Complications following caesarean section

The patient suffered a broad ligament tear during the course of a caesarean section. This caused a large intra abdominal haematoma that led to multifocal incomplete bowel obstruction. The incomplete bowel obstruction did not settle on conservative management so the patient underwent a laparoscopy for relief of small bowel obstruction.

The laparoscopy posed a technical challenge. Damage was caused to the bowel by the surgeon during the laparoscopy who attempted to perform a repair. The patient appeared to have made a recovery and was discharged home 5 days later.
After 3 days at home the patient required re-admission as an emergency. She required resuscitation and underwent a laparotomy for peritonitis. The laparotomy revealed a leak along the ileum at the site of the previous repair and the leak was closed with stitches.

4 days later the patient developed an enterocutaneous fistula at the site of the repair that required extensive wound management as an in-patient. The patient underwent further surgery more than 2 months later.

The allegation was that there was a negligent failure to proceed to a laparotomy at the original surgery as the patient was not a suitable candidate for a laparoscopy and that there was a negligent failure to repair the bowel effectively at the time of the laparoscopy when damage had been caused.

The claim was fully contested on breach of duty but settled shortly before trial with a substantial six-figure settlement for the Claimant.

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