CASE STUDY: HC –v- Western Sussex Hospitals NHS Foundation Trust

3rd January 2018 by

Jonathan Austen-Jones represented this 38 year old female in her claim for medical negligence against Worthing Hospital.

Jonathan’s client  suffered from stress incontinence following the birth of her second child some years before and was referred by her GP to the Defendant’s Worthing Hospital. The Claimant had previously undergone a course of physiotherapy but reported being troubled by episodes of urinary incontinence on coughing, sneezing, running and dancing.

The Claimant was seen by a Consultant Obstetrician and Gynaecologist in September 2010 and during that consultation the Consultant recommended that the Claimant should undergo an AJUST mid-urethral tape procedure which he described as being the latest procedure and very easy to insert with little recovery time. The Claimant attended Worthing Hospital in January 2011 for the suggested surgery.

The only risks explained by the Consultant to the Claimant relating to the procedure were “bleeding and infection, damage to bladder or urethra and post-op tension”, at no time prior to providing her consent to this procedure was the Claimant told that the AJUST procedure was a procedure for which there was then no published peer-reviewed literature or other high quality evidence as to its efficacy and safety and nor was she informed of alternative available surgical procedures such as TVT (tension-free vaginal tape), Burch Colposuspension which all had longstanding published peer-reviewed studies showing good results for efficacy and safety.

During the course of the procedure the Claimant advised her Consultant that she was experiencing extreme pain and discomfort but he nevertheless continued, meaning that the Claimant was less able to remain still and the Consultant was therefore less able to achieve accurate placement of the tape, resulting in the fixation points being applied incorrectly and the Claimant suffering from post-operative severe pain.

Most significantly, the Claimant was left with significant vaginal and pelvis pain and discomfort post-operatively and diminished urinary control. The Claimant had to undergo a subsequent procedure in June 2011 to remove most of the tape previously inserted. The Claimant underwent a number of subsequent investigations including investigations and treatment, including continuing pelvis physiotherapy as well as acupuncture and botox injections which caused excruciating pain and simply exacerbated the situation.

We argued that had the Claimant known of the additional risk factors and that this AJUST was a relatively new product on the market, she would not have provided her consent to the AJUST mid-urethral tape procedure and therefore her Consultant had failed properly to discharge the duty of care he owed to her.

After starting Court action, although the Hospital’s solicitors maintained its denial that the surgery carried out in January 2011 was negligently performed or that the Consultant had failed to achieve accurate placement of the tape, the Hospital Trust did admit that the Consultant had not obtained the Claimant’s informed consent for the AJUST procedure and/or did not discuss with the Claimant available, alternative treatments.

After having obtained further expert evidence in support of the Claimant’s ongoing problems complained of, Jonathan was eventually able to settle his client’s claim amicably with the Hospital’s solicitors for a substantial sum in June 2016.