Pryers Solicitors has grown substantially over the last couple of years and have plans for further expansion in their key areas of medical law, product law and personal injury work. Principal Ian Pryer, commented “Tim’s  appointment as Partner is a vital step in the continued growth and development of the firm. He comes with a pedigree of achievement in the legal sector”. He continued “This appointment helps to further establish Pryers Solicitors as a centre of excellence in the York region serving clients both locally and nationally”.

This fits is with recent reports that many metal hips are failing at the junction between the ball or head and the stem, the long metal component that goes down the femur, or thigh bone.  Recent data from the National Joint Registry suggests that this problem is particularly common at six or seven years after surgery, so check-ups for five years would often miss the problem.

It appears that the tapered junction between the stem and the head is particularly prone to failure.  Over the years, the size of the heads has gradually increased, from 28mm, then to 36mm and now to as large as 63mm, while the length of the tapered junction has been greatly shortened.  It is believed that the junction is now too small to withstand the extra forces applied by the larger heads and that this has caused failure.

Some products have failed more often than others and there is particular concern regarding the combination of a Pinnacle joint on a Corail stem, made by DePuy.

The issue was covered recently by BBC Newsnight.  http://www.bbc.co.uk/news/health-17192520

Richard Starkie and his team of solicitors at Pryers are investigating potential product liability claims regarding these products.

This particular problem is different from the failure of the DePuy ASR hips, which is caused by excessive wear at the bearing surface between the head and the cup, although some ASR total hip replacements have also failed at the taper between the head and the stem.  Pryers now act for over 220 patients whose ASR hips have failed prematurely.

Email: – hips@pryers.co.uk

This leaves 40,000 women in the UK worried about the health risks of rupture and leakage of their PIP  implants. Testing has shown that implant covers have an increased risk of rupture, though the effects of the silicone are unknown, with unconfirmed risk of toxicity damage other than the symptoms of inflammation and other reactions to any known irritant.

Women are receiving conflicting advice from health professionals. The NHS are advising against routine removal of the implants, but the British Association of Plastic, Reconstructive and Aesthetic Surgeons are recommending removal, due to the uncertainty of the health risks. This leaves women with uncertain advice as to what to do, where to go and how to fund it.

A number of private clinics which provided the PIP  implants have now ceased trading. This leaves some women without recourse, although the NHS have confirmed that they will remove (but not replace) implants which have ruptured, if your doctor agrees there is a clinical need.

The following private clinics have said they will replace PIP implants free if clinically necessary: Holly House, Highgate Hospitals, Make Yourself Amazing, Ramsay Health Care, Spire Healthcare, BMI Healthcare, Nuffield Healthcare and HCA International. The Transform medical group has said it will remove the implants free for its patients who had them fitted since 2001 and The Hospital Group said it would offer free removal to patients it operated on from 2001-2009; both will charge for replacements.

Women are still entitled to compensation for breach of contract, to cover the cost of any surgery and for any damage they have sustained.

Medical advice to women with the PIP implants  is that you should see your doctor if you have any of the following symptoms:

• lumpiness of the breast
• lumpiness or swelling in the area around the breast
• change in shape of the breast
• deflation of the breast
• redness
• tenderness of the breast
• swelling of the breast
• pain or sensitivity

Pryers Solicitors of York, who have successfully mounted product liability claims for patients affected by the faulty DePuy ASR hips, are acting for a number of ladies to ensure legal redress by way of support and recourse.

If you have had a breast implant which is a PIP silicone implant and wish to discuss your options , contact Robyn or Carmel at Pryers on PIP@Pryers.co.uk or 01904 556600.

Question and Answer

Q. I have had a breast implant. What do I do?

The team, headed by Richard Starkie, has been strengthened by the recruitment of two more solicitors, Lucy Macklin-Smith and Lindsay Perryman, who join Aftar Waris and Jamie Paddock.

The ASR hip was introduced in July 2003 and used extensively in a few areas of the UK, particularly York, North Tees, Surrey, Rotherham, Merseyside and Cardiff.  By 2007, a number of surgeons raised concerns that they were experiencing a higher than expected failure rate with the ASR.  DePuy’s response was that this was a problem with surgical technique, rather than a problem with the product.  However, as concerns grew, DePuy withdrew the product form the Australian market in December 2009 and from the rest of the world in August 2010.

