Bowel operation
P v NORTH WEST LONDON HOSPITALS
NHS TRUST (2007)
Out of Court Settlement May 2007
The claimant, a 33-year-old woman, received £230,000
after a hospital attempted to repair perforations to her bowel in
July 2003 but she subsequently developed a faecal fistula and
required further operations. She suffered from depression and her
mobility was such that she was unable to care for
herself.
Claimant: Female: 29 years old at date of accident; 33 years old
at date of settlement.
Clinical Negligence: On July 21, 2003, the claimant (C)
underwent a laparotomy and bilateral salpingectomy at a hospital of
the defendant trust (D). During the procedure, a tear was
inadvertently made to C’s colon. A surgical registrar repaired the
perforation. However, C subsequently developed a faecal fistula and
remained in hospital for approximately 150 days.
C sustained injuries and brought an action against D alleging
that it was negligent in failing to carry out a Hartmann’s
procedure rather than attempting to repair a full thickness bowel
injury as, on the balance of probabilities, had a Hartmann’s
procedure been carried out, the fistula would not have formed and
she would have avoided the subsequent bowel-related problems.
Breach of duty was admitted although the extent of causation
remained in dispute.
Injuries: C suffered from a faecal fistula.
Effects: In September 2003, C underwent a further laparatomy to
defunction her bowel. That operation had to be abandoned and C was
transferred to another hospital where further procedures were
performed.
At the time of settlement, C continued to suffer from abdominal
bloating and bouts of nausea. She had ongoing problems with her
abdominal wound and required vitamin injections because of
insufficient absorbance. She also suffered from major abdominal
scarring and continued to suffer pain in her anus and ongoing
problems with her stoma bag.
C required a reversal of the ileostomy but at the time of
settlement was still not well enough to undergo the operation.
C’s social life deteriorated greatly. She also suffered from
psychological symptoms including loss of enjoyment of life, poor
concentration, poor body image, fatigue, sleep disturbance, weight
loss and depression which was diagnosed as adjustment disorder or
depressive disorder.
C was unable to care for herself and after the accident lived in
her downstairs lounge as she was unable to walk up or down the
stairs. As a result, C’s mother visited from India to look after C
and remained living with her at the date of settlement.
Prior to the accident, C had been employed as a sales
representative. At the date of settlement, she remained unfit for
work. As a result, her debts increased which in turn made her
depression worse.
Prognosis: It was hoped that the reversal of the ileostomy would
be performed within 12 months of the date of settlement and that
after that date she would be able to return to work.
Out of Court Settlement: £230,000 total damages.
Background to damages: It was accepted that even if a Hartmann’s
procedure had been undertaken, C would still have had a stoma and
would therefore have required an ileostomy reversal. However, it
was also accepted that C should then have been able to return to
work approximately three months after the procedure was carried out
and would have only needed to stay in hospital for a subsequent 10
to 14 days.
The case was settled on a global basis, with no particular
breakdown of damages. However, the following breakdown was
estimated by the claimant’s solicitors:
Breakdown of General Damages: Pain, suffering and loss of
amenity: £30,000
Breakdown of Special Damages: Miscellaneous past and future
losses including costs of care, aids and equipment, travel, future
therapy costs and loss of earnings: £200,000
Body Part: COLON - INTESTINE - BOWEL - BOWELS - INTESTINUM -
INTESTINE - BOWEL FUNCTION - ABDOMEN – STOMACH - ANUS -
BOTTOM
Condition: TORN COLON - FAECAL FISTULA - ABDOMINAL BLOATING -
NAUSEA - INSUFFICIENT ABSORBANCE - ABDOMINAL SCARRING - LOSS OF
ENJOYMENT OF LIFE - POOR CONCENTRATION - POOR BODY IMAGE - FATIGUE
- DEPRESSION - DISTURBED SLEEP - IMMOBILITY - WEIGHT LOSS
Hodge Jones & Allen for the claimant. Capsticks for the
defendant.