We have recently settled a complex case for a client who experienced a significant delay in diagnosing and treating her fallopian tube torsion.
Our client developed abdominal pain which became progressively worse, and she was transferred to hospital with suspected appendicitis. On review by the surgical team, it was considered that appendicitis was unlikely, and a differential diagnosis of ovarian pathology or endometriosis was made. She was admitted to the surgical ward with a plan to undergo an ultrasound scan. On being reviewed by a gynaecologist, the impression was of IBS, and it was confirmed that no gynaecological input was required, despite a failure by the gynaecologist to perform an internal examination.
Our client was admitted to the surgical ward and even though she was receiving morphine, she remained in extreme pain. Over the following days, there were significant delays in performing the ultrasound and an MRI. Once the MRI was reported and tubal pathology was identified, our client was transferred to the gynaecological ward. It was not until five days after her admission to hospital that our client finally underwent laparoscopic surgery. Her left fallopian tube was noted to be twisted and had become necrotic, such that it had to be removed.
Under the pre-action protocol, the defendant admitted a delay in diagnosing and treating our client, causing pain and distress, but denied that the fallopian tube would have been saved, even if prompt treatment had been provided.
As tubal torsion is a relatively rare occurrence, the arguments regarding causation were complex. Expert evidence was commissioned from experts in the fields of gynaecology and radiology. Based on this evidence it was our client’s case that, with prompt treatment, the fallopian tube could and should have been de-torted and saved. The experts confirmed that the failure to operate within 24 hours, and at the very latest within 48 hours, was negligent, especially in light of our client’s desire to have a family, and her pre-existing non-negligent pathology in her right ovary which might also affect her fertility.
To ascertain the extent of injuries caused to our client by the delay, and the value of her claim, we obtained condition and prognosis and quantum evidence from a specialist in reproductive medicine. He confirmed that her fertility had been reduced by the unnecessary removal of her left fallopian tube and the damage to her healthy left ovary, which was either as a result of the delay in managing the torsion or caused during the salpingectomy itself. Further evidence from a psychiatrist confirmed that our client suffered from both depression and PTSD as a result of the defendant’s negligent treatment.
The defendant continued to deny causation regarding the reduction in fertility so court proceedings were issued. Following without prejudice exchange of expert evidence, we were able to negotiate a settlement with the defendant and resolve this claim for our client. Full and final settlement of this claim has given our client some closure following what was a very traumatic experience and we hope that her damages will allow her to obtain the fertility treatment and counselling that she requires.