Since then, hospitals have been recalling patients for tests, including blood tests; ultrasound and MRI scans; and aspirations of fluid from the hip.  Hundreds of people have been found to be suffering from excessive wear of the components, which can lead to damage to the soft tissues around the joint and even to the bone.  Revision surgery is then required, with a lengthy recovery period.  Patients frequently fail to make a full recovery and many require further surgery after revision.

Although, at the time of the product recall in August 2010, DePuy put the 5 year failure rate at 12-13%, some surgeons now estimate the 6 year failure rate as being as high as 49%.  If that is correct, it is likely that several thousand people in the UK alone will require further surgery.

Over the last 18 months, Pryers have worked with some of the world’s leading biomechanical engineers, biotribologists, metallurgists, metrologists, surgeons, toxicologists, epidemiologists, histopathologists and microbiologists.

We have been one of the leading law firms in the investigation of these claims and in the discussions with DePuy.

We have carried out extensive work the following: -

• the precise nature of the design defect;
• the testing procedures and how they failed;
• the manufacturer’s delay in recalling the product;
• establishing causation in individual cases and excluding other potential causes of joint failure;
• determining prognosis after an ASR failure;
• establishing causation of cobalt and chromium toxicity;
• and the long-term health risks posed by exposure to these metals.

We have also been instrumental in establishing and co-ordinating a patient support group for the North of England, called Altogether ASR, which has had several meetings and will shortly be launching a website.  The group’s next meeting will be in March 2012.  Please contact Pryers for details.

If you or a relative has suffered the premature failure of a metal-on-metal hip replacement or resurfacing, particularly the DePuy ASR, please contact Pryers Solicitors on 0800 316 0166 or by email at hips@pryers.co.uk.

The team, headed by Richard Starkie, has been strengthened by the recruitment of two more solicitors, Lucy Macklin-Smith and Lindsay Perryman.

The ASR hip was introduced in July 2003 and used extensively in a few areas of the UK, particularly York, North Tees, Surrey, Rotherham, Merseyside and Cardiff. By 2007, a number of surgeons raised concerns that they were experiencing a higher than expected failure rate with the ASR. DePuy’s response was that this was a problem with surgical technique, rather than a problem with the product. However, as concerns grew, DePuy withdrew the product form the Australian market in December 2009 and from the rest of the world in August 2010.

Since then, hospitals have been recalling patients for tests, including blood tests; ultrasound and MRI scans; and aspirations of fluid from the hip. Hundreds of people have been found to be suffering from excessive wear of the components, which can lead to damage to the soft tissues around the joint and even to the bone. Revision surgery is then required, with a lengthy recovery period. Patients frequently fail to make a full recovery and many require further surgery after revision.

Although, at the time of the product recall in August 2010, DePuy put the 5 year failure rate at 12-13%, some surgeons now estimate the 6 year failure rate as being as high as 49%. If that is correct, it is likely that several thousand people in the UK alone will require further surgery.

If you or a relative has suffered the premature failure of a metal-on-metal hip replacement or resurfacing, particularly the DePuy ASR, please contact Pryers Solicitors on 0800 316 0166 or by email at hips@pryers.co.uk.

The wound was stitched closed in A&E and she was given antibiotics tablets before being allowed home.

Unfortunately, Jane began to feel unwell after sleeping through the night.  The following morning she had a fever and her arm felt very painful and heavy.  She also noticed there was an area of redness spreading out from underneath the dressing.  She went back to the A&E department at her local hospital.

A plastic surgeon examined her wrist and explained that the wound should have been left open for at least five days in order to prevent infection.  Jane was admitted to hospital immediately and given intravenous fluids and antibiotics.  She underwent a further 3 operations to thoroughly clean and debride the wound.  Jane now has extensive scarring and struggles to use her dominant hand without pain.

In August 2010, Jane approached Pryers Solicitors and investigations were begun by Richard Starkie, a Solicitor specialising in Clinical Negligence.  In October of the same year, having obtained copies of Jane’s medical records and x-rays, Richard wrote to the Hospital Trust setting out the allegations of negligence.  The Trust responded and denied any liability.

Richard then instructed an expert in accident and emergency medicine, who supported Jane’s case unreservedly.  The expert stated that the wound should not have been stitched in the A&E department.  The wound should only have been stitched closed once a plastic surgeon had performed a thorough cleaning and debridement of the wound.

