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James Bell: Clinical Negligence Surgical Errors

By Principal Lawyer, Clinical Negligence

Unable to stop talking shop, I found myself chatting to a urologist at a social function a few weeks back. He assured me that the only errors urologists made were in cases involving urosepsis and the loss of a testicle arising from a vasectomy. As an example of a urosepsis claim, I outline below a current case in which I am acting.This case concerns a kidney stone removal operation and the failure of the surgeon to administer  pre; peri or post operative anti-biotics to remove the risk of septicaemia. Our independent experts considered that the risk of septicaemia was obvious in the kidney stone removal operation because the surgeon had to break through into the blood stream during the "digging out" process.  If there was infection in the urinary tract that would enter the blood stream and could cause septicaemia.The experts also advised me of the golden hour in which to treat septicaemia after the symptoms have arisen.  It starts with the emergence of clinical symptoms: tachycardia and greyness and clammy skin and unwellness.Septicaemia is the proliferation of bacterial infection in the blood stream in such quantities that the blood pools in the peripheral parts, bacterial poison is released, the heart beats harder to move the blood and hypoxia is caused in the peripheral parts and multi organs.Gentamicin and other powerful antibiotics can both kill off the bacteria but the golden hour is the time when no damage has been done.  Thereafter although the bacteria may be killed off the by products, the bad chemicals remain in the blood until it is cleaned out.  Damage is caused whilst this is being done.For some reason which is unclear in my particlur case , the surgeon failed to prescribe IV anti-biotics at all.  This was despite the fact that there was a bedside urine test which indicated infection due to the presence of nitrates. These are by products of bacterial activity in urine which convert nitrites into nitrates.  The urologist  failed to prescribe IV anti-biotics despite them being provided  every time that the stent was changed before (3 times).The surgeon also  saw cloudy urine during the operation (a sign of infection) but failed to ask the anaesthetist whether he had given IV anti-biotics. Liability has recently been admitted on this case, immediately after court proceedings were served on the NHS Trust.The effects of septicaemia can be very profound. Following the admission of liability I have secured a £200,000 interim payment to assist with the care of the Claimant and cover her loss of earnings. The money can be put to some use I hope in assisting rehabilitation of the patient.James Bell is a Partner in the Russell Jones & Walker clinical negligence team. If you or a member of your family have a clinical negligence enquiry please call our expert clinical negligence solicitors on 0800 916 9049, fill in our short online claim form or email and one of our specialist clinical negligence team will be in touch