A man has received £150,000 after suffering a tear in the small bowel during general surgery.
The tear was not discovered for two days and the contents from his bowel leaked causing him to suffer symptoms including acute respiratory failure, sepsis, an acute kidney injury, a deep vein thrombosis and ongoing breathlessness.
On 7 November 2012 the man underwent a robotic-assisted laparoscopic radical prostatectomy at a hospital of the defendant Trust following his diagnosis of cancer of the prostate. He was positioned in the Trendelenburg with lithotomy position, with his head significantly down. During the procedure he sustained a bowel injury of 5cm in length adherent to the anterior abdominal wall in the midline. A diagnostic laparoscopy within the abdominal cavity was not performed and, due to his positioning, bowel content leaked towards the diaphragm. Neither the bowel injury nor the bowel content were noticed at the end of surgery as the ports were removed.
The following day, the man took pain relief but subsequently vomited. The pain relief had to be escalated to morphine and he began suffering from acute respiratory failure, sepsis and an acute kidney injury and had to be transferred to the intensive care unit (ICU).
On 9 November 2012 the man underwent an emergency laparotomy. It was found that there was a moderately large tear of 5cm in the small bowel adherent to the interior abdominal wall which had caused a substantial leak of content from the small bowel into the abdominal cavity. The adhesions were taken down and 15cm segment of small bowel was removed. The man developed a right-sided deep vein thrombosis extending from the right common femoral vein into the superficial femoral vein.
On 29 November 2012 the man suffered a cardiac arrest. He required two cycles of cardio-pulmonary resuscitation with adrenaline, was re-intubated and transferred back to the ICU. He developed a urinary infection and remained in ICU for 10 days. On 30 November, due to the DVT, an inferior vena cava filter had to be implanted. On 6 December he was extubated and returned to the ward. He was discharged from hospital on 4 January 2013.
The man instructed a medical negligence solicitor to pursue a claim alleging that it was negligent in (a) failing to perform a diagnostic laparoscopy at the beginning of the procedure on 7 November 2012; (b) failing to check the bowel with the laparoscopic camera; (c) failing to consider, after he was transferred to ICU, that his bowel might have been damaged during surgery and that bowel content was likely to be leaking into the abdominal cavity.
Liability was admitted and it was further admitted that if the injury had been recognised and dealt with during the operation, he would have made a full recovery, albeit with a prolonged hospital stay. The case was settled out of court for £150,000.
Johnathan Steventon-Kiy, specialist medical negligence lawyer, says:
“As the story above demonstrates, failing to diagnose and/or treat a bowel injury can have catastrophic consequences for the patient. Such injuries can often lead to considerable amounts of pain, suffering and loss of amenity and cause permanent symptoms.”