Urogynaecological treatment provided by Dr Angamuthu Arunkalaivanan is currently under scrutiny by the Sandwell and West Birmingham NHS Foundation Trust where he previously worked.
A number of patients have already been contacted by the Trust and recalled as part of the ongoing investigation into Dr Arunkalaivanan’s practices.
It is our understanding that the Trust is looking specifically into the continued use by Dr Arunkalaivanan of a banned synthetic mesh for treating pelvic organ prolapse (POP). The Trust had previously decided not to use the mesh back in January 2009, but it appears that Dr Arunkalaivanan continued to do so.
The use of mesh in gynaecological procedures has provoked significant debate in recent years due to the increased incidence of chronic complications including erosion, infection and pain. In some cases, the mesh needs to be removed, but this can in itself be a traumatic and high risk procedure.
The decision to use mesh must be taken with careful consideration and, in 2013, the National Institute for Clinical Excellence recognised those concerns when updating their guidance on the use of mesh in vaginal wall repair, and indicated that using mesh was a technically challenging procedure that should only be carried out by gynaecologists with special expertise in the surgical management of pelvic organ prolapse (see guidance here).
Similarly, in 2014, the Scottish government imposed a total ban on the use of mesh in vaginal procedures (see our comment on this here).
The circumstances whereby Dr Arunkalaivanan was able to use the mesh and the extent of his experience, training and supervision remain unclear.
Slater and Gordon clinical negligence solicitors are providing legal advice to patients of Dr Arunkalaivanan and are investigating the allegations further.
The Trust has reviewed all of the cases where Dr Arunkalaivanan has performed surgery with mesh and has contacted those patients to invite them to undergo a clinical review and address any concerns that they may have. It is suggested by the Trust that, in some cases, surgery has not been carried out in the right circumstances and that there are concerns over the level of information that patients have been given about the risks of surgery they have agreed to undergo.
The recall of some of Dr Arunkalaivanan’s patients will be of immense concern to all those patients who have been treated by him in the past.
It is to the Trust’s credit that they are taking the initiative and initiating a patient recall, but it would appear that this treatment has been ongoing since January 2009 and it will be important for the Trust to ensure that all patients are contacted and that adequate awareness of the concerns is raised. It should also be incumbent upon the Trust to advise patients to take independent legal advice if they are not satisfied with any aspect of their treatment.
In our experience in dealing with these types of clinical negligence claims, and in particular, compensation claims against the Liverpool Women’s Hospital with regards to the treatment of Mr George Rowland, we found that clinical negligence concerns pre-dated the recall period and it will be important to ensure that all aspects of Dr Arunkalaivanan’s practices are looked at.
It is also vital that patients do not suffer in silence and that they are given adequate assistance to seek a review of their treatment. This is particularly important for elderly patients who may have difficulty travelling to hospital and I would hope that the hospital will ensure that they are provided with support in this regard.
The implications of such medical conditions can be devastating and it is important that the Trust ensures that all patients who may need further treatment are contacted and seen urgently.
Any patients who received medical treatment from gynaecologist Dr Arunkalaivanan and who are concerned should contact Slater and Gordon Lawyers for a free consultation as soon as possible.
Ian Cohen is the Practice Group Leader for clinical negligence at Slater and Gordon in Liverpool.
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