Our client (A) was admitted to hospital in December 2008 to undergo a vaginal hysterectomy. A was admitted to the QE II Hospital which formed part of the East and North Hertfordshire NHS Trust. There were problems with the consent form in that risks were recorded as bleeding, infection, pain, anaesthetic DVT, injury to other viscera. The notes indicated risks explained but there are no details of exactly what risks were explained. The operation commenced at 14.00 on 8th 2008 and was completed at 18.30 according to the anaesthetic sheets. The records indicated a blood loss of 1.8 litres with a drop in haemoglobin level and 2 units of blood were transfused post operatively.
At the post operative review the A’s abdomen was found to be distended with a soaked dressing. A full blood count and clotting were requested. 1½ hours later it was noted that her blood pressure had reduced as had haemoglobin levels. A was reviewed 3 more times before midnight and it was noted that her blood pressure had dropped further and her abdomen was more distended. A further full blood count was requested. By midnight blood pressure was not recordable. A was taken back for an urgent surgical intervention. Loops of small bowel were found to be adherent around the entry to the wound with one centimetre of small bowel injury and three other sites of superficial damage. A General Surgeon was called and he repaired the injury and performed a segmental resection of 10cms of bowel. A little under 3½ litres of blood was in the abdomen and the client was bleeding. The total blood loss from both procedures was between 5½ and 6 litres. A had to be admitted to critical care and a total of 15 units of blood, 4 units of FFP, 1 unit of cryo precipitate and 2 pools of platelets were transfused. A’s recovery was complicated and she remained in hospital. A surgical review on 20th showed a slight change in the collections.
A was eventually discharged from hospital on 28th suffer symptoms after discharge. There were multiple failures on the part of the Hospital Trust at consent, on surgery, post surgery and during recovery. A had to have her ovaries removed and as a result of that needed HRT until the natural age of the menopause to replace the missing hormones. She would not have required HRT if her ovaries had been left in situ. But for the failures of the Trust the bowel injury would not have occurred had an alternative procedure been undertaken then on balance the small bowel injury would have been avoided and the A’s recovery would have been much quicker. But for the negligence of the Hospital Trust in delaying A’s return to theatre, the greater blood loss, on balance, would not have occurred and, the blood transfusion would not have been required. A suffered an in-patient stay of 20 days. She would, in normal circumstances, have been expected to stay in hospital no longer than 2 days. She remained off work for 5 months, she suffered physical symptoms thereafter and her return to work had to be phased. She was left with scarring and psychological consequences.
Alison Ainsley was instructed to pursue the claim and after appointing a Gynaecological expert, evidence was obtained in support of the A’s claim. A further report to record A’s condition and prognosis was obtained from the same Gynaecological expert and, as a result of that an overall settlement was agreed in the sum of £45,000. A was extremely happy with that sum.
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