Medical Mistake Claims - Simpson Millar LLP
 
 

Delay in diagnosing perforated bowel

Our client had previously undergone emergency surgery for crohn's disease which required an ileostomy to rest the bowel. Our client subsequently underwent surgery to reverse the ileostomy and whilst he had made a good recovery from that surgery, he had developed a hernia at the original operation site.

Arrangements were made for our client to be admitted to hospital where he underwent a laparoscopic incisional hernia repair. During the procedure it was identified that the bowel had been damaged which was repaired by the surgeon.

Following the hernia repair surgery our client was unwell and was making a slow recovery. A CT scan was eventually performed some 5 days following surgery which showed free fluid in the abdominal cavity. Our client was subsequently returned to theatre where a small perforation of the small bowel was identified and necessitated a small bowel resection and formation of an ileostomy. The mesh was contaminated and, therefore removed.

Had the fact that our client was not making a normal recovery been recognised immediately and had he received appropriate treatment which would have involved re-operation within 48 hours, then the perforations would have been identified in the small bowel and there would have been minimal contamination in the area. This meant that on the balance of probabilities, primary repair of the defects would have been possible and it is unlikely that our client would have required a small-bowel resection or ileostomy.

Our client would not have required a period in the Critical Care Unit and would have made a much more rapid recovery, being discharged 10-14 days after surgery, and would have made a full recovery by 3 months.

As a result in the delay in diagnosis of a small, bowel perforation, our client suffered significant pain for a period of 5 days until the laparotomy. He had to undergo a major laparotomy, developed signs of significant sepsis, he required a small bowel resection and formation of a double-barrelled ileostomy. He required a period in the Critical Care Unit and a prolonged and protracted hospital stay.

Our client has had several further admissions with sub-acute obstruction. He also required surgery to reverse the loop ileostomy and suffered a psychological reaction.

Our client argued that during the hernia repair surgery the surgeon caused a tear or perforation of the small bowel but failed to ensure that the defect was repaired adequately and effectively, either by missing it altogether or failing to repair it effectively.

He also argued that there was a failure to monitor and respond adequately to his clinical state following the hernia repair surgery, especially given the knowledge or suspicion that at least some degree of tear, perforation or defect had been present in the small bowel during surgery and that there was a failure in fact to undertake appropriate or any investigations within 48 hours of the surgery, namely by way of CT scanning, re-laparoscopy and/or laparotomy – and/or continuing to fail to do so for 5 days, despite the fact that he had clear and unequivocal signs of systemic sepsis including tachycardia, low oxygen saturations, significant abdominal pain, difficulty in breathing and spreading cellulitis. An out of court settlement was reached in the sum of £60,000.

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