Bradfield-Kay v Cope [2019] EWHC 3881 (QB) (21 May 2020)

C alleges that D was negligent in the performance of a left total hip replacement on 18 December 2009 and in connection with a consultation that took place on 9 August 2010. [1]

C had a complex history of back and leg pain. X rays taken in 2008 demonstrated that he had osteoarthritic changes in both hips. He was referred to D. D performed a diagnostic right hip block which demonstrated that the pain in C’s right leg emanated from his right hip joint. D performed a right total hip replacement on Mr Bradfield-Kay on 6 November 2009. Mr Bradfield-Kay made a rapid recovery and he was happy with the outcome of the operation. [3]

At a consultation on 27 November 2009, it was decided to proceed to a left total hip replacement. [4]

D performed the left total hip replacement on 18 December 2009. Unfortunately, C did not recover rapidly, as he had done when his right hip was treated. C says that immediately after the operation, he developed serious pain in the thigh and groin. He had a consultation with D on 9 August 2010. C says that he reported his symptoms of thigh and groin pain to D, but D did not investigate it. There is a dispute about whether C reported his complaints to D and whether D undertook any examination (and if so what) during this consultation. [5]

D saw C again on 7 February 2011. D recorded that the claimant was “doing not too well.” He identified painful clicking “which probably relates to the psoas tendon catching over the anterior part of the cup.” D informed D’s general practitioner that if the clicking persisted, he would consider a psoas tendon release. [6]

C’s GP referred him for a second opinion to H. On 15 March 2012, H performed a left hip revision. His operation note recorded: “There was no evidence of trunnionosis. The cup was found to be retroverted and the anterium of the cup was prominent and was catching on the anterior structures. There were no signs to suggest wear of the head of the metal liner. The cup was well fixed and I removed it… The stem was found to be well fixed and therefore I elected to leave it in situ.”

After H’s operation, C’s symptoms improved but did not resolve. C underwent a further revision of the left hip on 23 May 2016. [7]

In this action, C complains that D was negligent in the following respects:

(a) When he performed the left total hip replacement on 18 December 2009, D permitted the acetabular component of the prosthetic hip to be prominent, in such a position that the iliopsoas tendon caught on it, causing him to develop iliopsoas tendonitis.

(b) When he performed the left total hip replacement, Mr Cope used the incorrect femoral component.

(c) When he saw the claimant on 9 August 2010, he failed to record or investigate the claimant’s groin pain. [8]

the allegations of breach of duty at paragraph (a) and (b) have been made out. The allegation at paragraph (c) has not been established. [78]