Damages Obtained for a Client who Suffered a Bile Leak and Chronic Pain Condition as a Result of Substandard Surgery
In complicated and highly contested litigation, a £130,000 compensation agreement was obtained for our client, who had previously been told by another firm of solicitors that her Claim was too unlikely to succeed for them to justify investigations.
Our client complained about gall bladder surgery that took place at a hospital in North West Wales.
The client alleged that she had suffered a bile leak as a result of substandard surgery that had led to a series of complications, including a need for further surgery and her being left with chronic pain in her scars.
Our client was diagnosed with cholecystitis (swelling of the gallbladder) at a hospital in North West Wales.
Following an ultrasound scan, she was diagnosed with gallstones and underwent a laparoscopic cholecystectomy (keyhole surgery to remove the gallbladder).
On the day following surgery, our client developed severe stabbing pain in her abdomen and began vomiting. She was given morphine, reviewed by a surgeon, and discharged home.
Unfortunately, at home, our client continued to suffer pain, nausea and developed abdominal swelling. She returned to hospital and underwent an urgent exploratory surgery (a laparotomy). Surgeons diagnosed her with biliary peritonitis. They performed a wash out of the wound, fitted her with two wound drains, and identified the presence of four litres of purulent bile. After surgery, our client was transferred to the intensive care unit.
Following the exploratory surgery, our client underwent a series of tests and procedures.
An ERCP (Endoscopic retrograde cholangiopancreatography) was performed, which enabled the surgical team to examine the bile ducts with an endoscope and to identify that the complications were the result of a bile leak. Immediately thereafter the surgeons performed an endoscopic biliary sphincterotomy and stenting of the biliary tree.
Five days after the ERCP and stenting procedure, it was thought that our client had improved sufficiently to be moved to the High Dependency Unit (HDU).
Unfortunately, six days after being moved to the HDU it was identified that she required CT guided drainage of a large pelvic collection. When that procedure was carried out it was identified that our client had developed MRSA in her wound and was therefore given further treatment, including being fitted with a VAC dressing.
After a period of around one month as an inpatient, our client was discharged home with a prescription of antibiotics.
Again, unfortunately, our client required re-admission to hospital only a month later. She complained of abdominal pain, was assessed, and it was decided that clinicians would monitor under out-patient review. It was thought her symptoms were likely to be the result of surgical adhesions.
Just over six months later, our client required further surgery to remove the common bile duct stent that had been inserted as part of the treatment of her bile leak.
Our client’s abdominal pain did not resolve and she returned to hospital on several occasions. She was eventually diagnosed with an incisional hernia and (after a delay of several years) she underwent further surgery to repair her hernia.
Unfortunately, our client’s pain did not resolve and she was diagnosed with chronic pain syndrome (CPS), causing her to suffer persistent pain that severely compromised her function. The prognosis for treatment was considered to be poor and, in any event, our client was unable to engage with any treatment program.
Conduct of the Case
After another firm of solicitors had declined to act, the client contacted Longden Walker and Renney.
Whilst the other firm of solicitors had said that the prospects of her winning her case were insufficient to justify their investigations, we agreed to consider the medical records, take a witness statement and consider the matter further.
After careful consideration of the case, we obtained helpful supportive evidence from a consultant colorectal surgeon, indicating that our client had been subject to substandard treatment.
The surgical expert advised that, during the gall bladder removal procedure, the surgeon had negligently used diathermy (heat produced with an electric instrument), causing her to suffer a bile leak from her common bile duct. The expert surgeon’s advice was that, but for diathermy injury, our client would not have endured such post operative problems – such as the need for subsequent intensive care nursing, an ERCP with stenting of the common bile duct, and she would not have suffered an MRSA infection or have developed an incisional hernia.
Allegations were put to the Defendant in the form of a Letter of Claim. The Defendant denied liability and, therefore, a claim was issued at Court. Proceedings were served upon the Defendant and the Defendant Trust reiterated its denial of any breach of duty.
Litigation was complicated because our Client was not (at the time that proceedings were issued) in a medical condition whereby the Court could come to any final determination as to the appropriate level of compensation that she should receive if her Claim was won. This was because she was pregnant and understood that she would require further surgery, after the birth of her child, before she knew whether her symptoms had resolved.
On our client’s behalf, we made representations to the Court, asking that it arrange two trial hearings; one to establish whether our client had been subject to substandard treatment and a later hearing to establish the appropriate level of compensation, which would take place after she had received treatment. The Court agreed to our request.
Further expert evidence was obtained on behalf of our client. A consultant radiologist helped us identify that key pieces of evidence (ERCP images) had not been provided to us and it transpired that the Defendant Trust had lost these images.
The Court directed the parties, our client and the Defendant Trust, to exchange copies of the expert evidence that they relied upon, in their disagreement over whether the surgery had been substandard and what harm it caused.
The experts disagreed as to the location of the bile leak. The Defendant’s expert argued that the surgery was competent and that the leak was an unfortunate complication - un-related to the use of diathermy and originating from a rare accessory duct.
Our client’s expert maintained his view that the leak was the result of substandard surgery and that it had been caused by the surgeon negligently inflicting injury on the common bile duct by means of diathermy.
The experts discussed their respective views by telephone but could not reach agreement as to the location of the bile leak or whether it had been caused by substandard practice.
In the circumstances, on our client’s instructions we entered into settlement negotiations with the Defendant Trust. It was agreed that the issue of liability would be settled without Trial, on a basis whereby the Claimant would receive 60% of any damages that would have been awarded to her on a full liability basis.
The next step was towards obtaining a Court ruling on the appropriate compensatory award.
Once our client’s medical situation was in a position where we could do so, we obtained a report from a Specialist in Pain Medicine and a further report from a Consultant Surgeon. Given the previous agreement on liability, the Defendant agreed to jointly instruct these experts so that they could comment on our client’s condition and prognosis.
The evidence of the pain specialist was that our client was suffering from chronic pain syndrome and would require further medical treatment in the form of a pain management program.
Our client declined further treatment of her condition and instructed us to enter into settlement negotiations. Soon after, the claim was settled. Our client was delighted with the result.
The claim was funded under the terms of a Condition Fee Agreement ( a “no win no fee agreement”), supported by “After The Event” insurance cover.
If you would like to discuss a potential clinical negligence claim arising out of surgical error, such as substandard gall bladder surgery for example, please contact John Lowther on 0191 5666500 or email email@example.com.
Likewise, if you have developed a chronic pain condition following substandard treatment, please contact us to discuss matters further.
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