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Woman bled to death at Basildon Hospital after screw to secure hip pierced vein
A WOMAN bled to death after a surgeon cut into a vein during a hip replacement operation.
Eileen Brown, 60, went into Basildon Hospital where surgery was supposed to fix her hip – but she died the next day.
Her brother, Peter Humphrey, and her two sons, Roger and Steve Brown, are now considering legal action after an inquest at Chelmsford Coroners Court yesterday which found the operation led to her death.
The court heard Mrs Brown, who was less than 5ft tall and weighed nine stones, also suffered from brittle bones and osteoporosis and could have had her new hip set into her pelvis with a quick-drying cement.
However, orthopaedic locum consultant Dr Amgad Nakhla opted for a procedure involving widening of the hip socket and drilling through bones.
The court heard this fractured her hip in several places and some of the screws, up to 35mm long which were meant to hold the hip in place, ended up passing through the bone before a vein was ruptured.
Medics tried to repair the tear, but she lost “a significant amount” of blood and later died.
At the inquest, pathologist Dr Martin Goddard said she had to be given about six litres of blood in a bid to save her life.
He gave the cause of death as a haemorrhage caused by the ruptured vein and existing heart disease may have affected her chances of survival too.
Dr Graham Keene, a consultant orthopaedic surgeon, who wrote a report for the coroner, said: “It appears the first inserted socket was loose and did not fit well when screwed in place.
“It was removed and the socket was drilled up and a larger one put in and in that process a fracture was noticed.”
He said the punctured vein was likely to have been caused by the drilling or a screw.
Dr Nakhla, who carried out most of the surgery, on May 2 last year, initially stood by his decision, saying patients under 70 would usually have the uncemented procedure.
However, he told the inquest: “I perfectly accept if it was cemented it could have prevented the fracture and vein injury and that the cementless procedures have higher incidents of fracture.”
He added: “The risk of this happening was very low, but unfortunately for everyone here it did happen.”
Coroner Eleanor McGann said: “The conclusion I reach is she died as a result of a complication of a medical procedure which was necessary to relieve her pain.”
Mrs Brown’s grieving relatives said her death could easily have been avoided.
Brother Peter Humphrey, of Kennedy Avenue, Laindon, and her sons Roger and Steve Brown, from Aveley, attended the inquest.
Outside court, Mr Humphrey said: “This should never have happened.
“For someone with her history of brittle bones, they should have cemented the hip. There are a lot of unanswered questions from the inquest and we will be looking to take legal action.”
The hospital carried out an internal investigation after the death.
Dr Amgad Nakhla said: “I am currently working on a system to drill into bones and avoid vascular injury.”
Lack of communication between surgeons and anaesthetists during the operation was also criticised at the inquest, but Dr Nakhla said: “We now speak to anaesthetists more often than ever, even when there are no problems.”
Mrs Brown lived in Elm Road, South Ockendon.
2010 – Eileen Brown originally had three screws inserted to hold her hip in place after a fracture 2012 – It was found the repair had collapsed after screws came loose, meaning a full hip replacement was needed May 2, 2013 – Mrs Brown admitted for surgery in Basildon Hospital. During the operation at 5.30pm concerns were raised about her low blood pressure.
5.59pm – a second anaesthetist was called as she was not responding to treatment 6.20pm – vascular surgeons called to repair vein She was later transferred to intensive care, but died the next day.
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