Patient was a fifty-six year-old, obese male with a history of sciatica. He presented to A&E complaining of pain around the left buttock, which had developed over twenty-four hours, and complained of feeling feverish.

Examination showed tenderness over the buttock, spreading into the top of his thigh, though his temperature was normal. No blood tests were carried out, and he was diagnosed with sciatica and sent home with pain relief. Three hours later, he collapsed at home and was brought back to hospital by ambulance. Examination showed a swelling, which was severely tender over the lower buttock area. A scan was carried out and showed severe damage to the underlying musculature. He was sent for emergency surgery, which revealed severe necrosis (death) to the muscle underneath the fascia of his buttock. Unfortunately, he was in septic shock and died within two to three hours.

It could be argued there was a breach of duty of care in terms of the examination, by not undertaking blood tests and/or a scan of his buttock when he presented. However, even if a diagnosis had been made several hours earlier, on the balance of probabilities, the outcome would unfortunately have been the same. Therefore, although the consequences of the disease process – a necrotising myositis – were severe, the breach of duty of care causing a three-hour delay did not materially affect the outcome. As such, there was no chance of success in either a civil or criminal suit.

MDU figures for 2023 show that fewer than one in six actions in medical negligence actually succeed, with the vast majority failing on the grounds of causation. It must be remembered that subsequence is not the same as consequence.

Initial screening is, therefore, essential to manage client expectations at an early stage. This avoids unnecessary effort and costs for all concerned. Too many cases are taken to court with no chance of success. This is stressful for both the client and their legal adviser, and indeed for the medical personnel involved.

For fast and effective screening of all potential medical negligence cases, contact Peyton Medico Legal Services now on +44 (0)28 87724177 or email rpeyton@rpeyton.com

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