Extravasation injuries suffered during medical treatment

How are extravasation injuries caused?

Extravasation injury is caused by the leakage of a liquid flowing into a vein into the surrounding tissue. This can occur when a medicine or fluid is being sent directly into a vein through a cannula or a central line, during, for example, the administration of anti-cancer therapy.

Extravasation can occur for many reasons. These include an obstruction to the line administering the medicine, the drug being administered too quickly or cannulas in small veins repeatedly being used. Certain medicines are also more likely to cause extravasation injury than others.

Extravasation injuries are rare but it is vital that all measures are taken to prevent them from happening and in circumstances when extravasation occurs, the correct action is taken swiftly, so that injury is avoided. In cases in which medical professionals do not ensure that standard preventative measures are in place and/or do not undertake the correct action when extravasation occurs, they may be negligent.

Signs and symptoms of extravasation injuries

The signs and symptoms that extravasation injury has occurred are as follows:

• Pain (including a stinging and burning sensation)
• Erythema (redness of the skin) at the site where the medication or fluid enters the vein
• Swelling at the site where the medication or fluid enters the vein
• Tenderness
• Local blistering
• Mottling/darkening of the skin
• Ulceration (usually evident about 1-2 week after extravasation has occurred)

Not all of these signs and symptoms will always be present.

Treatment for extravasation injury

If the signs and symptoms of extravasation injury occur, treatment must be undertaken quickly. The infusion of the therapy/medicine or fluid must be stopped and the infusion site must be carefully assessed. Treatment also includes the aspiration of as much of the extravasated therapy/medicine or fluid as possible through the catheter, and attempts for the aspiration of the extravasated agent in the surrounding tissue. This aspiration may help to limit the extent of tissue damage and the severity of the injury.

The affected area may also need to be washed out salt water and a plastic surgeon may need to be called to assess the injury and recommend further treatment.

Preventing extravasation injury

Measures must also be taken in order to prevent extravasation injury.

These include choosing an appropriate site for cannulation in order to reduce the risk of extravasation injury, ensuring the infusion site is clearly visible and regularly checking the site to ensure there are no signs of extravasation.

Further and in order to prevent extravasation injury, it is important that medical professionals are fully aware and have a good understanding of the types of medication which can increase the risk of extravasation.

It is also essential that when extravasation occurs, these incidences are fully investigated, so that measures can be put in place to prevent them from happening again.

The Guidelines for the Management of Extravasation of a Systemic Anti-Cancer Therapy including Cytoxic Agents were published by NHS England in 2017. If these Guidelines are not complied with by medical professionals, then they may be negligent.

In cases in which medical negligence occurs, tissue damage can be significant and further surgery and treatment could be required. Cosmetic treatment may also be required, in cases in which individuals are left with scarring, to approve the appearance of the skin.

How Hodge Jones & Allen helped

I recently acted for a lady who sustained an extravasation injury during her chemotherapy treatment following the diagnosis of breast cancer. This was caused by the negligence of the treating medical team. Consequently, this lady sadly became very ill as a result of the injury and spent long periods in hospital undergoing surgery and treatment. She also sustained abdominal scarring. Liability was admitted in this case and I recovered a substantial five figure settlement for this client.

Strict time limits apply to injury claims so if you think you may have suffered injury due to extravasation, please get in touch:

If you have suffered extravasation injuries due to medical negligence you may be entitled to a compensation. For a free initial consultation with one of our medical negligence experts please call 0808 271 9413 or request a call back online.