£150,000 damages for strangulated hernia dismissed as “winter vomiting bug”.

23rd January 2024 – Our client, a 55 year old teacher from Whitstable, presented to her GP practice, Whitstable Medical Centre in Harbour Street, Whitstable, in October 2020 with a large swelling in her right groin. She was seen and examined by her GP who attributed the swelling to heavy lifting at work.

At the same time she advised of the potential for a hernia to develop and said that if the lump became painful then an ultrasound scan of the abdomen would be arranged.

The swelling re-emerged in January 2021, accompanied by abdominal cramping and pain, and our client spoke with the same GP, accompanied by her husband, (the calls taking place on speaker phone), on 5th , 6th , 8th and 11th January.

During those calls, our client reported to the GP the progression of the size of the lump, pain, fever and repeated vomiting. During the 6th January call the GP attributed these symptoms to possible gastroenteritis, mentioning a winter vomiting bug going around which was affecting a number of her patients. This appears to have remained her perspective during the further consultations on the 8th and 11th of January. On the latter date she signed the Claimant off sick due to “abdominal pain and vomiting”.

On none of these occasions did the GP consider a strangulated femoral hernia/small bowel obstruction, offer a face to face consultation with examination or arrange an ultrasound investigation. It was further alleged that she failed to take an adequate history.

On 15th January 2021 the lump in the Claimant’s right groin ruptured and she was admitted to the QEQM Hospital Margate for emergency surgery. This revealed a strangulated right sided femoral hernia with an ischaemic and perforated loop of small bowel inside it. It was necessary to excise 10 cm of the small bowel followed by anastomosis of the bowel.

Our client suffered wound infection following the surgery and subsequently underwent a prolonged period of recovery in the community. She has been left with permanent physical symptoms with ongoing pain, altered bowel habit, fatigue, loss of energy and restrictions in movement effecting her social, domestic and working life.

Ultimately she had to give up the teaching job she loved, at the end of August 2021. The physical injuries also put pay to her plans to work part-time as a specialist gardener in her retirement. She also suffered psychiatric injury in the form of an adjustment disorder.

The case was fully investigated with the assistance of an expert colorectal surgeon and a Letter of Claim was sent on 18.11.21 alleging a negligent failure to take a full history, examine our client in person, have a suspicion of strangulated hernia / bowel obstruction and investigate same. An examination would have confirmed a strangulated hernia and resulted in an emergency referral to hospital at the point of any of the consultations.

Had this been done by or at the time of the consultation on 8 th January then the hernia would have contained small bowel but it would not yet have been ischaemic and could have been reduced leaving the small bowel intact and viable. The resection of the bowel would have been avoided together with all the ongoing complications and symptoms that our client has suffered since with dire financial and personal consequences.

Within a Letter of Response sent on 14.03.23 liability was fully denied with a significant conflict of evidence between the account of the telephone consultations given by our client and her husband and that given by the GP and her practice. Within a further Letter of Response, dated 19.05.23 the Defendant, whilst still fully denying negligence, conceded that, on causation, had a referral taken place by the 8th then the outcome argued for by our client would indeed have occurred.

To her great credit, our client persevered, with us, in establishing her case through pre-action correspondence and negotiations. In particular, we put together witness statements from her and her husband setting out, in great detail, with supporting documentation, their position as regards the telephone consultations. These were served on a without prejudice basis on 16.11.22, together with a full Letter of Rebuttal critiquing and drawing out inconsistencies within the Defence case. The letter was a product of our having returned to our experts with the Letters of Response.

During this process a positive relationship was struck up with the Defendant’s solicitors, looking to engage in resolving the case without recourse to Court proceedings.

Ultimately on 19.05.23, we received a letter from the solicitors making full admissions of negligence in relation to the telephone consultation on 08.05.23.

This enabled us, in turn, to serve a very detailed Schedule of Losses, incorporating a full analysis of the value of the case, which we served together with our expert evidence on condition and prognosis, in September 2023, on a without prejudice basis.

This enabled negotiations to begin, and ultimately, the case was settled by way of the Defendant’s Solicitors making a Part 36 Offer in the sum of £150,000 in December 2023, which offer was accepted.

The case was thus resolved within the primary limitation period which expires in January of this year.

Nick Fairweather who had conduct of the matter commented as follows: “This was a sad but interesting case. My client worked hard all her professional life and was looking forward to finishing her career as a teacher and then enjoying her retirement whilst keeping active through part-time work which she would have greatly enjoyed. This has all been hugely compromised by the actions of her GP Practice on this occasion. She has shown great fortitude in taking forward and persevering with this case and, in particular, I have admired her sensible and pragmatic approach notwithstanding the effect of the negligence on her. The parties cooperating to investigate the case fully pre-action without the unnecessary time, expense and delay that can occur through contested legal proceedings is to be welcomed. No amount of money can ever give my client back the future that she had planned but I hope that this compensation can make life easier and more comfortable for her and her family going forward and I wish her all the very best for the future”.

Our client commented: “Firstly I would like to thank all the staff at Fairweather solicitors for all they did for me at such a difficult time in my life. From the very start of what can obviously be a very difficult, and at times quite an emotional process, they were helpful, empathetic and caring with their dealings with me, from the video calls and telephone calls, from emails and person to person contact. I never once felt pressurised and, although at the start, I felt rather daunted by my case and what it may entail etc, they alleviated all my fears and I always felt comfortable and at ease at all times. They always informed me of what would happen every step of the way and the various outside experts I would meet. All of these encounters were friendly, helpful and supportive. I only have the utmost praise for my solicitors, for their professionalism, their kindness, humour and of course their unfailing support throughout this very difficult time in my life. Thank you so much.”

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