Diagnosis Failure Following Hysterectomy

Diagnosis Failure Following Hysterectomy

Successful Claim Following Failure To Diagnose Fistula

Our client was 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 five days and oral cephalexin.

Our client had to 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. She was discharged on 25 September 2000, with an indwelling catheter.

She was examined 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.

She 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.

She 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. Our client received £45,000 in compensation.

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