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Six Figure Compensation for Negligent Gallbladder Surgery

14 August 2014

Slater and Gordon Medical Negligence Lawyer James Bell successfully settled a gallbladder surgery negligence claim against two defendants for a six figure amount of compensation.

The First Defendant was a Consultant General and Laparoscopic Surgeon. The Second Defendant was Homerton Hospital.

In March 2006 the Claimant began to experience epigastric pain. On 12 April 2006 she was admitted to the Second Defendant hospital with a diagnosis of possible gastritis and arranged liver function tests. As a result of the epigastric pain the Claimant consulted her GP who arranged an ultrasound scan of the gallbladder and referred her on a private basis to see the First Defendant. The gallbladder was reported as showing the presence of gallstones. The Claimant then saw the First Defendant at the London Independent Hospital.

The First Defendant recommended surgery by way of a laparoscopic cholecystectomy (keyhole removal of the gallbladder) and on table cholangiography ( an x-ray of the bile ducts during the operation). On 15 May 2006 the Claimant was admitted to the London Independent Hospital where the First Defendant performed a laparoscopic cholecystectomy and on table cholangiography. The Claimant was discharged home on 17 May 2006. The Claimant was very unwell and weak following surgery and in June 2006 began to experience similar attacks of abdominal pain to those which she suffered prior to the surgery. Her symptoms continued and were progressive in nature as a result she found it difficult to look after her baby son and to continue working.

In March 2007 the Claimant went back to see the First Defendant on a private basis, he recommended investigations. As a result the Claimant's GP referred her on the NHS to the First Defendant NHS Outpatient Clinic at the Homerton Hospital. An endoscopy and MRCP were carried out, the results of which were normal. The First Defendant referred the Claimant to Dr Si, Consultant Gastroenterologist for further assessment and investigation. The Claimant underwent further investigations between January 2008 and July 2009.

An MRCP with pre/post-secretin images as well as post- gadolinium liver/pancreas contrast, revealed the Claimant's abnormal biliary anatomy. Dr S informed the Claimant following this procedure that there was a problem relating to her bile duct and referred her to Professor Davidson at Wellington Hospital. A CT scan was performed in September 2009 which showed the obstruction of the right duct system was at a level where there were five cholecystectomy clips leading to the suggestion that the ductal stricture was related to the Claimant's cholecystectomy. At the recommendation of Professor D the Claimant underwent a Roux-en-Y biliary reconstruction of the right ducts from her liver in October 2009.

The Claimant suffered significant pain following this procedure and had allergic responses to multiple medications. The Claimant underwent further MRCP in April 2010, October 2010 and December 2011. She remained subject to ongoing investigations and is under the continuing care of Professor D, Dr H and Professor W. The Claimant still suffers from bouts of abdominal pain, radiating up to the shoulder, several times a week. The Claimant feels very weak and tired for much of the time. The Claimant maintained that the treatment which she had received from the First and/or Second Defendants, their servants or agents, was negligent. The Claimant experiences upper abdominal pain, pain in the right flank, pain in the right shoulder, itching and excessive tiredness and weakness. The Claimant needs assistance with household tasks and has had to reduce her working hours.

The Claimant lost significant weight. The Claimant has a 10% risk of developing cholangitis, a 10% risk of developing a biliary stricture, a 4% of requiring major surgery to revise her hepatico-jejunostomy, a 5% risk of developing incisional hernia, and a 5% risk of developing complications from adhesions, with a 2% risk that abdominal surgery will be needed for adhesions. The Claimant has suffered considerable emotional distress.

Letters of Claim prepared and sent to both the First and Second Defendant on 31 August 2011. Liability was denied and a claim Form was issued on 7 March 2012. The Claimant alleged that the anatomy had not been properly identified in the on table intraoperative cholangiogram and the clips were placed in the wrong location, causing a stricture.

The First Defendant denied liability and stated that a general surgeon should not be expected to identify the anatomical variations in the biliary tree at the time of surgery. The First Defendant's case was that the Claimant's anatomy was correctly identified at the time of surgery and the complication of surgery was not negligent. It was denied that any of the clips were placed in the wrong location and it was asserted that the Claimant's problems arose due to fibrosis which was entirely unrelated to the surgery. The Defence of the Second Defendant admitted breach of duty and failing to diagnose the Claimant's biliary tree was abnormal, causing continued abdominal pain for two years.

In April 2013 a substantial offer ( a high five figure sum) was received from the Second Defendant . On 3 July 2013 an increased Part 36 offer was received from the Second Defendant and this was accepted.

The offer was accepted on the basis that it represented additional pain and suffering and a partial contribution to past losses in the period from 31 August 2007 to 6 July 2009.

The claim against the Second Defendant settled on the basis that if the NRCP Scan on 31 August 2007 had been correctly interpreted, then the Claimant would not have suffered an additional 22 months of severe abdominal pain, itching, debility and lethargy before her drainage operation and reconstruction was performed, and would not have experienced the same degree of financial losses in that 22 month period.

In November 2013 the First Defendant's condition and prognosis report of Mr J was received together with the First Defendant's care report. In light of the fact that Mr J had advised that the Claimant was suffering from psychological symptoms and related to her surgery, the First Defendant sought permission for the Claimant to be seen by a psychiatric expert nominated by them with a view to applying to the Court for leave to adduce psychiatric evidence at trial. In view of this Dr P was instructed to attend upon the Claimant in December 2013 and prepare a further report on behalf of the Claimant.

A Round Table Meeting took place on 16 January 2014, a few weeks before trial, when a settlement was reached against the First Defendant for substantial six figure sum.

James Bell is a Medical Negligence Lawyer at Slater and Gordon in London.

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