§ GUIDE · COMPARTMENT SYNDROME

Compartment syndrome,
and the cost of a delay.

Compartment syndrome is pressure building inside a muscle compartment until the blood supply fails. Treated quickly with surgery to release the pressure, the limb is usually saved. Treated late, it is not. These judgments show both the admissions that follow and the size of the awards.

Riley award

£4,676,442

Chocken settlement

£2.85M + PPO

Prosthetics in Riley

£737,466

Accommodation in Riley

£983,313

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§ THE CONDITION

Pain out of proportion, and a clock.

Compartment syndrome most often follows a fracture, a crush injury or surgery. The classic warning is pain far worse than the injury seems to justify, made worse by stretching the muscle, with tightness, altered sensation and later numbness. The treatment is a fasciotomy, an operation to open the compartment and release the pressure.

It can also arise from pressure applied during long operations or in intensive care. In Chocken v Oxford University Hospitals [2020] EWHC 3269 (QB) the claimant developed compartment syndrome in both legs after a ten-hour facial reconstruction, thought to be linked to leg pressure cuffs in intensive care, and needed fasciotomies from knee to ankle, leaving permanent nerve and muscle damage including foot drop.

§ WHEN THE HOSPITAL ACCEPTS THE DELAY

The claim becomes about valuing a lifetime.

In Riley v Salford Royal NHS Foundation Trust [2022] EWHC 2417 (KB) a 20-year-old motorcyclist with leg fractures developed compartment syndrome. The trust admitted breach of duty and admitted that with appropriate treatment the amputation would have been avoided. His right leg was amputated below the knee.

With liability admitted, the trial was about money, and the judgment sets out the full schedule: general damages of £120,000, past losses of £323,426, future earnings £769,100, pension £27,403, care and case management £980,557, surgeries £45,230, therapies £92,198, transport £308,990, prosthetics £737,466, aids and equipment £160,887, accommodation £983,313, holidays £113,879 and shopping £5,245. The total was £4,676,442.

Chocken settled 70 days before trial for a £2,850,000 lump sum plus periodical payments of £48,000 a year rising to £85,000 a year.

§ NOT EVERY LATER AMPUTATION IS THE HOSPITAL'S FAULT

Causation is decided injury by injury.

Tuffin v University Hospitals Coventry and Warwickshire [2024] EWHC 3318 (KB) is the counterweight. After spinal surgery the hospital failed to give the prescribed anti-clotting injection and the claimant developed a deep vein thrombosis and post-thrombotic syndrome. Three years later her leg was amputated above the knee.

The judge held the trust liable for the DVT and the post-thrombotic syndrome but not for the complex regional pain syndrome or the amputation, which he found were caused by the surgery itself rather than the clot. Compensation covers the harm the negligence actually caused, and a court will split the outcome where the evidence requires it.

§ MISSED VASCULAR EMERGENCIES

A wrong diagnosis is not always negligent.

Beatty v Lewisham and Greenwich NHS Trust [2023] EWHC 3163 (KB) shows the other way a limb claim can fail. In hospital with severe cellulitis, the claimant developed ischaemic toes. A vascular surgeon diagnosed vasculitis rather than an embolism and did not order a CT angiogram, and she later needed a below-knee amputation. The judge found the diagnosis was supported by a responsible body of medical opinion and dismissed the claim.

§ THE JUDGMENTS BEHIND THIS GUIDE

Four judgments on limb loss.

Two where the hospital's failure was accepted and the court valued a lifetime, and two where causation or breach was not proved.

Claimant succeeded£4.68M

Matthew Riley v Salford Royal NHS Foundation Trust

[2022] EWHC 2417 (KB)·2022·Damages assessed at trial

A 20-year-old motorcyclist with leg fractures developed compartment syndrome which the trust admitted it treated too late, so his right leg had to be amputated below the knee. Liability was admitted and the court assessed damages at £4,676,442 covering lifelong prosthetics, care, adapted housing and lost earnings.

Where a hospital admits that quicker treatment of compartment syndrome would have saved a limb, the case becomes about valuing lifelong needs, and prosthetics, accommodation and care can each run to six or seven figures for a young claimant.

Claimant succeeded£2.85M

Chocken v Oxford University Hospitals NHS Foundation Trust

[2020] EWHC 3269 (QB)·2020·Appeal decision

After a 10-hour facial reconstruction the claimant developed compartment syndrome in both legs in intensive care and was left with permanent damage; the trust settled 70 days before trial for a £2.85 million lump sum plus annual payments of £48,000 rising to £85,000. This later judgment dealt only with the lawyers' success fee and dismissed the claimant's appeal on that point.

