We have recently settled a claim against a private surgeon for errors during surgery to remove our client’s gallbladder.
The claimant was referred to the defendant by her GP, to have her gallbladder removed after an ultrasound scan showed cholecystitis. Following the procedure, the claimant was in significant pain for days, and unable to be discharged home until almost a week later. She continued to feel unwell and was readmitted two days after her discharge due to increasing abdominal pain.
During her second admission, the claimant underwent various investigations to try to confirm the cause of her pain, including a laparoscopic wash out. The claimant subsequently underwent an ERCP procedure, after which it was hoped that a bile leak would settle.
The claimant was discharged home with a drain in situ, but was readmitted for a third time, three days later. She was in significant pain and became increasingly unwell with sepsis. After further investigations, a laparotomy under a different consultant was arranged to drain the bile and deal with any leak.
During this procedure, the consultant found the cause of the bile leak. The right anterior segment bile duct had been misidentified in the original procedure as the cystic duct and had been clipped instead. The actual cystic duct had not been suitably divided and clipped and, therefore, bile was leaking onto the liver surface. As the output of bile from the injured duct was significant, a hepaticojejunostomy was created to drain this duct and its associated segment of the liver into the bowel.
Fortunately, after this procedure, the claimant began to make a good recovery and was discharged home a week later.
Following receipt of supportive expert evidence, it was the claimant’s case that the defendant, in carrying out the original surgery to remove the gallbladder, failed to display correctly and clearly the structure of the liver and the ‘Triangle of Calot’, prior to dividing the structures. As a result of the incorrect procedure used, the defendant misidentified the anatomy, resulting in him dividing and subsequently clipping the right anterior segment bile duct. He had misidentified it as the cystic duct. He therefore also failed to divide and clip the cystic duct.
The claimant’s case was that, on the balance of probabilities, in the absence of the breaches of duty, she would have proceeded to either a sub-total laparoscopic cholecystectomy, or an open laparotomy, which would have allowed the correct identification of the structures before dissecting, leading to a total cholecystectomy.
Without the breaches of duty, it is likely that the claimant would have been discharged home from the hospital on the day of the operation, if completed laparoscopically, or within five to seven days post-operatively, if it had needed to be converted to an open laparotomy. In either event, she would not have needed further surgery.
Liability was admitted after the letter of claim was sent to the defendant representatives. Reports were obtained from experts in general surgery, plastic surgery and psychiatry in order to assess the claimant’s condition and prognosis.
Fortunately, no further physical treatment was recommended; however, the claimant was diagnosed with post-traumatic stress disorder by the psychiatric expert instructed. As a result of the admission of liability, an interim payment to cover the cost of the recommended treatment was agreed between the parties. This enabled the claimant to undergo EMDR treatment, which both the claimant and her husband noted to be extremely beneficial to her recovery.
After the recommended treatment concluded, a further report was obtained from the psychiatric expert, which confirmed a dramatic improvement in the claimant’s symptoms as a result of the treatment she had undergone. Settlement negotiations were subsequently commenced, and the claim settled for the gross sum of £95,000, shortly after proceedings were served.
Laura Hanvey, an associate who specialises in surgical claims within the clinical negligence team at Penningtons Manches Cooper, comments: “It was pleasing to both the claimant, and us as a legal team, that liability was admitted early on in this matter. Even years after the event, the claimant was still severely affected psychologically by the treatment she had undergone, and this was initially a barrier to her in seeking legal redress as she was unable to process what had happened. An early admission meant that the claimant did not need to go over the facts of the case repeatedly in witness evidence and expert evidence for liability purposes.
“An early admission also made it possible to secure an interim payment to allow the claimant to undergo the recommended psychiatric treatment which made a huge difference to her recovery and prognosis. While the monetary sum agreed represented a good settlement for the claim, seeing the difference that psychiatric treatment made to our client and hearing about the positive impact that it has had on her day to day life is hugely rewarding.”