A north-west healthcare trust has admitted failings in care provided to a diabetic patient who needed an amputation after a blister developed on his toe.
Robert Pendlebury, 50, sought treatment at the NHS Widnes Urgent Care Centre on March 2nd 2017, having noticed the blister on the little toe of his right foot.
Despite being aware that he was a type 2 diabetic and that ulcers were developing on two other toes, he was not sent to a specialist diabetic foot clinic when seen on numerous occasions over a four-week period.
His wife Carol says that over that time his situation worsened continually, with the blister developing into an open wound which was ‘constantly seeping’ with a ‘horrendous smell’.
She says she stressed the need for specialist treatment at numerous appointments, as she herself has been diabetic for more than 20 years, and had supported her husband for more than a decade with managing the condition.
I wasn’t listened to at all. Rob’s diabetes had always been difficult and had never been successfully managed so I was worried as I was aware of how things like this can develop quickly. I was saying we needed to see a specialist but I was ignored.
It went on for a few weeks, having to go back and forth to change his dressings, and as it was weeping so often I had to change them at home too. It was really awful. His dressings needed changing one day by me and then the next day at a clinic. He was just given antibiotics, but all they did was make him horrendously sick.
By the end of the month, the blister had developed into a severe infection and due to the amount of dead body tissue around his little toe, it had to be amputated in hospital. Mrs Pendlebury added:
I can remember a nurse coming to see us in hospital and she was so shocked at how bad it was and how bad it smelled. We were told there and then that it needed amputation, so he lost his little toe and part of his foot in the operation.
Doctors pretty much suggested to us that due to Rob’s diabetes, he was always likely to have an amputation, but I think that’s rubbish. It’s all about appropriate management and treatment.
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The patient became a ‘shadow of himself’ and died of sudden heart failure
Having had the operation, Mrs Pendlebury says her husband became ‘a shadow of himself’ before dying suddenly of heart failure, aged 53, in November 2019.
It all had a huge impact on him, and in fact, it did on us all as a family.
It was hard after the amputation and he suffered a lot more infections. There were times when his foot was so bad you could see through to the bones. It caused him a lot of pain.
I lost the man I fell in love with and married well before he died. Before his amputation he was so full of life and loved his work in security, but afterwards, I’d go to work and when I returned home he’d be sat in the dark not doing anything. He gave up on life to be honest, and that was very sad as we have six children who saw him go through this.
He died in his sleep and that was such as shock to us all, but he’d said to me after all the stress of the amputation that I’d be left a young widow. I think it was all too much for him. It was heart-breaking for us as a family as he was in so much pain for so long.
Legal case for compensation settled out of court following admissions of breach of duty
Solicitor Shauna Page, of medical negligence specialists Hudgell Solicitors, led the case on behalf of Mrs Pendlebury and said: “This was a case where the patient should immediately have been referred to a specialist diabetic foot clinic to ensure all appropriate investigations were carried out to identify suitable treatment to prevent the infection worsening.
Diabetics are much more likely to need an amputation than someone without the condition, but many can be avoidable if a wound is treated and monitored correctly. In this case we alleged negligence in that the failure to refer to a specialist clinic meant the blister was being treated without any swabs being taken to determine what kind of bacteria it was, which would have identified appropriate antibiotics.
X-rays could also have been conducted to look for bone inflammation, and a vascular review should have been conducted to assess whether the blood supply to his feet was sufficient to help the wound heal. The decision not to refer to specialists removed all these possible investigations.
Bridgewater Community Healthcare NHS Foundation Trust, which was responsible for the care provided, admitted breach of duty of care for not referring to specialists not only on Mr Pendlebury’s first assessment on March 2nd but also on five other occasions where his condition was reviewed and treated.
Damages of more than £26,000 were agreed, with the Trust having at one stage offered £10,000 less to settle the case out of court. Mrs Pendlebury added:
A million pounds wouldn’t be enough to compensate for losing my husband, or for how he suffered physically and mentally, but it was peace of mind for me in that I’d fought for him and they’d admitted their failings.
I look back now and wish I’d fought more at the time for specialist review. I thought I was being insistent but I now regret not doing more. I’d advise anyone else who has an experience like this with a diabetic loved one to be strong-willed and insistent. Demand a second opinion and specialist reviews. Don’t be fobbed off like we were.
Thankfully I’ve had Hudgell Solicitors by my side and they have been absolutely wonderful. Shauna explained everything to me in the finest detail, so I was prepared for any outcome, whether that be a successful case or having to go to court. I had full confidence in Hudgells as they were so proactive at all times and built a team around me to ensure we had the strongest possible case.
