Abstract
General Damages: £20,000; Date of Settlement: November 2011; Total Damages: £39,448.84
Facts
On 12 April 2010 the Claimant underwent a laparoscopic repair of a large inguinal hernia under the care of Mr Al-Musawi.
In the first post operative day the Claimant suffered urine retention. His scrotum and penis became swollen, bruised and there was a haematoma. He was catheterised. His urine was coloured by blood. Despite this the Claimant was discharged on the second post operative day.
The Claimant continued to experience intermittent blood in his urine and by the sixth post operative day he began to feel unwell.
Upon obtaining an opinion from a Consultant Urological Surgeon, the Claimant was re-admitted on the eighth post operative day and catheterised. A CT scan on the tenth post operative day, the 22 April 2010, reported a strong suspicion of bladder perforation confirmed the following day by cystogram.
The Claimant was catheterised and treated conservatively. He was reviewed with further cystograms and following a multi-disciplinary team meeting needed to undergo a laparotomy and repair of a vesical fistula on the 29 May 2010. At laparotomy it was found that the bladder had been incorporated into the hernia repair.
Liability
The Claimant suffered direct injury to his bladder during either the dissection of the abdominal wall or when the mesh used to repair the inguinal hernia was fixed in place with screw tacks. Either mechanism of injury occurred due to surgical error which could not be supported by a responsible body of laparoscopic surgeons.
The immediate urine retention and unusual extensive post operative swelling, coupled with the presence of blood in the urine should have raised concerns that there was more to the Claimant's post operative complications. There was a substandard delay in diagnosing the bladder damage.
Quantum
As a result of his negligent treatment the claimant suffered damage to his bladder that was incorporated into the suture line. He suffered significant post operative symptoms before being referred to a Consultant Urologist. He was treated with an indwelling catheter before undergoing a laparotomy to repair the bladder damage. The claimant has experienced an exacerbation of bladder denervation that he may have suffered in the future due to pre existing diabetes and benign prostatic hypertrophy, resulting in the need for medication and annual follow up.
General damages were agreed at £20,000. Special damages including the Claimant's private medical insurer's outlay was agreed at £19,448.84.