13th Nov 2018 – Our client, a 59-year-old man from near Maidstone, Kent, lost his wife (D) in early 2014, when she was aged 55.
D had been diagnosed with early stage bladder cancer in 2012 which she had removed by a TURBT operation. However, the cancer returned in 2013 and was found to be stage 2 at that point. Treatment by chemotherapy and radical cystectomy (removal of bladder) was advised.
D agreed to the chemotherapy but sought a second opinion in respect of the proposed surgical treatment, and she came under the care of Mr Paul Reddy at the Maidstone Hospital.
Mr Reddy advised that he could perform a cystectomy and neo-bladder
(formation of new bladder using part of the bowel) operation. Alternative
options were not discussed by Mr Reddy, and upon D asking about any risks of the surgery Mr Reddy advised that there were none.
Mr Reddy performed the surgery on 04.11.13 at the Medway Maritime Hospital. Mr Reddy damaged D’s bowel during the operation. Rather than calling in a colorectal colleague to assist / repair the damage, he repaired it himself using an omental patch. Mr Reddy did not record this bowel damage in the medical notes and nor did he pass this information on to the doctors who would be looking after D post-operatively (Mr Reddy was based at Maidstone, and didn’t see D himself until nearly 3 months later).
Post-operatively, D was slow to recover, and the treating team discussed her condition with Mr Reddy for advice as to what investigations to undertake. Mr Reddy specifically advised against performing a CT scan. However, due to a deterioration in D’s condition, an urgent CT scan was performed a few days later and confirmed evidence of an obstruction and post-surgical ileus.
D then began passing urine via her rectum and a further CT scan identified 2 urinary leaks – one at the top of the neo-bladder and a large leak at the
bottom of the neo-bladder.
Ultimately, as a consequence of both the urinary leak, and the breakdown of the bowel repair leaking faecal matter, D developed a large pelvic collection which ultimately became the site of infection and abscess and precipitated the later complications which resulted in her death.
D initially underwent a laparotomy and bowel resection, but her condition continued to steadily decline. She had further operations over the next couple of months, but ultimately was found to have small bowel ischaemia. Nothing could be done to treat this condition, and D passed away.
Expert evidence from a urological surgeon and a colorectal surgeon confirmed that the neo-bladder operation was poorly performed. The bowel damage should have been avoided, and would have resulted in D surviving.
Additionally, if assistance had been sought from a colorectal surgeon, an adequate repair of the bowel injury (possibly including a temporary colostomy) would have been undertaken. The bowel would not have subsequently broken down and, again, D would have survived.
Further, because Mr Reddy had caused damage to the bowel, continuing with the neo-bladder was a high risk strategy and he should not have proceeded. Instead, the operation should have been converted to an ileal conduit (a urinary stoma). Had this been done, there would have been no leak into the abdominal cavity and the bowel would not have broken down.
There was some difficulty identifying the correct Defendant as both the Maidstone & Tunbridge Wells NHS Trust (Mr Reddy’s employer) and Medway NHS Foundation Trust (where the negligent surgery took place) said that the other was responsible. In the end, it was determined that Maidstone & Tunbridge Wells NHS Trust were responsible.
The Defendant admitted liability early on for the ancillary matters relating to the failure to record the injury / pass on details, but they denied that the bowel injury was the result of negligence, and they denied that it was negligent to proceed with the neo-bladder surgery.
The Defendant failed to agree to an extension of the limitation date, so we were forced to issue Court proceedings. Upon serving Court proceedings we made an offer of £340,000.
The Defendant confirmed that they were maintaining their denial of the claim, but made an offer of £200,000. After further negotiation, settlement was agreed in the sum of £300,000.
Alex Tengroth, who had conduct of this case, said “This case is an appalling example of how some surgeons treat their patients – believing they know best and having a ‘God-complex’. I understand from my client that Mr Reddy has since left the Trust, and we both sincerely hope that his days performing such surgery are behind him.”