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Damages obtained for Client who suffered Septal Perforation due to Substandard ENT Treatment

Damages obtained for Client who suffered Septal Perforation due to Substandard ENT Treatment

£2,500 damages were obtained on behalf of our client who suffered a nasal perforation due to allegedly substandard ENT surgery.

The client had undergone a cautery procedure to stop his nose bleeds.  The procedure involved use of KTP laser surgery and topical silver nitrate at the Royal National Ear, Nose & Throat Hospital operated by the Royal Free London NHS Trust.

The client’s allegation was that, had appropriate care been provided, he would not have suffered a septal perforation.  The Claim was settled after supportive expert evidence had been obtained and the case issued at Court.


In approximately April 2010, our client attended his GP Practice seeking help with nose bleeding that had troubled him over a period of five years.  The GP referred our client to the Royal National Ear, Nose & Throat Hospital for specialist attention. 

He met an ENT specialist at the Royal National East, Nose & Throat Hospital.  Our client was advised to undergo what was described to him as being a simple procedure to stop his nose bleeds.  He understood that the surgeons would use heat (cauterization) to burn away capillaries that were causing him to suffer nose bleeds.

Surgery to prevent further nose bleeds took place on 25th July 2010. 

Soon after the procedure had taken place, our Client’s nose became blocked and he thought that he had an infection.  At that time, the area was covered in scabbing, which our client presumed was normal given that he had recently undergone a surgical procedure.  He attended several outpatient appointments and was advised to use cream and keep the area clean.

Subsequently, in around August 2010, as the scabbing around the operative site cleared, our client became aware that there was actually a hole in his septum – between his nostrils.  He sought help in A&E but was advised to return for an appointment with a specialist.

The ENT Specialists alleged that he had injured himself (causing a perforation of his septum) by picking his nose.  Our client maintained that he had not been picking his nose and wondered whether the hole may have been caused by the recent use of a KTP laser and silver nitrate to burn-away capillaries in his nose.

The client was dissatisfied with the cosmetic effect of having a hole linking his nostrils and found that his nose made a whistling nose, which was intrusive and affected his personal life and work.  He sought a second opinion and was referred to a different surgeon.

Revisionary surgery was arranged to take place in August 2011.  This was re-scheduled to February 2012.  The perforation was filled and the client reported an excellent result.

Conduct of the Case 

John Lowther of Longden Walker & Renney was instructed to investigate the claim. 

 Our Mr Lowther obtained medical records and prepared a witness statement.  Expert evidence was obtained from a Consultant ENT surgeon who advised that:

 (i)   That the septal perforation could not have occurred in the absence of substandard treatment.

 (ii)  That on the overwhelming balance of probabilities, the most likely cause of the septal perforation was the surgery complained about (i.e. not our Client picking his nose)

 The expert explained that:

 (i)   It was inappropriate and unnecessary to use two forms of cautery – in this case, silver nitrate and a laser.  To do so, amounted to substandard treatment.

 (ii)  It was mandatory for the Defendant Trust to take a trial of antibiotics/antiseptic cream prior to commencing laser treatment.  This did not take place. 

 (iii) There was also a failure to identify the bleeding point, prior to applying cautery. 

Essentially, the ENT expert was supportive of our claim for damages and therefore a Letter of Claim was prepared and forwarded to the Defendant.

The Defendant denied that it had provided substandard treatment and maintained that the client’s perforation was caused by his picking his nose.

In the circumstances, a copy of the expert’s supportive evidence was forwarded to the Defendant and settlement proposals were made. The Defendant responded by stating that it would not settle the claim.

The claim was issued at Court and served upon the Defendant.  At that point, the Defendant proposed settlement of the claim.  Our client accepted the Defendants settlement proposals.

If you would like to discuss a potential Clinical Negligence claim concerning substandard ENT treatment please contact John Lowther on 0191 5666500 or email

 If you prefer, you can complete our short enquiry form and one of our Medical Negligence Solicitors will contact you.