Claimant aged 59 years, attended the defendant Trust hospital presenting with a pressure sore on his left buttock that had been there for three years but had been leaking for past four days. He felt hot and nauseous, suffering loss of appetite and diarrhoea. Upon review, surgical team noted necrotic sore was wet and gangrenous at the centre. Further, it was noted that the genitalia were swollen and there was cellulitis surrounding the sore and inner left thigh. He was diagnosed as suffering sepsis secondary to the pressure sores.
Five days later he underwent debridement of the sore under local anaesthetic plus hydrogen wash. However no surgical exploration of thigh, genitalia or suprapubic area carried out. Following day, it was noted that Claimant had swollen oedematous genitalia with erythema spreading over lower abdomen and thigh. In addition he had a tense swelling in groin which was foul smelling. Diagnosis of spreading cellulitis. Antibiotics prescribed.
Following review by upper GI team that night, it was noted that wound was large with underlying necrosis and therefore wide debridement was carried out and wound packed with proflavine. A small incision was also made in left suprapubic region but no necrotising fascitis seen. When Claimant was examined the next day, cellulitis appeared to be improving and debridement deemed unnecessary.
Two days later when seen by consultant colorectal surgeon, it was decided that radical debridement was necessary when he found gangrenous and necrotic tissue at scrotal area. Claimant underwent perineal debridement for Fournier’s gangrene. An unsuccessful ileostomy resulted in torn ileum and lower midline incision performed with ileum brought out through a double-barrelled ileostomy. After two weeks, Claimant was transferred to another hospital where he subsequently underwent further surgeries involving debridement and skin grafting. After two months Claimant was again transferred to another hospital where he remained for eight months.
He suffered prolonged pain and extensive surgical procedures. His skin was more susceptible to trauma and it became more difficult to care for the skin in the relevant area. His indwelling urethral catheter had been in place so long that self catheterisation became impossible and he had to switch to using a suprapubic catheter. Due to a colostomy, he was at risk of sustaining a parastomal hernia.
Claimant alleged negligence in failure to perform adequate debridement of affected area without delay. Liability disputed.
Out of court settlement: £35,000 (estimated General Damages £10,000)