Failure to diagnose bile leak following a routine operation

Case Studies

Failure to diagnose bile leak following a routine operation

We have settled a claim against Portsmouth Hospitals NHS Trust (Queen Alexandra Hospital) for failing to diagnose our client’s bile leak following a routine cholecystectomy (surgery to remove the gall bladder). This failure led to him suffering an avoidable period of extreme pain and suffering, resulting in a prolonged hospital stay.

Our client underwent the surgery in February 2016 and he was discharged on the same day. The following day, he began to experience increasing levels of abdominal pain, which culminated in him returning to hospital that evening with a reported pain level of 10/10. Despite this, he was not given appropriate medical attention and there were numerous failures in his care. Bile leaks are known complications following such surgery, but the treating clinicians failed to investigate our client’s symptoms or consider that they could have been caused by the recent cholecystectomy. The clinicians also failed to undertake radiology and perform tests, which would have identified the bile leak.

Although our client and his family repeatedly told the doctors and nurses that he was in extreme pain, which was clearly evidenced by the high quantity of painkillers and morphine he had been prescribed and his family’s fears that he may not survive, the staff thought he had constipation and so he was discharged. The following day, our client’s pain still remained at a critical level, so he called the NHS 111 helpline and described his symptoms. An out of hours GP attended his home, who advised him to return to hospital immediately.

Our client was admitted to the Royal County Surrey Hospital that evening, where doctors were significantly concerned and began to investigate his symptoms, promptly noting that they could be caused by a bile leak or bile duct injury.

Accordingly, a scan was carried out which confirmed the diagnosis, and our client underwent laparoscopic surgery the next day. It was discovered that he had a bile leak of 460ml. Our client had to undergo further surgery to remedy the leak and was finally able to leave hospital 14 days after the original surgery had been carried out.

The events which followed the original failure to diagnose and treat the bile leak were understandably very distressing for our client and his family. Given the fact that a bile leak was a known risk of this type of surgery, the medical expert we instructed in the case advised that Portsmouth Hospitals NHS Trust’s dismissal of his symptoms and failure to take any steps to investigate our client’s pain was a breach of duty.

After completing our investigations and obtaining a supportive expert report, we wrote to the defendant trust to set out our allegations of negligence. Following investigations by NHS Resolution, the trust admitted that it had failed to appreciate the severity of our client’s symptoms after the operation in February 2016 and that he should have been referred for scans and further procedures, as eventually was the case at the second hospital he attended. A settlement was reached shortly after this admittance.

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Penningtons Manches Cooper LLP