A pensioner died from a rare and unforeseeable complication following a hip replacement operation.
Shortly after the prosthetic implant was fitted, Bertha Durrant suffered a catastrophic fat embolism – globules from bone marrow getting into the lungs, preventing blood being oxygenated sufficiently.
Mrs Durrant (86) died in Boston’s Pilgrim Hospital on May 22 this year, the day after the operation.
Giving evidence at an inquest into her death, orthopaedic surgeon Theo Joachim said it was the first such fatality he had encountered in three years at the Pilgrim, which has about 350 hip op patients per year.
Pathologist Dr Mike Harris accepted a suggestion that it could be as rare as 1 in 1,000, adding: “I have seen it but it’s uncommon.”
The inquest heard that Mrs Durrant suffered a broken left hip during a fall at her home in Marsh Road, Holbeach Hurn, on May 20.
After a 45-minute wait for an ambulance she was taken to A&E at Pilgrim. Family members at the hearing – including Mrs Durrant’s daughter Jayne Catterall and granddaughter Natalie Howard – were unhappy that she was left on a trolley bed in a corridor for about two hours before being seen.
Medical records showed that Mrs Durrant arrived at 7.16pm and was triaged at 9.10pm. A doctor saw her at 10.45pm.
Mr Joachim confirmed that the times for assessing Mrs Durrant were within government guidelines and did not contribute to the outcome of her injury.
He confirmed to Prof Robert Forrest, senior coroner for South Lincolnshire, that without treatment an injury such as Mrs Durrant’s “inevitably leads to death”.
Speaking generally about the loss of bone structure in people of her age, Prof Forrest added: “Even though there is only a minimal amount of force required to produce a break with a fall from their own height, the effect is devastating.”
Mr Joachim explained to the hearing how the prosthestic hip is used as a wedge into the marrow cavity of the femur.
Everything appeared to be progressing as expected with Mrs Durrant’s operation until about ten minutes after the new hip was in place.
He said: “There was a slowing of her heart rate and a drop in blood pressure.”
An oxygen saturation test suggested that something was not right, but Mrs Durrant responded to treatment by the anaesthetist.
Five minutes later her blood pressure dropped again but this time did not pick up with an increase in drugs. Adrenaline had no effect either.
Mrs Durrant was transferred to the intensive care unit but her condition never improved and she died the following morning.
Natalie Howard said her grandmother was “a playful, loving, caring person” who would help her great-grandchildren with their homework and was adept with the internet.
Verdict: accidental death.
