Medical Compensation Claim for Compartment Syndrome
Compartment syndrome needs to be treated quickly if widespread tissue death is to be avoided. Should medical practitioners fail to achieve this standard of care, there may be grounds for a compensation claim.
Additionally, if medical practitioners fail to prevent compartment syndrome during treatment for another condition, there may be grounds for a claim.
To find out if you are eligible to pursue a medical negligence compensation claim, please contact us at Glynns Solicitors. We will provide you with expert legal advice, free of charge and obligation.
What is a compartment?
The legs, arms and abdomen are made up of different 'compartments'. These compartments consist of muscles, nerves, blood vessels and adipose tissue. All these elements are surrounded by soft tissues, which also help to keep the compartment in place. Each compartment is separated by fascia, which is a fibrous tissue.
What is acute compartment syndrome?
Compartment syndrome is when bleeding or swelling increases the pressure inside a compartment, restricting the flow of blood. Acute compartment syndrome is when the condition develops very rapidly, as opposed to chronic compartment syndrome, which develops slowly over a matter of months.
Normally the pressure inside each compartment is kept at a constant level by the body's circulation system. Blood enters the compartment through the arterial system, the pressure of which is high. Blood then leaves the compartment through the venous system, the pressure of which is low.
But bleeding or swelling will increase the pressure inside the compartment. This is because the ability of the venous system to drain blood will be adversely affected. However, blood will still be able to enter the compartment via the arterial system. Consequently there will be too much blood in the muscle and soft tissue, causing them to become swollen.
This swelling will make it difficult for blood to flow through the veins – something which is needed to provide the area with oxygen and carry away waste products. Within a short space of time the tissues will become so deprived of oxygen that the cells begin to break down. This can take just hours to develop.
What causes compartment syndrome?
Compartment syndrome is caused by bleeding or swelling inside the compartment. This can occur due to:
- Traumatic injury – e.g. fracture, crushing injury
- Burn
- Sickle cell disease/being a carrier of the sickle cell trait
- A tight plaster cast or bandage
- Surgery to repair a blocked or damaged blood vessel
What are the symptoms of acute compartment syndrome?
The primary symptom of acute compartment syndrome is intense pain that is disproportionate to the injury (if an injury has been sustained).
There are also other symptoms that together give a strong indication that compartment syndrome is present. Medical practitioners refer to the clinical features of compartment syndrome is the 5 Ps:
- Pain – pain inside the compartment which is worse when moving the muscles
- Pallor – pale colour across the affected area with possible bruising
- Paraesthesia – the medical term for pins and needles
- Paralysis – due to the vessels being engorged with blood
- Pulseless – inability to feel a pulse, although this only occurs in the late stages
Diagnosing and treating compartment syndrome
These clinical features alone should enable doctors to diagnose acute compartment syndrome. Suspicions should be especially raised if the patient has a recent history of trauma, surgery, burn or plaster cast/bandage.
There are certain tests that can confirm compartment syndrome. A specialist may use a device that involves placing a needle inside the compartment to measure the pressure. An MRI scan may also be useful in aiding a diagnosis.
Compartment syndrome must be treated with surgery to reduce the pressure inside the compartment. This is called a fasciotomy. The surgeon will cut open the compartment, alleviating the pressure inside. The wound will often be left open for several days or there is a risk that pressure will build up once again.
Alongside surgery a patient may be given oxygen to assist the delivery of oxygen to the muscles. Fluids may also be administered intravenously.
Timing of treatment
Acute compartment syndrome is considered a 'medical emergency', meaning it needs to be treated in the early stages. If treatment is delayed, the lack of oxygen will cause extensive tissue death. The dead tissue will ultimately have to be removed as it cannot be restored. This can leave a large deformity that results in severe dysfunction, or it can necessitate an amputation of the limb.
Preventing compartment syndrome complications
To prevent these complications, medical practitioners must be quick to diagnose and treat acute compartment syndrome.
Furthermore, clinicians must actively prevent compartment syndrome in patients at risk of developing the condition – such as one who has recently undergone blood vessel surgery or had a plaster cast applied while the tissues were still swelling.
At-risk patients should be monitored by nursing staff, who should watch out for the 5 Ps described above. If signs of the condition develop, action must be taken immediately to minimise the extent of damage.
Compartment syndrome and medical negligence
If medical practitioners fail to offer a reasonable standard of care to a patient with compartment syndrome, there may be grounds for a compensation claim.
Typically a claim will arise for two reasons:
- Medical practitioners have failed to diagnose and treat compartment syndrome in a reasonable amount of time
- Medical practitioners fail to actively prevent compartment syndrome in a patient who is at risk of developing the condition
Sometimes there will be a double breach of duty, whereby a patient at risk of compartment syndrome develops the condition in a hospital environment. Clinicians then fail to recognise the issue, resulting in a severe delay in treatment.
Medico-legal claim for compartment syndrome
If you have suffered extensive tissue death, dysfunction or amputation as a result of compartment syndrome and you believe medical error is to blame, please contact us. We specialise in clinical negligence claims and will be able to say whether you compartment syndrome care fell below an acceptable standard. If so, we can help you obtain the justice you deserve.
Get in touch with us today to talk to a legal expert about making a medical compensation claim.
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