Gynaecological Obstetric Negligence – A Brief Layman’s Guide

Introduction

Clinical negligence claims arising out of gynaecological treatment are highly specialized and need to be dealt with in a compassionate manner. The majority of these claims are bought as a result of problems arising during sterilisation, termination of pregnancies or hysterectomies.

The remainder of these claims are brought on behalf of the mother’s estate (in the case of a fatal accident). In the case of a death caused by negligent treatment, an inquest may be required.

The medical and legal issues involved in gynaecological claims are similar to those found in obstetric negligence claims and a single case may involve both types of treatment. Expert evidence is obtained from a Consultant in Obstetrics and Gynaecological Medicine.

Gynaecological negligence may result in a catastrophic injury and in such cases you will also need to be properly advised on issues particular to that sort of injury, including the appointment of a Receiver.

Many other claims arising out of gynaecological treatment cause injuries which have less severe effects (for example, where a patient is given an inadequate anaesthetic block). The effects on the person concerned are no less important and deserve to be properly investigated.

What are the signs?

Whilst gynaecological negligence can occur in a variety of unexpected ways, in our experience certain mistakes crop up more frequently than others. The consequences set out below are often clear with the benefit of hindsight but the warning signs can be open to differing interpretations by your treating doctor at the time treatment is given. This is not necessarily wrong and can lead to difficulties arising in pursuing a claim for compensation, if clear medical records are not kept at the time. Whilst you should be cautious, you can help by telling the doctor or nurse about any concerns that you may have about the treatment being given.

You should always consider asking for an explanation from the medical team or the hospital’s management if you have concerns about the treatment you have received. We do not advise you to attempt to tell the treating health professionals what to do. However, keeping a note of your questions and the responses you receive can often help later (particularly in emergency situations).

Consequences

There are a variety of consequences which can arise. These can result in injuries to the baby; to the mother; or to both. We have successfully represented many clients with such injuries.

Some common complications of gynaecological procedures include:

• A failed sterilization – which can lead to an unwanted pregnancy. This may lead to the termination of that pregnancy or the birth of a healthy baby. If this would not have happened anyway, compensation can be claimed for the effects of the termination of pregnancy or for the costs of bringing up the child (this is known as a ‘wrongful birth’ claim). 
• Negligently performed abortions – which can lead to unnecessary complications. In addition to failing to terminate the pregnancy (either partially or entirely), negligence during this procedure can also result in:

                 - ‘Wrongful births’
                 - Perforation of the uterus (possibly followed by an infection) during the surgery

                   (e.g. by the surgical instruments being used).
                 - Damage to other organs or parts of the body.
                 - The need for an otherwise unnecessary hysterectomy.
                 - Preventing the patient from having children in the future.

• Similarly, negligently performed contraception procedures can lead to:
         - ‘Wrongful births’.
         - The death of or catastrophic injury to the mother (e.g. by either the effects of

                     oral contraception or by resultant cardiovascular problems).
                  - Injuries caused by the side-effects of injected steroid-based contraceptives.
                  - Perforation of the uterus (possibly followed by an infection) by the inter-uterine

                    contraceptive device inserted.

• Failing to properly understand or interpret the information contained in cervical cytology results can lead to infections going untreated or being treated ineffectually.
• Failing to carry out other gynaecological surgical or diagnostic techniques (such as laparoscopy; or laparotomy) to an acceptable standard can lead to:
• Invalid consent being given by the patient (e.g. as a result of a failure to explain the risks of the procedure adequately).
• A perforation (or other injury) occurring to the posterior abdominal wall during a laparoscopy.
• Failing to detect or stop an internal haemorrhage (internal bleeding).
• An injury to the gastrointestinal tract, bladder or ureters of the patient.
• Leaving items used during the surgery (such as surgical swabs) inside the patient after the operation has finished.
• Delays in diagnosing pregnancy (ectopic or otherwise) and genital cancer.
  Accidental sterilisation can occur following a hysterectomy or if an infection is allowed to develop during the operation.
• The operation itself (or subsequent, remedial operations) may have been completely unnecessary. 

Conclusion

As with any medical condition, it is important not to jump to the wrong conclusion. Doctors are highly trained and cases of medical negligence are rare – we do not have a ‘compensation culture’ in the UK. Sometimes, however, things do go wrong and you should be prepared for this. In those circumstances, it may be appropriate to seek compensation after trying the official NHS Complaints Procedure. Legal Aid may be available to help you with the legal costs involved in investigating and pursuing a claim for compensation.

If you require additional information then our Clinical Negligence Team will be happy to assist. For further information contact Geoff Simpson-Scott on 0208 296 7951 or geoffrey.simpson-scott@colemans-ctts.co.uk 

Colemans-ctts solicitors have offices in Manchester, Kingston and Walsall and can offer legal guidance in a wide range of areas. Email enquiries@colemans-ctts.co.uk to find out how we can help