“They Said It Was a Pulled Muscle”: Missed Blood Clots (DVT and PE) and Medical Negligence

Missed and delayed diagnosis guides · 15 min read · Published 10 November 2026 · Reviewed 10 November 2026 · Next review May 2027

By Dr Rosemary Listing, PhD (Law) · Medical negligence lawyer since 2014 · Of Counsel, Peter Evans & Associates

If you are reading this after a clot was missed, for yourself or someone you love, I want you to know that your questions are reasonable. Blood clots are one of the most recognised risks after surgery and hospital stays, which is exactly why there are national standards for preventing them and clear warning signs to look for.

This guide is for anyone affected by a deep vein thrombosis or pulmonary embolism that was not prevented, recognised or treated in time. It covers what these clots are, who is at risk, what Australian standards say, the warning signs, how they should be tested for, what your records should show, and how the law looks at it.

Start with your question

• What is the difference between a DVT and a PE?
• Who is at risk of blood clots?
• What should hospitals do to prevent clots?
• What are the signs of a blood clot in the leg?
• How should a blood clot be tested for?
• When is it an emergency?
• Can a missed blood clot be medical negligence?

DVT and PE

A pulmonary embolism can be life-threatening if not treated quickly.¹ Some people with a DVT also develop post-thrombotic syndrome, with ongoing swelling, discolouration, pain and sometimes skin ulcers.²

Who is at risk

Risk factors include a hospital stay for surgery or serious illness, recent injury such as a fracture, major surgery such as a hip or knee replacement, cancer, heart failure, oestrogen-containing medicines such as the contraceptive pill or hormone replacement therapy, pregnancy and recent childbirth, a previous clot or a genetic clotting condition, long periods of immobility or long-haul travel, older age, being overweight and smoking.²¹

What Australian standards say about prevention

The Australian Commission on Safety and Quality in Health Care has a national clinical care standard for preventing VTE. The Commission notes that hospitalised patients have a far higher risk of VTE than people in the community, that many cases occur after people go home, and that prevention strategies are associated with a large reduction in VTE.³

The standard has seven quality statements. In summary, patients who may be at risk should have their risk assessed and recorded; a prevention plan should balance clot risk against bleeding risk; patients should be informed and involved; the plan should be documented and shared; appropriate medicines or mechanical methods should be used; risk should be reassessed regularly, when things change, and at discharge; and patients should leave hospital with a written plan, with their GP receiving it within 48 hours.⁴

Questions to ask in hospital

• What is my risk of a blood clot?
• What are you doing to prevent one, and for how long?
• Should I keep taking anything after I go home?
• What signs should I watch for, and who do I call?
• Will my GP get my prevention plan?

Going home

Because many clots happen after discharge, what you are told on the way out matters. Under the national standard, you should leave with a written plan you have discussed, and your GP should receive it promptly.⁴ If your discharge information said nothing about clots, that is worth noticing.

Signs of a clot in the leg

The main signs of a DVT are pain and swelling, usually in the calf or thigh. The area may be sore, red or swollen. Some people have no symptoms at all. If you have signs of a DVT, such as a red, swollen leg, see a doctor straight away.²

Leg swelling after surgery can have other causes, and that is part of why clots get missed. But a hot, tight, swollen calf in someone who has just had surgery is exactly the situation where a clot should be considered and tested for, not assumed away.

Signs of a clot in the lungs

Signs of a PE include sudden or worsening breathlessness, chest pain that may be worse with deep breaths, a racing heart, fast breathing, coughing (including coughing up blood), and fainting or light-headedness. If you have these symptoms, go to an emergency department or call 000.¹

How clots should be tested for

A doctor will ask about your symptoms and risk factors and examine you. A D-dimer blood test can help, and an ultrasound or other scan is used to confirm a DVT.² For a suspected PE, tests may include blood tests, a chest X-ray, an ECG and a leg ultrasound, with a CT pulmonary angiogram (CTPA) or a ventilation/perfusion (V/Q) scan to look for a clot in the lungs.¹

Expected, worth a review, or emergency

A general guide only. If you are worried, get help.

