Claim Against Royal Free London NHS Foundation Trust Settled

9 May 2024 | Jodi Newton

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Client obtains settlement after being victim of a surgical negligence

Jodi Newton, Partner in our Clinical Negligence department, recently settled a case against Royal Free London NHS Foundation Trust (“the Trust”) relating to negligence which occurred during surgery in May 2021 leaving our client with serious physical injuries and lifelong psychological injuries. It was admitted that a suction drain was used during abdominal hysterectomy surgery, without carefully considering the risk of it attaching to other structures causing harm.

The Trust accepts in their Serious Investigation Report (“SIR”) that “the suction is likely to have resulted in the drain adhering to bowel and causing serous tears when attempts were made to remove it”. The application of suction was in breach of duty. Please see below case report for further details.

The events that occurred causing the surgical negligence

The Trust received a referral from our client’s GP for suspected endometrial cancer on 23 March 2021. Our client was diagnosed on 12 April 2021 with FIGO stage II grade 2  endometrioid endometrial adenocarcinoma as a consequence. The MDT agreed that surgery was required.

She therefore underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (BSO) at Chase Farm Hospital under the Trust, in May 2021. A Redivac drain was inserted. The SIR notes that “the documentation did not state if the Redivac drain had been placed with the suction on or off. Clarification was sought from the gynecological surgeons who confirmed that the drain had been placed with suction following the surgery”. The day following the surgery, the surgeons attempted on four occasions to remove the drain but without any success, causing distress  to our client.

Our client was therefore advised that she needed to be transferred to another hospital for the emergency team to remove the drain and that they may require a second surgical procedure to achieve this. She subsequently underwent a laparoscopy during which it was identified that the Redivac drain was in the right iliac fossa attached to the small bowel. The drain was 16mm long. During the surgery applying gentle traction on the bowel, the Redivac drain was released following which the bowel was examined and four hemorrhagic spots were identified of 5mm in size. It was determined by the consultant that laparoscopy should be converted to laparotomy to allow full inspection of the bowel and oversee the serous tears. 19 sites were overseen.

The management and care received by our client fell below an acceptable standard

During the hysterectomy surgery and in breach of duty, a vacuum drain was used without careful consideration as to whether use of the drain could be avoided to abstain from the risk of it adhering to other structures thereby causing harm. Instead, a non-vacuum drain ought to have been used to prevent this risk. The Redivac drain was placed with the suction activated. This was a vacuum drain which adhered to the bowel by drawing in the bowel wall through the perforations intended for fluid. The Trust accepts in the SIR that “the suction is likely to have resulted in the drain adhering to bowel and causing serosal tears when attempts were made to remove it”. The application of suction was in breach of duty.

The Trust failed to ensure that the vacuum was released prior to each attempt to remove the suction drain which was in breach of duty. As a consequence of the decision to use a vacuum drain applied with suction, the drain attached itself to the bowel and also led to unsuccessful removal of the drain thereby causing damage to her bowel. Due to the use of the Redivac drain and its unsuccessful removal, our client required both a laparoscopy and laparotomy surgical procedure to remove the drain and repair the associated damage including adhesions to the bowel which required repair.

Our client suffered multiple physical injuries to her bowel and continues to suffer from a significant psychological reaction to the complications of her original surgery and the need for emergency surgery to remove the drain and repair the damage to her bowel, as a result of which she has required counselling and endured a far longer and more difficult recovery. She has been advised that she is at higher risk of bowel toxicity as a result of the injuries suffered and that the risks of bowel toxicity are amplified by the fact that the site of the adhesions is close to where the endometrial cancer had been.

Settlement obtained after a Serious Incident Report and Civil Proceedings

The Trust, in accordance with its duty of candor, prepared a Serious Incident Report by which they accepted that there had been failures and they apologized accordingly. Our client instructed Osbornes to serve a Letter of Claim following receipt of the Serious Incident Report and we served the Letter of Claim in August 2022, which achieved an admission of liability in January 2023. We then obtained expert evidence from a Consultant Psychiatrist and Consultant Colorectal Surgeon, which were supportive of our client’s injuries.

Following instruction of specialist Counsel, Christopher Stephenson of Deka Chambers in London, and following his advice, a Schedule of Loss was served in August 2023, which set out in detail our client’s significant losses. We received an offer to settle in January 2024 which was considered inadequate, so further negotiations took place and final settlement was secured in March 2024 for a 6-figure sum, which provided for general damages for the Claimant’s pain and suffering, past and future loss of earnings, gratuitous care, and past and future counselling.

Following the settlement, our client stated “I would highly recommend Jodi, she was professional at all times and provided an excellent service. She gave me good advice and kept me well informed”.

Contact Osbornes Law

If you’ve suffered due to a medical procedure, our Medical Negligence solicitors are here to support you. Contact Osbornes Law by filling out the form below or calling 0207 485 8811 to speak to us about a surgical negligence claim.

If you want to find out more about claiming compensation from the NHS, read this article.

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