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Gynaecology cases

K v The Central Manchester and Manchester Children's University Hospitals NHS Trust

Mrs K gave birth to a baby boy on 08 August 2005. During the course of delivery she suffered a perineal tear. She was referred by the midwife to the Surgical SHO who examined Mrs K and who noted a tear. The SHO repaired the tear, believing it to only be a second degree tear and therefore no rectal examination was performed.  In fact the tear was a fourth degree tear involving damage to both the internal and external sphincter and causing an ano-vaginal fistula.

Mrs K was discharged home on 10 August 2005. On 23 September 2005 Mrs K was referred back to hospital suffering with the passing of faeces and flatus into her vagina. She also suffered with anal incontinence and anal soiling on a daily basis, causing her great distress and embarrassment, and effectively leaving her housebound.

Mrs K continued to suffer from severe symptoms of faecal incontinence until a secondary repair operation was finally performed in July 2006, following which her ano-vaginal fistula healed and she noticed a marked improvement in anal control. Mrs K was referred for bio-feedback sessions which led to a further improvement in her symptoms to the extent that she was able to return to work.

Mrs K instructed Mark Bowman, who acted under the terms of a Conditional Fee Agreement.

Expert advice was sought from a Consultant Gynaecologist as well as a Consultant Colo-Rectal Surgeon. A Letter of Claim was served on the Defendants alleging negligence in failing to perform a rectal examination, which would have revealed the full extent of the sphincter damage and which would have led to an immediate primary repair operation. It was claimed that with such an operation, Mrs K would have avoided the symptoms that she suffered with for the next 11 months and would have been able to return to work following her maternity leave. Expert evidence confirmed that Mrs K's long term symptoms would have been the same, regardless of whether the repair was performed in August 2005 or July 2006.

The Defendants admitted negligence in their Letter of Response and put forward an offer of £35,000 in settlement of Mrs K's claim, which was accepted. Mrs K received the full £35,000 and did not pay any legal fees.

 

G v Homerton University Hospital NHS Foundation Trust
 
Ms G had a history of numerous gynaecological operations. In June 2005 she was referred to the Homerton Hospital because of pain at intercourse and painful periods. An ultrasound scan was performed which revealed multiple fibroids and it was agreed that Ms G required a subtotal hysterectomy and right salpingo-oophorectomy.
Ms G underwent surgery on 21 September 2005. Post operatively she was monitored and was allowed to go home on 24 September 2005.

On the morning of 25 September 2005 Ms G developed sudden severe abdominal pain and was re-admitted by ambulance to the Homerton Hospital. She arrived at 10:20. She was examined on admission and was noted to be shivering uncontrollably and cold to touch. Examination of her abdomen revealed guarding and rebound tenderness, suggestive of peritonitis, however a diagnosis of infection was made instead. Ms G was given antibiotics and sporadically monitored, until 21:30, when a chest x-ray was performed. The x-ray showed gas under the diaphragm, indicating a perforated bowel. In spite of this, no surgical opinion was sought, and Ms G continued to receive further antibiotics. It was not until a colo-rectal surgeon was called, at 23:15, that a diagnosis of a perforated sigmoid colon was made, and an urgent laparotomy, sigmoid colectomy and primary anastomosis loop ileostomy were performed.

Ms G's recovery was lengthy and complicated, and she remained in ICU until 09 October 2005 and was not finally discharged until 16 November 2005. She was initially unable to return to work as a teacher until June 2006.

Mark Bowman received instructions to act for Ms G in March 2006 with the benefit of LSC funding. Expert opinion was sought from a Consultant Gynaecologist and a Consultant Colo-Rectal Surgeon and a Letter of Claim was served on the Defendant alleging that there had been a negligent delay in treating Ms G following her re-admission to hospital on 25 September 2005. It was argued that but for the delay, Ms G's length of admission to the ITU department, her post operative symptoms including continuing sepsis requiring a Vacupac, and her period of convalescence, would all have been significantly reduced.

