This case study demonstrates the expertise of our Clinical Negligence team who recently acted for a patient who suffered scarring as a result of negligently performed cryotherapy treatment at Queen Victoria Hospital NHS Foundation Trust.
Cryotherapy (also known as cryosurgery) is a commonly used for the treatment of a variety of benign and malignant lesions. The procedure involves liquid nitrogen being sprayed on to a cancer to freeze it, destroying the abnormal cells.
In October 2009, the claimant sought advice from his local pharmacist regarding a crusted lesion on his right forearm that had developed over several months. The pharmacist was concerned about the appearance of the lesion and advised him to see his general practitioner.
The GP thought that the lesion may be cancerous and advised specialist treatment. The claimant was able to use the 'Choose and Book' scheme to arrange an appointment to see a specialist plastic surgeon at Queen Victoria Hospital in East Grinstead.
At the appointment, he was advised by the surgeon that the lesion was actinic keratosis and that he should have cryotherapy to remove it. The claimant had undergone this type of surgery before with good cosmetic results and he was therefore not unduly worried. However, he was not advised by the surgeon of any risks associated with cryotherapy surgery, nor was he asked to sign a consent form.
The claimant's first concerns arose just prior to the procedure when he noticed the surgeon reading the instruction leaflet which was attached to the cryotherapy kit.
The surgeon prepared an aerosol can from the cryotherapy kit and attached a plastic tube to the nozzle and began to spray cold liquid over the lesion. He sprayed liquid not only over the area of the lesion but in the large area surrounding this and continued until fluid was running down the side of the claimant's forearm. The treatment was extremely painful and lasted between one and two minutes. After the treatment the claimant was allowed home. He did not receive any advice about aftercare, such as protecting the area from being knocked or moisturising.
After a few days, the claimant noticed a scab forming on the extensor surface of his forearm which separated after about four weeks leaving a delicate, sore and tender area of skin.
The original lesion measured between 5 and 10mm in diameter but following the cryotherapy, the claimant was left with a tear drop shaped scar measuring 7.5cm x 3.5cm at its widest point.
The claimant contacted Thomson Snell & Passmore. We were able to act for him on a conditional fee agreement (no win no fee). Copies of his medical records were obtained. We sought an opinion from a medico-legal expert in plastic surgery who advised that the treatment the claimant received was excessive and that sadly his scarring would be permanent.
We undertook some research into the background of the surgeon involved and it appeared that at the time of treatment, he was not sufficiently experienced to be carrying out this type of procedure without supervision.
We wrote a Letter of Claim to Queen Victoria Hospital NHS Foundation Trust alleging a breach of duty of care in respect of the cryotherapy procedure. It was alleged that the treatment received was excessive and that the surgeon sprayed the aerosol for an excessively long time over an excessively large area. We also alleged that the surgeon was insufficiently experienced to be carrying out such procedures unsupervised and that there was a failure to provide advice about aftercare.
We also put forward an offer to settle the case in the sum of £3,500 plus payment of legal costs. This offer was accepted and the claimant received £3,500 compensation.
Jennifer Waight specialises in clinical negligence cases. If you would like to ask Jennifer a question about a potential case involving unnecessary scarring or you have a general query about medical negligence, contact her on 01892 701374 in confidence.