Hannah’s Story: ‘Unsafe’ pacemaker advice led to unnecessary surgeries and complications

Our client – who received incorrect and unsafe advice regarding her pacemaker – has settled her medical negligence claim against two defendant trusts.

Timeline of events

 Summer 2018

Hannah attended the first defendant trust for a pacemaker implantation after she had been diagnosed with a heart blockage. Despite the consent form stating she would be given local anaesthetic and sedation for the procedure, Hannah was only administered local analgesia and recalls the events and pain she experienced in detail. She was discharged the same day.

During the next two months, Hannah attended the hospital five times due to bleeding from the wound.

Autumn 2018

During an appointment, Hannah described experiencing sharp stabbing pain over her device and scar. The consultant told Hannah there was a serious risk of erosion and the pacemaker could break through the skin, which would require a prolonged hospital stay on intravenous antibiotics. As a result of this advice, Hannah agreed to return to the hospital for a reburial of the device under general anaesthetic.

Winter 2018

The same pacemaker that was used in the first procedure was reburied. On awakening from the operation, Hannah was immediately aware of a severe nerve pain in her left arm as well as soreness from the site of the reburial. Following a review, no explanation was offered for the nerve pain. It was noted that the arm was sore but likely to take at least a week to settle. She was discharged the same day.

The following month during a consultation, it was noted that Hannah had revisited the defendant hospital on two occasions complaining of neuropathic sounding pain and that the edge of the pacemaker was catching and causing significant pain. She was advised there was some soft tissue swelling, which could take some time to heal.

She also saw her GP due to a lump in her armpit, which had appeared following the pacemaker implant. The plan was to get a second opinion from her cardiologist.

Winter 2019

At another follow up consultation, Hannah was advised that the pain would take several weeks to resolve. Hannah was also experiencing neuropathic pain that was shooting from her left elbow down to her wrist. Her neuropathic pain was discussed with her neurologist, who agreed that the description of the pain is not in any typical distribution and it would be difficult to target with any definitive therapy. A small dose of pregabalin was suggested.

Spring 2019

Hannah’s GP referred her a second opinion due to sharp neuralgic-type pains and loss of confidence. She was admitted to a different defendant trust the following month, which reported that there was no obvious damage to the pacemaker and discharged her.

A month later, a clinic appointment took place with a consultant cardiologist at the second defendant trust. The pacemaker’s wires and generator were noted to be quite prominent, with the generator digging into the armpit. Hannah was listed for further surgery and to replace the device for another one, which took place in autumn. Since then, Hannah has been informed that she has a lot of scar tissue, which could be problematic for her throughout her life.

How we helped Hannah’s case

Hannah approached us with her claim due to concerns about the care and treatment she received. We issued a letter of claim, which was drafted in line with the supportive expert evidence we received, and took steps to quantify the case. An out-of-court settlement was secured.

A note from James Anderson

“There were multiple failures in this case. Firstly, Hannah had agreed to be sedated, but this was failed to be administered, which caused her lots of pain and distress during the first procedure.

“Secondly, the advice Hannah was given to rebury her pacemaker was wrong and unsafe. The risk of erosion leading to skin perforation was very low and needed to be responsibly balanced with advice that the risk of infection through re-insertion was real. Hannah’s continuing experience of pain around the insertion site was not clearly understood and it was entirely speculative to advise that a second procedure to bury the device deeper into her body, which would inevitably involve new and deeper incisions and tissue disturbance, would reduce her experience of pain.

“Finally, medics incorrectly advised Hannah to have her pacemaker removed and a different, smaller device implanted. Hannah should have been advised and counselled that the only likely benefit of further surgery to implant a marginally smaller device was cosmetic – a factor that should have been balanced against the increased risks of injury and death arising from changing the entire pacemaker device.

“These failures caused significant pain and discomfort and, as a result, Hannah has developed PTSD with depression. The quality of her life has been reduced and she continues to have sleep problems.”