Afterwards

Treatment for a clot usually involves blood-thinning medicine, sometimes for months. Some people recover fully. Others live with lasting leg problems or reduced lung function, and the anxiety of having nearly died can stay. If you were left with lasting effects, or a family member died, you are entitled to an explanation. Our guide to failed diagnosis explains how the law looks at missed conditions more broadly.

If you felt dismissed when you raised concerns, see when being dismissed by a doctor becomes a legal issue.

What to look for in the records

Your records are often where the story becomes clear. You have a right to access your own health information. In NSW the Health Records and Information Privacy Act 2002 covers both public and private providers, and the Information and Privacy Commission explains how to ask.⁵ Our step-by-step guide to getting your medical records in Australia walks you through it.

How the law looks at it

Not every blood clot is preventable, and not every missed clot is negligence. Clots can happen despite good care, and symptoms can be unclear. The legal questions are whether the care you received met the standard expected, and whether any shortfall caused harm.

A claim usually turns on three questions: whether the care fell below what peers would widely accept as competent practice (section 5O of the Civil Liability Act 2002 (NSW))⁶, whether that shortfall probably caused harm you wouldn't otherwise have had (Tabet v Gett)⁷, and, where it matters, whether you were told the material risks first (Rogers v Whitaker)⁸⁹. Our guide to how a medical negligence claim works explains each one in plain terms.

In a blood clot case, the questions might be: was your clot risk assessed and was appropriate prevention given, in line with the national standard? Were you given information about prevention and warning signs at discharge? When you had symptoms, did the doctors you saw consider a clot and order appropriate tests?

In plain terms, the question is whether proper prevention, or earlier diagnosis and treatment, would probably have avoided the clot, the PE, or the lasting harm.

For prevention, that would usually include the options, their risks such as bleeding, and what to watch for at home. Consent also matters if you declined prevention: you should have understood the risk of doing so.

Who can claim, and when

The person harmed can claim. If someone died from a clot, members of their family may be able to bring a claim on their own behalf. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, not from the treatment itself, and courts can sometimes extend it, so an old injury may still count. See time limits in NSW or other states, and ask early.

More: complaint or claim? · how a claim is paid for · what a claim can cover

In my practice

When I read files about missed clots, I almost always find that the risk was known. A risk form ticked “high”. Injections given on the ward. And then a gap at discharge: no plan for home, nothing about what to watch for, nothing sent to the GP. When symptoms appear, each person who hears about them sees only one piece: the after-hours nurse thinks wound, the GP thinks muscle strain. Nobody puts the leg next to the operation. It is a chain of small failures, and each clinician might reasonably think someone else had it in hand. The national standard exists precisely to stop the chain breaking at those points.

Both things can be true

The hospital may have managed your clot risk well while you were on the ward, and still let you down at discharge. The GP may have been thorough in other ways, and still missed the signs. You can be grateful to the paramedics and emergency team who saved a life and still want to know why it came to that.

The bigger picture

The Australian Commission on Safety and Quality in Health Care published the national VTE Prevention Clinical Care Standard to reduce variation in how hospitals prevent clots. The Commission notes the burden of hospital-associated VTE and that prevention works.³⁴

You can check any practitioner’s registration on the Ahpra public register,¹⁰ and complaints about care in NSW can go to the Health Care Complaints Commission.¹¹ Clots after surgery overlap with our guides to surgical errors and hospital negligence, and oestrogen-containing medicines with medication, drug and device harm.

Support

You don't have to work through this alone. These services can help:

• Lifeline, 24-hour crisis support: 13 11 14 (listed on healthdirect's helplines page)¹²
• Beyond Blue, anxiety and depression support: 1300 22 4636
• Medicare Mental Health, help finding mental health support: 1800 595 212
• healthdirect, 24-hour nurse advice: 1800 022 222
• Health Care Complaints Commission (NSW): 1800 043 159

A woman who grabbed the wall in her hallway is walking further now, and knows it wasn’t her fault. You and your family deserve that understanding too.

With care,
Rosemary

Frequently asked questions