£235k in compensation - failure to diagnose tear caused by childbirth
A 25-year-old woman received £235k in compensation after a hospital failed to diagnose that she had torn her anal sphincter whilst delivering her child in April 2004. As a result of this negligence, she suffered a loss of palpable muscle in her perineum, incontinence, an adjustment disorder and a hypoactive sexual desire disorder.
On April 21, 2004, she underwent an episiotomy and gave birth to her son at a hospital of the defendant trust. As a result of the episiotomy, she suffered a third-degree tear of her anal sphincter, but this went undetected by hospital staff. Her anal sphincter was not examined but her episiotomy wound was sutured.
After a few hours, she complained of soreness and bleeding from her perineum. Upon examination it was noted that she had a haematoma in the perineum and she was advised to use ice-packs. Her anal sphincter was again not examined and the tear was not detected. The following day she was discharged from hospital.
On June 8, 2004, she visited her GP for a post-natal examination and returned to see her GP again on July 14, complaining of faecal incontinence and urgency. Upon examination her GP found that she had suffered a complete loss of perineum and that her anus was adjacent to the introitus of the vagina.
She was referred to the hospital’s gynaecology unit and on August 25, it was found that the perineum was essentially lost and that her vagina was in immediate proximity to her anus. The anterior portion of the anal sphincter was completely disrupted and there was no palpable muscle. On October 15, following a further referral, it was noted that the anterior half of her anal sphincter and her perineum were missing. On December 13, an anal manometry revealed that she had significantly reduced resting and squeeze pressures which were consistent with injury to her internal and external sphincters and a unilateral left pudendal neuropathy.
Between April and October 2005, she underwent an electrically stimulated graciloplasty, reconstruction of the perineum, a loop ileostomy and had a stimulator surgically inserted.
She brought a claim against the defendant hospital alleging that it was negligent in (i) failing to examine the anal sphincter adequately or at all; (ii) failing to identify the existence of the tear; (iii) failing to repair the tear.
The defendant hospital only admitted that it should have diagnosed the sphincter injury after delivering her baby and before she was discharged the following day.
As a result of the hospital negligence, the woman suffered from faecal incontinence, underwent many medical investigations and operations and later suffered from collapsed lungs and pleural effusions and was transferred to a high dependency unit and later discharged. Her incontinence was improved by the graciloplasty and the stimulator. If she became pregnant again she would have to undergo a caesarean section.
She also suffered from an adjustment disorder with mixed anxiety and depressed mood and a hypoactive sexual desire disorder.
There was uncertainty concerning the long-term outcome of her graciloplasty. Medical evidence suggested that, on the balance of probabilities, she would require a permanent colostomy before she was 50 years old, that she would not otherwise have required.
The matter settled out of Court in the sum of £235k.
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