We have recently settled a case against East Sussex Healthcare NHS Trust involving an incorrectly performed catheterisation which had serious consequences.
Our client had attended the urology clinic for a non-urgent assessment of urinary retention, and as part of this required a urinary catheter to be placed. This is a routine procedure that all doctors should be capable of performing, and in male patients involves retracting the foreskin to place the catheter in the urethral meatus. Once this is done, the foreskin is replaced back in its usual position.
The procedure was performed by a junior doctor, but in this case the foreskin was not returned to its usual position as it should have been. This was then compounded by a failure to check the catheter during nurses’ rounds or during ward rounds. As a result, our client developed a painful paraphimosis (a condition where the foreskin and penis become too oedematous and swollen to reduce back to their normal position) and after several unsuccessful attempts to reduce the swelling, he was admitted for an emergency circumcision. Following that operation, he developed an infection which continued for many months. He was forced to stop work as a driver and was not taken back on by his employer afterwards.
Our client had already entered into complaint correspondence with the trust and we felt that the facts suggested an obvious breach of duty. Therefore, as an initial step to encourage a settlement, we sent an early letter of claim to the trust, inviting it to admit liability. As well as bringing about a prompt resolution, this can also have the benefit of removing the need for expert evidence on the standard of care, thus reducing the costs of an investigation. It is particularly important in the current climate where claimant solicitors are obliged to keep the costs of an investigation proportionate but does also rely on the defendant trust taking a pragmatic approach to the claim and admitting failings where they are obvious and unlikely to be defensible.
In this case, NHS Resolution did take a sensible approach and accepted liability at an early stage. We were therefore able to focus on investigating the level of damages that our client was entitled to. This included obtaining expert evidence from a consultant urologist to confirm what harm could have been avoided with appropriate care. Unsurprisingly, our evidence was that it should have been a routine procedure and that the paraphimosis, surgery and subsequent infection could all have been avoided had the junior doctor performed the procedure correctly.
The claim included damages for the pain and suffering caused from the paraphimosis, emergency surgery and resulting infection, along with a loss of earnings claim. In total the case took just over six months to settle.