Compartment syndrome arising from post-operative monitoring failures can attract multi-million-pound settlements with periodical payments for lifelong care, although this figure comes from a costs judgment rather than a damages judgment.

Mixed outcome

Jessica Tuffin v University Hospitals Coventry and Warwickshire NHS Trust

[2024] EWHC 3318 (KB)·2024·Liability decided at trial

After spinal surgery the hospital failed to give Ms Tuffin the prescribed anti-clotting injection, and she developed a deep vein thrombosis and post-thrombotic syndrome; three years later her leg was amputated above the knee. The judge held the trust liable for the DVT and its after-effects but found the amputation was caused by complex regional pain syndrome from the surgery itself, not the clot.

A missed dose of thromboprophylaxis that causes a DVT is negligent, but compensation covers only the harm the clot actually caused. Where a separate condition drives the worst outcome, the claimant must show the negligence at least materially contributed to it.

Claim failed

Jacqueline Beatty v Lewisham and Greenwich NHS Trust

[2023] EWHC 3163 (KB)·2023·Liability decided at trial

Ms Beatty, in hospital with severe cellulitis, developed ischaemic toes; a vascular surgeon diagnosed vasculitis rather than an embolism and did not order a CT angiogram, and she later needed a below-knee amputation. The judge found the surgeon's diagnosis was supported by a responsible body of medical opinion and dismissed the claim.

A diagnosis that turns out to be wrong is not automatically negligent; if a responsible body of specialists would have reached the same view on the information available, the claim fails under the Bolam test.

Browse the whole case library →

Contains information licensed under the Open Justice - Licence v2.0. Judgments from Find Case Law, The National Archives. Summaries are ours; amounts only where printed in the judgment.

§ QUESTIONS

Common questions

What are the warning signs of compartment syndrome?

Pain far out of proportion to the injury, worse on stretching the muscle, with tightness, altered sensation and later numbness or weakness. It is a surgical emergency treated by fasciotomy.

How much is an amputation claim worth?

It depends on age, the level of amputation and lifelong needs. In Riley v Salford Royal a below-knee amputation for a 20-year-old was assessed at £4,676,442, of which prosthetics alone were £737,466 and adapted accommodation £983,313.

Why is pain and suffering only a small part of the award?

General damages follow published brackets. In Riley they were £120,000 out of £4.68 million. The rest replaces care, housing, equipment, transport and lost earnings across a lifetime.

The hospital admitted fault. Why is the claim taking so long?

Because valuing lifelong needs is the slow part. Prosthetic, care, accommodation and employment evidence all has to be obtained, and the parties often disagree sharply. See our guide on how long claims take.

My amputation came years after the negligence. Can I still claim for it?

Only if the evidence links it to the negligence. In Tuffin the trust was liable for the DVT and post-thrombotic syndrome but not for the later amputation, which the judge attributed to a different condition.

Can compartment syndrome happen without a fracture?

Yes. Chocken v Oxford University Hospitals involved compartment syndrome in both legs after a ten-hour operation, associated with pressure during intensive care.

§ MORE GUIDES

Plain answers to the other questions people ask.

Why claims fail →

Eleven real judgments where the claim failed, and what each one teaches about proving breach of duty, causation and loss in a medical negligence claim.

How big awards are built →

How a multi-million medical negligence award is assembled: general damages, care, accommodation, prosthetics, lost earnings and lost years. Real judgments.

Payout examples →

UK medical negligence payout examples by claim type, typical compensation ranges, and what decides the amount. Then check your own claim free.

Fatal negligence payouts →

What compensation after a death caused by medical negligence can include: the bereavement award, dependency, funeral costs and the estate's claim.

Time limits →

The 3-year time limit for medical negligence claims, the date-of-knowledge rule, and the exceptions for children, mental capacity and fatal claims.

NHS payout data →

Official NHS Resolution figures, band by band, for 2024/25.

This guide is general information about the law in England and Wales, not legal advice about your case. ClaimGavel is run by Costart Projects Ltd on behalf of Tomlin & Partners, a specialist medical negligence firm regulated by the SRA. The free assessment on this page is an AI overview to show you roughly where you stand; a solicitor confirms the position in a free, no-obligation conversation.

Compartment syndrome,and the cost of a delay.