A hand surgeon was then instructed in order to provide a view on the effect of the failure and how Jane’s wrist was at the time.  The expert stated that if the wound had not been stitched closed in the A&E department then the risk of developing a serious infection would have been less than half.  The hand plastic surgeon also stated that Jane’s injury and infection had caused considerable short term pain and disability, and pain, weakness and stiffness in the long term.

These points were put to the Defendant but it maintained its denial of liability so Court proceedings were issued and served on the Trust.

The Defendant then made an initial settlement offer of £7,500.  This was rejected and Richard entered into negotiations with the Defendant.  Jane’s case was settled for £20,000.

The case was funded by a conditional fee agreement and Jane kept all of her compensation, with nothing to pay towards legal costs.

Unfortunately, during the procedure the performing surgeon removed excessive tissue when forming the left implant pocket. This occurred when electrically induced heat was used to seal a bleed within the pocket. The removal of the excessive tissue did not perforate the skin but it did reduce the underlying tissue.

Although the burn that resulted on the surface of the skin healed after approximately three months, Rachel was left with a small round visible scar on the upper inner side of her left breast, directly on her cleavage. The scar was similar in appearance to a cigarette burn and measured 1.5 centimetres in diameter.

In September 2009, Rachel contacted Laura Turner, a solicitor specialising in clinical negligence at Pryers Solicitors.

Investigations into the case were made and an expert opinion from a Consultant Plastic Surgeon was sought. The expert evidence was supportive of the case and critical of the way in which the procedure had been carried out.

In July 2011, the Defendant put forward an offer to settle for £2,500 plus costs, which started negotiations. The Defendant eventually settled the claim for £4,250 plus costs.

Unknown to Richard, he had at this point developed a DVT which went undiagnosed for nine days until he collapsed and was rushed to his local hospital. As a result of the hospital’s failure to diagnose the pulmonary embolism (PE), he had to have a filter inserted for fourteen months and suffered with ongoing shortness of breath.

In September 2008, Richard approached Pryers Solicitors and investigations were commenced. Then in October 2009, Laura Turner, a solicitor specialising in clinical negligence, sent a letter to the Defendant’s setting out the allegations of negligence. In the Letter of Response, the Defendant admitted a breach of duty for failing to diagnose the DVT. However, the Defendant denied that there was any significant injury caused by this failure as Richard had a contra indication to anticoagulation.

Laura Turner undertook research into this area and discovered that some people with contra indication to anticoagulation can be preventively treated for a PE developing. She also found medical evidence to support the argument that at the very least all patients should be admitted and monitored carefully.

In 2011 these further allegations were put to the Defendant followed by an offer to settle the case for £5,000 plus costs, which was accepted.

However, over time the mole continued to grow, bleed and change in appearance. Simon re-attended his GP in November 2009 by which time the mole was nearly twice the size it previously was. In addition, it was also bleeding and irregular.

A referral was then made to a specialist at Simon’s local Hospital and a diagnosis of a malignant melanoma was made. Simon ultimately underwent excision of the melanoma but the cancer had proportionately spread to his brain, lungs and chest wall.

In February 2010, Simon contacted David Sears, a solicitior specialising in clinical negligence matters at Pryers Solicitors.

Investigations into the case were commenced and an expert opinion from a GP was obtained. The expert evidence was extremely supportive of the case on the basis that the Defendant had failed to make an urgent referral despite Simon presenting with classic signs of skin cancer.

Further expert evidence ws obtained from a Consultant Dermatologist who confirmed that had the cancer been detected sooner, then Simon would have had a greater life expectancy.

In July 2011, the Defendant’s insurers made an offer to settle of £45,000 plus costs. David Sears then entered into negotiations with the Defendant’s insurers and reached a settlement of £65,000 plus costs, which Simon was extremely happy to accept in full and final settlement.

In September 2009 Maria contacted David Sears, a solicitor specialising in clinical negligence matters at Pryers Solicitors.

Investigations were undertaken and expert evidence was obtained from a Consultant Gynecological Surgeon and a Consultant Neurologist. Both were in agreement that although the damage that was caused to the urethra was noted as a potential complication on the Consent Form, Maria had a normal anatomy and the Surgeon would have had a good surgical field of vision during the operation.

The Defendant commenced investigations shortly prior to the Defence being due and an early settlement offer of £10,000 was made. Maria happily accepted the offer given that she did not have any ongoing problems as a result of the negligence.