an extravasation injury

AB v Clatterbridge Cancer Centre

Richard Malloy a Solicitor and Head of Medical Negligence at Gregory Abrams Davidson Solicitors recovers substantial damages for injuries suffered as a consequence of an extravasation injury sustained by our client at Clatterbridge Cancer Centre.

What is an extravasation injury?

This is an injury caused by the leakage of certain medicines for example from a cannula (flexible tube) into the tissues, rather than going into the vein. The medicine therefore interacts with the surrounding tissues. This can be relatively harmless if spotted early. It can however be very serious and a medical emergency, as in this case, particularly if the type of medicine has a higher potential for causing injury.

Facts of the case

Our client was being treated for cancer. A referral to a Consultant Haematologist at the Royal Liverpool Hospital was made for treatment.

Our client attended the Royal Liverpool Hospital for the administration of chemotherapy.  According to the Cannulation Documentation, a 22g blue cannula was inserted into the Claimant’s right hand. Difficulties were experienced and multiple attempts made to insert the cannula into her right hand and eventually the nurse proceeded to administer the course of chemotherapy.

Our client was left on the ward on her own. After a short time she began to feel a burning sensation on her right hand. The cannula had began to leak into her skin and the area became bright pink and red. When the nurse returned she began to panic attempted to stop the treatment. Our client was in shock at what was happening and how painful this was.

She had suffered a Vesicant Extravasation injury. An attempt was made to draw back the fluid from the cannula. A Junior Doctor (F1) reviewed the extravasation injury prior to discharge home, and an examination revealed: hands and fingers were warm to touch, sensation intact, radial pulse present, Capillary Refill Time (CRT) < 2 seconds, power and sensation were normal.

She was discharged and a few days later the right hand flared up, becoming very swollen and she was in a great deal of pain. On calling the ward for advice she was told to attend the A&E department as soon as she could and was admitted.

She required input from the plastics team but went on to experience increasing pain and new blistering at the site

She was taking co-codamol to assist with the pain and discomfort but it was noted that the pain was not completely relieved by this medication. She also reported that her hand was stiff and therefore difficult to use. She required a prescription of morphine to cope with the pain.

The pain was constant, fluctuating from a continuous sting to very sharp pain radiating up her arm from the site down towards her fingers with pins and needles in her ring finger and little finger.

Treatment involved dead necrotic skin being repeatedly cut away which was a traumatic and very painful experience.

8 months on from the incident she was still experiencing severe pain in her right hand and she could not apply a dressing. Once the wound had healed, she was left with permanent scarring to the upper aspect of her right hand and ongoing pain and sensitivity.

Complaint to the Hospital

A detailed complaint was made in accordance with the NHS complaints procedure. The complaint was comprehensively investigated by the Clinical Director for haemato-Oncology. The conclusion of that investigation was categorical in that there had been no failings in respect of the care provided to our client. Very clear reassurance was given to our client that all of the care was “in line with best practice”. It was therefore simply an unfortunate but unavoidable incident.

Our Involvement

Following this response we investigated the events and obtained independent expert opinion which was highly critical of the care provided. This included criticisms that;

• There was a failure on the part of the pre-assessment nurse to undertake a formal peripheral venous assessment at the time of the pre-treatment assessment.

• There was failure on the part of the oncology nurse administering the chemotherapy to provide advice about the risks and benefits of a PICC line.

• There was a failure by the Trust to follow their own guidelines regarding the administration of Vesicant drugs

A Letter of Claim which set out formal allegations was sent and liability was admitted in full within a short space of time by Clatterbridge Cancer Centre. The Trust admitted there had been failures in regards to their treatment and those failures had caused the injury.

In terms of the impact of the injury upon our client we obtained evidence from a multitude of experts including a;

• Consultant Plastic surgeon
• Pain Consultant
• Plastic Surgeon

A Schedule of Loss was prepared and provided to the Defendant along with independent expert evidence, documentary evidence and witness evidence in support.

Following negotiations between the parties a settlement was reached without the need for Court proceedings to be commenced.

Richard Malloy is a Solicitor and Head of Medical Negligence at Gregory Abrams Davidson Solicitors. Gregory Abrams Davidson Solicitors have a dedicated team who specialise in obtaining compensation for clients who have sustained injuries as a result of Medical Negligence. We deal with claims for compensation against hospitals (both NHS and Private), dentists, general practitioners, pharmacists and opticians. We have offices in Liverpool City Centre, Allerton, Garston Village and Golders Green, London. We offer a free initial case assessment and No Win No Fee Funding is available. To enquire contact a member of our Medical Negligence new enquiries team on 0151 236 5000, email This email address is being protected from spambots. You need JavaScript enabled to view it. or complete our online contact form.