Royal Marsden Hospital apology to man over cancer treatment

John* had been undergoing treatment for myeloma, a type of blood cancer, for which he was admitted to the Royal Marsden Hospital in Sutton.

He was there to receive a stem cell transplant and hemofiltration - a process during which a patient’s blood is passed through a machine to remove waste products and water.

In preparation for the hemofiltration, blood thinning therapy was started which saw John given soft, flexible tubes into his veins.

In order to keep his calcium levels steady, John was given calcium chloride - a drug that can potentially be dangerous if it leaks out of the blood vessel and into the surrounding tissue (extravasation).

The drug is normally administered into a large blood vessel, and any signs of blood leakage must be responded to quickly.

However, the calcium chloride was administered through a smaller vein in John’s right hand.

He initially reported a stinging pain, but the infusion was continued.

Over the next few hours, John continued to complain to his nurses about the pain in his hand along with skin redness, warmth, and swelling.

Despite these complaints, no action was taken in response and the infusion continued.

A while later, the skin on John’s hand started to peel, and the redness and swelling had started spreading up towards his wrist.

His hand also felt extremely stiff, and he struggled to flex his fingers.

John alerted his nursing team again and they agreed that there was a problem.

It was obvious that John was suffering from extravasation – the calcium chloride was leaking out of the blood vessel into the surrounding tissue.

The nurses stopped the infusion and commenced treatment.

 John had already sustained a severe chemical burn from the leaked calcium chloride, damaging the underlying structures in his right hand.

The Royal Marsden apologised to John, saying“We wish to sincerely apologise for the substandard care that John received.

“The Trust is extremely sorry that this happened”.

Despite some initial improvement, the hand remained significantly impaired.

John continues to experience reduced strength and dexterity in his hand and suffers from numbness and pain.

He tries to be as independent as possible but still needs assistance from friends and family.

John’s hobbies and activities have also been restricted, including his ability to enjoy playing golf and music.

His daily activities continue to be severely impacted and there has been a negative impact on John’s mental health.

The Royal Marsden NHS Foundation Trust did an investigation and found out that there were some problems with the care they provided.

These problems caused an injury that could have been prevented.

The issues included using the wrong equipment, not following proper procedures, and not properly checking the patient's skin.

John instructed solicitor, Michael Roberts of Leigh Day, to investigate a potential clinical negligence claim.

The Royal Marsden NHS Foundation Trust was invited to make an early admission of liability, but its response was delayed, which led to further investigations.

A number of changes to hospital practice were made, as well as updates to local policies and guidelines, in order to stop anything like this happening again.

Michael Roberts said: “We are pleased that the matter could be resolved amicably between the parties in the end, but this was an extremely unfortunate and serious injury that should never have occurred.

“I hope that the Trust has now learnt important lessons from this event so that it will never reoccur.

“Above all else, I sincerely hope that the settlement will allow John to focus on his recovery and living his life to the full in future.”

John said: “Whilst I was initially surprised as to how long the whole process took, this was a testament to all the thorough and diligent work required to be undertaken, borne out by the excellent final result and settlement.”

*This is not the person’s real name