Diagnosis Failure Following Hysterectomy
Failure to diagnose bladder problem
Our client was aged 43 when she underwent a vaginal hysterectomy at City Hospital on 17 August 2000, to relieve continuing pain from endometriosis. After the surgery a problem in the bladder was identified and the consultant obstetrician and gynaecologist carried out a laparotomy and attempted to repair the bladder. He was not able to stop the leaking and called in a consultant urologist, who reopened the defect and re-closed it. The urologist advised urethral catheter drainage for 5 days and oral cephalexin.
Our client had top use a catheter and had to wait to see whether the bladder healed, unfortunately it didn’t and our client was found to have a fistula. Continuing drainage with the catheter was advised by the urologist. The Claimant was discharged on 25 September 2000, with an indwelling catheter.
Our Client was eximined on 9 October 2000, and she was still leaking vaginally and a flexible cystoscopy was arranged. The cystoscopy took place on 13 October 2000. This revealed no obvious gaping fistula, although there was still a little vaginal leakage.
On 25 October 2000, a cystogram was carried out and concluded that the fistulous tract had healed. On 30 October 2000, our client attended an outpatient review with the urologist. He advised removal of the catheter and no further follow up.
Our client continued under the care of the obstetrician and gynaecologist, and was seen as an outpatient on 10 January 2001 she was again leaking vaginally and a cystogram was arranged, which took place on 24 January 2001. This did not show a fistula and on 15 February 2001 an ultrasound scan of the urinary tract reported no issues.
Our Client was seen again on 22 February 2001, describing ongoing leakage. She underwent a urology review on 8 March 2001, where it was decided that further uro-dynamic studies should be arranged.
Our client continued to have regular leakages. During the course of the litigation, the Claimant’s urology expert diagnosed the presence of a fistula, and confirmed the diagnosis via a simple methylene blue dye test. As a result, our client was referred to a specialist surgeon for surgical repair of the fistula.
The case was settled shortly after the exchange of expert evidence, on 22 November 2004. The case was settled for £45,000 on a global basis with no particular breakdown of damages.
The Claimant was awaiting corrective surgery at the time of settlement, and her prognosis was not clear.
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