Gynaecology Surgery - Medical Negligence Compensation Claim Solicitor UK


The term 'informed consent' applies in all surgical procedures which means that it is a requirement that consultants, doctors and surgeons must fully explain the medical procedure both in detail and in layman's terms and also outline all attendant risks. Failure to fully carry out this process of disclosure before any surgery is commenced may be considered to be medical negligence and could well give rise to a medical negligence compensation claim or in extreme cases to a charge of criminal assault. If the procedure fails and informed consent has not occurred then in all probability a surgeon will be guilty of unlawful behaviour and liable to pay compensation for medical negligence notwithstanding that the actual surgery may have been carried out entirely properly. The detailed explanation in non-medical terms, in order for a surgeon to avoid a solicitors medical negligence compensation claim, must include the following information :

  • The reasons for undergoing the surgery.
  • How the procedure will be performed and an estimate of the time it will take.
  • The implications for the patient's immediate and long term future.
  • Any possible complications that may occur.
  • The expected outcome, both in terms of medical results and what it means to the patient’s quality of life.

If, after surgery, the patient claims she did not fully understand every one of those points clearly, then it is considered defective consent. Each adult, who is capable of reasoning, has the right to determine what happens to her body and any surgical procedure performed without the patient's express consent, is liable to lead to legal action to determine damages. As the offence is considered an assault, this may mean a lengthy court action and high value claim.

Abdominal Wall Injury during Laparoscopy

A proficient surgeon is responsible for ensuring this complication is prevented from occurring, but it does occasionally happen. The abdominal wall injury may take place if one of the major abdominal arteries or veins is penetrated by the needle as it makes its way through this region.

It can be easily detected by blood coming up the needle. When an injury is suspected, there is a search for the location of free blood in the peritoneal cavity and around the location of the uterus. Dramatic collapse can occur if a blood vessel is damaged - meaning the vein or artery can suddenly completely collapse, leading to a life threatening situation. A thorough search must be made if there is even a suspicion of vessel damage.

Another complication that can occur in the abdominal wall during a laparoscopy is the inadvertent introduction of air into the area under investigation. This causes severe pain and must be repaired immediately as it can be life threatening.

The pelvic brim is the most common location of perforation during a laparoscopic surgical procedure. The repair may involve opening the abdomen and moving aside the intestines to expose the aorta above the pelvic brim. This form of abdominal injury is more likely to occur in very thin patients and children.

Failure to Detect Internal Haemorrhage

If an internal haemorrhage is detected before becomes life threatening, there is the possibility of repair. However, there are times when a laparoscope may cause the forming of a blood clot or thrombosis and this will mean the patient will suffer shock later. Other symptoms present when there is a failure to detect internal haemorrhage are :

  • Chills, fever or vomiting.
  • Drainage problems at the site of the incision and redness around the wound.
  • Severe pain that is not relieved by medication.
  • Inability to urinate.
  • Acute leg pain.
  • Any other unusual or painful symptoms.

This situation may require a full opening of the abdomen to locate and repair all the damaged caused by what may have begun as a very slow leak of blood into the abdominal cavity. The bleeding must be stopped as soon as possible because, not only is there a risk from blood loss, the leaking blood may cause septicaemia which will quickly lead to death.

Bowel Injury

This is always a serious situation that can occasionally occur during a laparoscopy. Immediate management of the situation is usually to perform a laparotomy (open surgery) to locate and suture the perforation. This requires constant irrigation with saline to ensure that even the smallest possibility of bowel contents coming into contact with the abdominal cavity is avoided at any cost.

Failure to detect a bowel injury will result in the patient developing peritonitis (inflammation of the peritoneum) and consequently septicaemia (also known as systemic inflammatory response syndrome - or SIRS), typically a fatal condition.

Injury to Bladder or Ureters

When damage to the bladder occurs during laparoscopic (or any other) surgery, the bladder laceration must be immediately sutured to avoid further damage and infection. The suturing is usually done in two layers and a urinary catheter is inserted into the bladder until the injury is healed in a couple of days. Once healing has progressed, the catheter is removed.

Although it is much less likely to occur, surgical damage to the ureters is extremely serious as it is difficult to repair and has a high likelihood of causing loss of kidney function, a potentially fatal situation.

It should be noted that very small injuries to the bladder or uterus can be sutured, but they can also heal by themselves. However, all injuries to all internal organs should be inspected and treated until they have fully healed.

Delay in Diagnosis of Pregnancy, Ectopic Pregnancy and Genital Cancer

Pregnancy: Delayed diagnosis of pregnancy may lead to a mother not receiving appropriate medical care during the vital first semester and general monitoring of the pregnancy for complications. Premature or over term deliveries, which may carry risks to the infant’s health, are possible if diagnosis is delayed.

Ectopic: An ectopic pregnancy is typically a medical emergency to avoid rupture of the fallopian tube. Infertility may ensue if the ectopic pregnancy is not attended to in a timely manner. It is for this reason a pregnancy test is carried out for women of childbearing age with abdominal pain.

Genital Cancer: Genital cancer is most prevalent in women and accounts for a substantial number of deaths. Over fifty percent of genital cancers involve the cervix, which is often asymptomatic until the advanced stages. Regular screening tests for cervical cancer are standard.

Inadvertent Sterilisation by the Introduction of Infection

Pelvic inflammatory disease (PID) can lead to infertility due to blockage of the fallopian tubes. Often these infections are caused by surgery.

Failure to Remove Swabs

Swabs can be left in place after the suturing the perineum after childbirth, but it happens more frequently after abdominal surgery, eg caesarean section. The first symptom is general discomfort and failure of the wound to heal. Increased pain and infection are the strongest indications of failure to remove swabs. If not corrected, a swab can lead to septicaemia and cell death.

Unnecessary Operation

Hysterectomy (removal of the uterus) is the most frequent unnecessary operation, closely followed by caesarean section (removal of the baby through the abdominal wall) and episiotomy (cutting of the perineum in anticipation of tearing).

Medical Negligence Solicitors

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here