Death following negligent bowel surgery

The patient suffered from pain in his abdomen for around three months. A colonoscopy revealed that he was suffering from sub-acute intestinal obstruction from intusuccepting cancer at the splenic flexure and he required emergency surgery.

The patient underwent an emergency laparotomy that day when an obstructing carcinoma was found at the splenic flexure. The tumour was resected and a colostomy was performed.

Following the operation the patient was unwell. He had a high heart rate and poor urine output. By the second day, he was found to be in septic shock and later that day was diagnosed with pneumonia. He continued to deteriorate.

The following day his condition deteriorated further and during the morning a decision was taken to proceed with a re-laparotomy for peritonitis. Surgery was undertaken some 2½ hours later and it was found that the patient had advanced faecal peritonitis with leak of faecal contents from the stoma site into the peritoneal cavity. The area where the proximal and distal stoma were joined had retracted into the peritoneal cavity and was leaking faeces into the abdomen.

Despite ongoing medical care the patient continued to suffer from sepsis and its complications. He developed multi-organ failure, his abdomen continued to drain faecal fluid. He required continuing hospital management for the following 4 months at the end of which his condition deteriorated further and he died. The cause of death was hepato renal failure due to septicaemia due to peritonitis.

A claim was made on the basis that there was a failure to intervene sufficiently early when the patient had signs of faecal peritonitis. Had a re-laparotomy been performed earlier, then the consequences arising from the faecal peritonitis would have been less and the patient would have survived.

Following the service of proceedings no defence was offered by the Trust and judgement was entered for the patient’s widow for damages to be assessed.

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