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Iona Millais: Surgical excellence is undermined by poor maths

I have recently recovered damages for a gentleman who suffered a retained swab after surgery.
My client underwent an Ivor Lewis Oesophagogastrectomy for carcinoma - cancer of the oesophagus.  The oesophagus is the muscular tube passing food from the mouth to the stomach.  An Ivor Lewis procedure involves removing the patient's oesophagus and top part of the stomach. A portion of the stomach is then pulled up into the chest and connected to the remaining normal portion of the oesophagus. The patient then has a new oesophagus made up of the normal portion of the oesophagus not removed at surgery connected to a portion of the stomach pulled up into the chest.
This major gastrointestinal surgery is undertaken in three stages; abdominal, cervical and thoracic. One Consultant Surgeon performs the abdominal dissection, followed by a Consultant ENT Surgeon who performs the cervical dissection and then finally the thoracic dissection is performed jointly.  Each surgeon has his own team of scrub nurses.
Such a procedure requires extremely skilled surgeons and carries enormous risk. There is no doubt that the surgery was carried out to a very high standard. However, there were very basic system errors resulting in a large swab being left in the abdominal cavity of my client. As a result, instead of recovering from major surgery, my client had to have his painful scar re-opened to remove the swab extending his period of convalescence
The Trust admitted failings in ensuring that there was an efficient system of counting swabs in and out during surgery and communication failures between the two surgical teams.
This case raised an interesting paradox - the admirable efforts of the surgeons carrying out a cutting edge and extraordinarily risky procedure juxtaposed with the basic error of failing to count swabs in and out. This was an easily avoidable error and one which has caused my client pain and distress. He is extremely grateful to his surgeons, but has been justly recompensed for his additional suffering.Iona Millais is a solicitor specialising in clinical negligence. 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.