Phoenix Legal Limited recently acted on behalf of a client, Miss Dallison, who suffered medical negligence during a procedure following a suspected miscarriage.
Our client was in the early stages of pregnancy, approximately 8 weeks, when she started to experience heavy bleeding. She was referred to Royal Derby Hospital where she was advised that she has suffering from a suspected miscarriage. She was discharged home, but returned shortly afterward with further bleeding. As a result, it was recommended that she undergo a Dilatation and Curettage (D&C) procedure in which the cervix is dilated so that the uterine lining can be scraped with a curette to remove any remaining tissue. Our client was reviewed by a Locum Gynaecology Specialist, and it was recommended that the D&C procedure be undertaken by an experienced Doctor as our client had a retroverted uterus and unusual scan findings.
Our client was booked in for surgery with the Locum Gynaecology Specialist and a risk of the surgery noted on the consent form was, amongst other things, bowel injury. The Locum Doctor carried out the procedure during which he became aware that during the suction he had perforated our client’s bowel. A serious incident investigation was carried out and the Locum reported during the investigation that when he became aware that he had perforated our client bowel, he immediately abandoned the procedure and called for the Consultant on call to attend the theatre.
However, the theatre staff, who were also in attendance during the procedure, gave a very different recollection of events. They advised the investigator that they had become concerned when our client began to bleed, more than normal, and that the Locum Doctor had advised them that there was a large piece of placental tissue which he needed to remove. As he removed the tissue, the theatre practitioners reported that they became even more concerned as they did not believe it to be placental tissue. Most importantly, the theatre staff reported that they asked the Locum Doctor if he needed help and he refused, contrary to his recollection that he abandoned the procedure and called for help.
The theatre staff advised the investigators that they asked him on two occasions if he required help, which he refused, however, they felt that the matter required senior assistance and one of them left the theatre and requested the urgent attendance of the on-call Consultant. The theatre staff then witnessed the Locum Doctor returning the tissue into our client’s vagina. When the on-call Consultant arrived, he removed the swab and noted the tissue was present in the vagina and immediately called for the colorectal surgeon to attend urgently. Our client went on to have a laparotomy, and approximately 30-40cm of her small bowel removed, after she was admitted to Intensive Care.
It is recorded in the investigation report that the Locum Doctor attended upon our client that evening twice. On the first occasion apologising for what had happened. It does not record why he returned the second time. However, our client’s recollection is that whilst he did apologise, he was very abrupt with our client and advised her that he had intended to return home to Ireland for the weekend to see his family which he could not now do, because of her. This had added further distress to our client as she felt that he was blaming her for not being able to return home to see his family.
The investigation concluded that “During the procedure the surgeon undertaking the procedure was faced with a set of circumstances which he had not experienced before, and for which he was unprepared, leading him to become situationally unaware. The theatre team became concerned and encouraged him to seek assistance which did not happen immediately, the theatre staff then took appropriate responsibility and summoned immediate consultant attendance to theatre. As a result of the incident she suffered bowel damage, lost part of her bowel and was subjected to both physical and emotional discomfort and continued anxiety about the ongoing effect on her future fertility”
A letter of claim was drafted, with the assistance of Mrs Sara Sutherland, Barrister at Exchange Chambers, in which it was alleged that the trust and/or their employees had failed to consider whether a D&C procedure was the correct procedure for someone with a retroverted uterus; damaged our clients bowel; failed to seek supervision and/or assistance during the procedure; failed to stop the procedure; perforated our clients uterus; refused assistance when suggested by the assisting team, as well as further allegations.
Upon receipt of the Letter of Claim the Defendants admitted liability and made an early offer of compensation in the sum of £15,000 which we advised our client to reject this offer as our medical evidence was not completed.
We obtained medical report from a Consultant General Surgeon, Mr Lees, who advised that following the surgery and discharge from hospital our client suffered from abdominal pains, bloating, faecal urgency, faecal incontinence, which she had not suffered previously. It was suggested that our clients NHS treating Physicians that she had adhesions which were best managed non-operatively. Our Colorectal expert suggested that the problems may be caused by irritable bowel syndrome (IBS), bile salt malabsorption or bacterial overgrowth. Our expert noted that our client was undergoing investigations via the NHS regarding the bile salt malabsorption.
