Clinical negligence team secures compensation for failure to diagnose faecal peritonitis

Posted: 30/09/2016

A claim against The Whittington Hospital NHS Trust has been successfully settled by the clinical negligence team at Penningtons Manches’ Cambridge office for a failure to diagnose and promptly treat faecal peritonitis, as a result of the internal staple line failing after the claimant’s appendix was removed. 

The claimant was referred to Whittington Hospital by his GP due to concerns that he may be exhibiting early signs of colorectal cancer. Following an urgent colonoscopy, he was diagnosed with diverticulosis and a grumbling appendix. The decision was taken to remove his appendix laparoscopically to manage his symptoms.

He was discharged the same day but remained in significant pain and discomfort which was not alleviated by pain relief. Three days later he attended the A&E department at Whittington Hospital with sharp abdominal pain and bloating, along with an elevated pulse, respiratory rate and blood pressure. Blood tests revealed a grossly abnormal CRP level indicating infection.

A CT scan was performed and showed an intra-abdominal collection of fluid and gas. The claimant was given intravenous antibiotics and CT guided drainage of the abdominal fluid was undertaken, with conservative management and further drainage recommended.

Over the next three days, the claimant began to deteriorate and was placed on the High Dependency Unit. He continued to suffer with a rapid heart rate and was consequently transferred to Intensive Care. Further deterioration prompted the decision to undertake an exploratory laparotomy. The operation revealed complete failure of the staple line resulting in bowel content leaking into the abdominal cavity causing faecal peritonitis.

A hemicolectomy removed half of the claimant’s affected colon and the faecal fluid was drained. He remained in Intensive Care. Post-operatively, the wound became infected and later re-opened requiring the placement of a VAC vacuum dressing. The claimant was discharged a month later but continued to suffer with an incisional hernia. This required further surgical intervention 16 months later. 

Penningtons Manches was instructed in May 2013 and obtained supportive expert evidence from a consultant general surgeon. He noted that while the claimant suffered a non-negligent complication of an appendectomy, the delay in diagnosing a failure of the staple line and the subsequent management of his deterioration was negligent. The consultant general surgeon stated that had the problem been diagnosed promptly, the claimant would have avoided five days of faecal peritonitis, the onset of cardiac events, admission to Intensive Care and a protracted period in hospital as well as further hernia repair surgery. 

The defendant denied liability in full. However, settlement was eventually reached without admission.

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