Our client, a 46-year-old woman from Ashford, Kent, experienced the sudden onset of severe abdominal pain and sickness in the early hours of 31.08.03 and was taken to hospital by ambulance. Following some tests, she was diagnosed with constipation and a urinary tract infection and discharged home.
The following morning, her symptoms remained and she also had a significantly swollen abdomen, so on the morning of 01.09.03 she attended on a GP who sent her immediately back to hospital.
Further investigations were performed and she was admitted to hospital for observation. Further investigations (including a CT scan) resulted in a decision to operate to investigate the abdomen and the bowel. This surgery did not take place, however, until 04.09.03.
By that time, part of our client’s bowel had died (as a resulted of the bowel being twisted and having a compromised blood supply for too long), and there was a perforation causing faecal matter to leak into the abdomen. Our client had to undergo a bowel resection with stoma formation. Post operatively she required a long stay in ICU. She was eventually discharged home around 6 weeks later.
Our client then had to undergo further surgery in June 2004 to reverse the stoma. Following that operation her bowels were difficult to manage and she suffered with both frequency and incontinence which were unpredictable.
She then suffered an incisional hernia which required surgical repair in November 2005.
Subsequently, she began to develop abdominal pain from around 2007, which was variously investigated by general surgery and later by gynaecology.
Eventually, this led to exploratory surgery in August 2011. This revealed an inflammatory mass within the abdomen causing extensive fibrosis (identified on histology to have been caused by faecal matter), which resulted in conversion to major surgery by way of subtotal hysterectomy, bilateral salpingo-oophorectomy, and bowel resection with stoma formation.
The stoma was very difficult to manage, with high output and frequent leaks, which was not improved with medication.
The stoma cannot be reversed and is confirmed to be permanent, but surgery has been performed to re-fashion the stoma. This has resulted in the stoma being more manageable and with fewer leaks, although it remains with a high output.
As a consequence of her bowel problems, our client has required a considerable amount of care and assistance (in particular with childcare), and she has been unable to work. She also suffered a psychological injury.
In addition, following the August 2011 surgery, our client developed various generalised aches and pains throughout her body. Following various investigations, our client was eventually diagnosed with fibromyalgia in June 2017.
Our client instructed us in 2013, and supportive expert evidence was obtained from experts in A&E, colorectal surgery, and gynaecology. This evidence confirmed that the hospital had been negligent in failing to operate shortly after admission on 01.09.03 (and by 02.09.03 by the latest). Had they done so, the bowel could have been untwisted, would not have perforated, and would have been salvaged. As such, our client would not have required any of the subsequent surgeries and would have been expected to have made a complete recovery with no ongoing complications.
Court proceedings were issued in August 2014, within 3 years of the date of the August 2011 surgery – which we assessed as our client’s date of knowledge.
The Defendant not only maintained a full denial of the claim on breach of duty (saying that it was reasonable to adopt a ‘watch and wait’ approach) and causation (saying that the faecal matter found in August 2011 was not a consequence of September 2003 events), but they also raised a limitation defence (saying that date of knowledge was many years earlier and that Court proceedings had therefore been pursued out of time).
The claim progressed towards a split trial on the issues of limitation and liability. There were significant risks on both issues, and on the eve of Trial, in June 2016, theses aspects were compromised on the basis that our client would receive 55% of the total value of her claim.
Subsequently, the parties proceeded to instruct the necessary experts to value the claim, and evidence was obtained from gynaecology, colorectal surgery, gastroenterology, psychiatry, and care/OT.
A significant issue in the claim was that our client was diagnosed with fibromyalgia very late on, but this condition was not linked to the negligence. The Defendant’s experts made much of this diagnosis, essentially blaming all of the abdominal symptoms upon this diagnosis from around 2007 onwards.
The Defendant made increasing offers of £125,000, £165,000, and £250,000, but these were unacceptable to our client and a mediation was held in September 2018 with a view to further exploring settlement (a few weeks before Trial, listed in November 2018).
The claim was settled at mediation in the sum of £280,000 (which equated to just over £500,000 at full value).
Alex Tengroth, who had conduct of this case, said:
“I am very pleased that this long running claim has now been successfully resolved without the need for Trial, and am confident that the claim found its natural level through the mediation process. I hope that my client can now put the litigation behind her and put the compensation to good use in order to improve her quality of life.”