Following protracted negotiations with the Defendants, Ms G received the sum of £7,500 in settlement of her claim. She did not pay any legal fees. 

At the conclusion of the case Ms G wrote "Mark, I am writing this final email to say thank you to you. From the very first time I came to see you you have constantly remained reliable, supportive, honest and always prompt in your actions. I must admit, like other people probably, that I really was expecting my first dealings with a solicitor to be a struggle and battle to get things done. You dispelled all those doubts. You did everything you said you would quickly and efficiently and always with humour, patience and politeness. You made this journey as pain free as possible and I want you to know how much I really appreciate that. I hope I never have need of legal assistance again but if I do I know where to come!!!!"

 

Endersby v. Jurkovic

Daily Mail 19 August 2006

“An eminent surgeon has agreed to pay more than £500,000 in damages to the family of a woman who died during a routine operation.

Catherine Ferguson – a £90,000-a-year BT manager – bled to death after Davor Jurkovic punctured a major blood vessel during a simple hospital procedure.

Lawyers acting on behalf of Mrs Ferguson’s 11-year-old son sued the doctor for clinical negligence in a case that was due to be heard at the High Court last month.

But the surgeon agreed to pay substantial damages – thought to be at least £500,000 – in an out-of-court settlement just days before the hearing.

Mrs Ferguson, 41, went to see Mr Jurkovic at King’s College Hospital, South London, as a private patient in July 2003 when she was suffering from abdominal pain.

The surgeon carried out a laparoscopy – a procedure which involves inserting a fibre-optic cable with a camera on the end into the stomach while the patient is under general anaesthetic. But the probe slipped and ruptured her aorta, a major artery connected to the heart. Despite desperate attempts to save her, she died from blood loss.

A verdict of misadventure was recorded at in inquest into her death at Southwark Coroner’s Court in 2003.

Mr Jurkovic denied that he was negligent, but issued an apology to the Fergusons and agreed to pay compensation, which will be covered by his insurers. Mrs Ferguson had the operation on a Saturday and had been expecting to return to work on the following Monday.

Her lawyer Paul McNeil said yesterday: ‘At the very beginning of the surgery, the operation went terribly wrong. During the insertion of an instrument into the abdomen, the surgeon ruptured Catherine’s aorta.

‘Notwithstanding the emergency attendance of a number of other doctors to theatre, Catherine bled to death.’

Mrs Ferguson’s parents Donald, a retired RAF officer, and Patricia, who live in Eastbourne, East Sussex, have been left distraught by the tragedy.

Her mother said: ‘She was a beautiful, a lovely person.’

Mr Ferguson added: ‘It’s been a very difficult time for everyone and now we are just trying to get on with our lives.’

Their daughter, a keen hockey player, was educated at the Royal Latin School in Buckingham.

Her son Fergus lives in London with his father Mark Endersby – a chartered accountant who was divorced from Mrs Ferguson.

Mr McNeil said Mrs Ferguson – who worked at the London Stock exchange before taking up her position at BT – had ‘considerable earning power’ ahead of her.

She headed a department pioneering new technology at the telecoms company. Mr Jurkovic, who qualified in Yugoslavia in 1981 claims that he ‘followed standard textbook procedures.’

The rupture of the aorta was ‘an event which could occur even in the best surgeon’s hands’, he added.

But just before the High Court hearing, he agreed to pay ‘very substantive damages and apologised to Catherine’s son’, Mr McNeil said.

Mr Jurkovic’s apology, given through his counsel, said: ‘Whether this court would ultimately have held Mr Jurkovic legally liable in respect of this tragedy is a matter for conjecture.

‘What is not in doubt is that legally liable or not, Mr Jurkovic is and keenly feels, responsible for what happened.

‘And the fact that his patient died during a minor operative procedure is something for which he offers a heartfelt and sincere apology’."