Our expert advised that if it were abdominal adhesions then 35% of patients who underwent abdominal or pelvic surgery were readmitted an average of 2 times over the subsequent 10 years for a disorder directly or possibly related to the adhesions, or for abdominal or pelvic surgery that could be potentially complicated by adhesions. He went on to suggest that our client had a 3-5% chance of needing emergency treatment for the adhesions within the next 10yrs. This additional surgery needed to be accounted for in the compensation that we were seeking from the Defendants and our expert put the cost of such surgery in the region of £10,000 – £15,000, privately, the cost of which we incorporated into our client’s schedule of loss.
If our client were to require further surgery, it was suggested by our expert that her recovery period would be 10-15 days in hospital followed by 6-12 weeks recovery. This would mean that our client may suffer future loss of earnings which we also needed to incorporate into her schedule of loss.
A report from a Consultant in Gastroenterology was obtained, from Dr Bowling, after our client was diagnosed with bile acid malabsorption in January 2021 and continued to have issues surrounding bloating and abdominal pains. Dr Bowling advised that he believed that our client had IBS which should settle over the coming years but that the bile acid malabsorption would be permanent requiring lifelong treatment.
Our client also suffered significant scarring to her abdominal area, a scar of around 19cm in length, which she had become increasing conscious of. We obtained a report from a Plastic Surgeon in respect of revision surgery. A report was obtained from Professor Jeffrey who advised that the cost of revision surgery would be in the region of £2,600. The cost of this surgery was incorporated into our client’s schedule of loss.
A report was obtained from Dr Kapadia, Consultant Psychiatrist, who advised that our client suffered from an adjustment disorder, which is a recognised psychiatric condition, from the time of the negligence until around July 2019. Furthermore, our client suffered from anxiety and social phobia form which 14 sessions of cognitive behavioural therapy (CBT) was recommended, after which our client was likely to recover within one year of commencement of the therapy. The cost of the therapy was estimated to be £175 per session which we also included in our client’s schedule of loss.
Our client was concerned about future fertility complications and a report was obtained from a Consultant Obstetrician and Gynaecologist, Mr Pickersgill who concluded that our client’s fertility should not be impacted physically by the uterine perforation which had healed completely. However, it was suggested that her abdominal pain could be due to pelvic and abdominal adhesions, which if they affected her ovaries then could reduce her chance of conceiving but an MRI scan showed no evidence of this.
Our client required assistance from her partner for around two weeks following her discharge from Hospital as well as assistance from friends and family with domestic chores, shopping, and help caring for her daughter and the help with the school run.
Our client was a self-employed beautician having only just started her business shortly prior to the negligence. She did not return to full-time work until September 2019. It was imperative that we included loss of earnings in our client’s claim, not only for the period of loss immediately after the negligence but for any future period when she would require time off to have the revision surgery that she required. Proving loss of earnings for a self-employed client can only really be done using profit and loss accounts which our client provided to us.
Once all of the medical evidence was gathered and evidence of our clients’ losses, we presented these to the Defendants and invited further offers.
Several offers were made which were rejected by our client, following our advice that they were too low. Eventually the claim settled for £73,000.00.
Medical Negligence is a very specialised area of law, and it is imperative to your claim that you chose the right legal team to pursue your claim for you. If you don’t your claim may settle for considerably less than it should or may not be pursued as an inexperienced solicitor may advise you that the claim is too risky.
Alisha Butler of Phoenix Legal Limited has over 23 years’ experience in Personal Injury and has over 10 years’ experience of dealing with multimillion pound claims, involving sepsis, amputations, and brain injuries at birth. Alisha prides herself on impeccable client care, always being available to her clients day or night, to discuss any concerns they may have. Being a medical negligence solicitor is not a career it’s a vocation and not everyone is experienced enough to deal with such claims.
If you have a medical negligence claim or you are not sure if you have then contact Alisha Butler on ab@phoenixlegalsolicitors.co.uk or call 0151 306 3694.
H Ellis et al. (1999)