Maternity hospital investigates iron infusion errors
Marcos Eleftheriou's client suffered permanent skin discolouration when a post-natal iron infusion leaked into her tissue at Queen Charlotte & Chelsea Hospital.
Ellie* gave birth to her third child by c-section with no complications at the maternity hospital, which is a private section of Imperial College Healthcare NHS Foundation Trust. She was given an infusion of the anaemia treatment Ferinject mixed with saline to aid her recovery. Ellie was not informed that that hypersensitivity and discoloration are side effects of the drug.
Just over an hour into the infusion Ellie alerted midwives that she felt hot, and the site of the cannula was hard, visibly swollen and tender. A midwife then went against Trust guidelines and removed the saline mix. She turned the undiluted iron up to full speed because she said that it was important for recovery.
Ellie immediately, felt a burning sensation in her arm. Her mother questioned this approach as they had been told by the doctor that the infusion should be administered slowly. Ellie was in lots of pain and felt concerned about the care she was being given.
A midwife recorded in Ellie's notes that extravasation occurred, where the drug had leaked outside the veins and into the surrounding tissue. Despite this, the infusion continued until it was completed, which goes against the Trust's own guidelines.
The day after the birth Ellie's consultant explained that she had sustained an iron extravasation injury and that her arm may be stained for life. Ellie was devastated and the news of the injury overshadowed the joy of having her newborn baby.
Following Ellie's experience, Imperial College Healthcare NHS Trust launched a serious incident investigation into five cases involving Ferinject cannula extravasation from August 2023 to March 2024.
The review concluded that that information sharing and decision making on the use of Ferinject was "suboptimal" leading to Ellie and four other mothers receiving inadequate care. The investigation found that staff did not follow guidelines in all five incidents and training gaps in IV pumps to manage infusions.
Ellie is deeply affected by her injuries and her confidence has deteriorated. Six months after the infusion, two thirds of her arm remains noticeably discoloured and is sensitive to touch. She keeps her arms covered to avoid questions and is now petrified of needles.
A consultant dermatologist that assessed Ellie said that laser treatment could not treat the pigmentation because of the size of the stained area. She is advised to keep it covered as it is sensitive to UV light and the staining will darken if exposed.
Marcos is investigating a claim against the hospital on behalf of Ellie for the negligent administration of her iron infusion.
He said: "This is an unusual incident where permanent injury was caused during what was assumed to be a straightforward procedure. The fact that our client was ignored when she raised concern about the pain she was feeling only amplifies the impact this has had on her. We hope to work with the hospital Trust to secure a prompt acceptance of responsibility."
*name changed
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