Negligently performed hysterectomy

We were instructed on behalf of MK in relation to her abdominal hysterectomy and bilateral salpingo oopthorectomy resulting in damage to her ureter. The claimant had a history of chronic pelvic pain and underwent a number of investigations in 2001.

Eventually, she was diagnosed with having a polyp which had grown in size to 7.5cm. Tumour markers and blood tests all indicated that this was normal. Following review the claimant was given 3 options, a laparoscopy with aspiration of the cyst, a right oopthorectomy and a total abdominal hysterectomy with bilateral salpingo ooptherectomy. The claimant was unsure which procedure would best suit her but was persuaded to undergo the total abdominal hysterectomy. During the operation, the claimant’s abdomen was opened and no adnexal mass was noted, only a few flimsy adhesions to the left adnexal were noted. However, the consultant proceeded to a total abdominal hysterectomy with bilateral salpingo ooptherectomy and during this procedure when the claimant’s uterine artery was clamped the claimant’s left ureter was ligated or crushed or otherwise damaged. This was not recognised during the course of the surgery.

Following discharge from hospital, the claimant was in constant pain, passing urine every 10 minutes. On return to hospital a few days later, during an ultra sound scan, there was noted to be a pool of liquid sitting above the vagina. This was put down to an infection and the claimant was given a course of 10 days worth of antibiotics.

The claimant continued to leak urine and continued to suffer significant pain upon urination and after further persistence by the claimant was eventually reviewed by a Urologist and underwent tests which showed a leak of urine from the left side of the ureter and a stent was fitted. Unfortunately, the procedure did not work and she was subsequently fitted with a nephrostomy.

Following further tests and consideration, eventually, the nephrostomy tube was removed but the claimant still continued to suffer pain and more frequency with urination.

The initial surgery was undertaken by the consultant obstetrician/gynaecologist. We obtained a liability report in relation to the consenting of the patient together with the procedure and investigations undertaken prior to the operation which resulted in the total hysterectomy. The findings were such that the abdominal hysterectomy was unnecessary and it was negligent to carry it out in light of the laparotomy findings.

There were failings prior to the surgery in not properly considering the ultrasound scans and the possibility of considering an investigative laparoscopy before proceeding to a total abdominal hysterectomy. Furthermore, the claimant’s urethra was damaged during the course of the operation and there was a failure to recognise that the claimant’s left urethra had been injured during the course of the procedure. This amounted to negligence as during medical investigations it was recognised that this is a known complication of the procedure however, the negligent aspect of it was to fail to recognise that the claimant’s left urethra had been damaged, not the damage to the urethra itself.

The clinical negligence protocol was followed however, the defendants initially denied liability and therefore proceedings were issued and served following obtaining all quantum evidence and reports, it was not until exchange of liability expert reports that the defendants were prepared to make any offers of settlement. The case was subsequently set down for Trial and a settlement was reached one month before.

In terms of quantification of the claim prior to her initial operation, the defendants only made a global offer, not separating the general and special damages. MK required a significant amount of care which was provided gratuitously by her husband and son and as a result of the damage to the urethra, this prevented her from returning to work.

The claimant worked as a payroll officer for the multi-national securities company on a temporary contract that was constantly renewed. Prior to her operation, she had agreed with the Vice President that she would take 1 month’s leave and then resume back to work on a three-day week on a temporary contract, however, because her contract of employment had been terminated and we had to obtain a significant amount of evidence to say that she would have had employment had the operation proceeded uneventfully and without damage to her ureter.

We also put forward a claim for disadvantage in the open labour market and also psychiatric injury due to the trauma of undergoing numerous operations.

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