High Court of Justice orders Defendant to pay compensation of £360,000 plus care costs after a patient suffers significant complications due to surgical error during a Cholecystectomy

High Court of Justice orders Defendant to pay compensation of £360,000 plus care costs after a patient suffers significant complications due to surgical error during a Cholecystectomy

A member of our medical negligence solicitor panel acted for this claimant and by order of the High Court of Justice on 15 November 1990, it was ordered that the Defendant pay the Claimant damages for injury arising from negligence in her management under the Defendant’s care on 18 June 1984. The claimant underwent surgery for cholecystectomy and suffered injury to her right hepatic duct and transection of the common hepatic duct.  She required surgery for biliary reconstruction.  The damages awarded to the Claimant by the Court were awarded on the basis that the Claimant would not in future develop complications of her injury, including a stricture of any of her biliary ducts; serious deterioration of the neurosis from which she then suffered; and other complications.  An order for provisional damages was made.

The Claimant did go on to develop -

(a)   A complex biliary stricture, involving the origin of both the anterior and posterior branches of the right hepatic duct, and for which she required treatment including surgery on 14 November 2011 for right hemi-hepatectomy;

(b)  Neuropathic wound pain;

(c)  A serious deterioration of neurosis, with recurrence of depressive disorder.

She underwent ERCP (endoscopic retrograde cholangiopancreatography) under intravenous sedation on 2 February 2010.  A PTC (percutaneous transhepatic cholangiogram) was performed under local anaesthetic on 22 February 2010.  Attempted balloon dilatation of the anastomosis was undertaken but had to be abandoned and a percutaneous drain was placed.  Images from this investigation showed a stricture affecting the origins of the left and right hepatic ducts at the confluence of the two bile ducts and the site of the hepatico-jejunostomy anastomosis.  A repeat PTC was performed on 23 February 2010 under general anaesthesia with balloon trawl for gallstones in the right anterior sectoral hepatic duct. The Claimant was discharged home on 26 February 2010.

The Claimant remained under the review at the Hammersmith Hospital.  She developed recurrent right upper abdominal pain.  Antibiotics were given and she underwent pain clinic review.

On 14 November 2011 the Claimant underwent surgery for right hemi-hepatectomy.  The previous incision was opened, with left subcostal and cephalad midline extensions.  Right hemi-hepatectomy was performed.  It appeared that the hepatico-jejunostomy into the left hepatic duct was patent and did not require revision.  The Claimant was discharged home on 2 December 2011 with an abdominal drain in place.

The Claimant was admitted overnight to the University Hospital of Wales, Cardiff, on 13 December 2011 with blood and pus in her drain.  She was discharged for further follow up and management at the Hammersmith Hospital.

The Claimant had three or four checks on her drain and re-suturing of the drain at Hammersmith Hospital to ensure that it stayed in place.  She was finally reviewed at the Hammersmith Hospital on 9 January 2012 when it was noted that she was feeling well and had no issues.  The drainage was minimal over 48 hours and the drain was removed in the clinic.

During February 2012 the Claimant spent four days in the Royal Gwent Hospital with fluid on her lungs.  This did not require drainage and she was treated with antibiotics.

Following the operation on the 14 November 2011 the Claimant had suffered pain by the lateral end of her right sided abdominal wound.  The pain was being treated by the Pain Clinic at the Royal Gwent Hospital and the Claimant underwent paravertebral blocks on 18 July 2012 and 21 November 2012.  The pain was neuropathic and was related to nerve damage from the intercostal nerves supplying the right lateral end of the abdominal wound which was extended to perform the liver surgery.

On the 14 November 2011 the right lateral end of the incision was extended by 9cm.  The vertical wound was extended upwards by 6cm.  There was a 6cm area of very weal abdominal wall with a cough impulse and with an increased risk of development of an incisional hernia.

The Claimant suffered recurrence of depressive disorder.  Her sense of well-being and quality of life was reduced and the depressive disorder contributed to her overall distress, the level of which had risen due to the changes in her physical health that led to the operation to remove part of the liver.

The prognosis for the Claimant’s recurrent depressive disorder was guarded as it was dependent upon the extent to which the chronic pain would continue.

Pleadings were served on the 3 December 2012.  A Case Management Conference took place on the 24 April 2013. 

A Joint Settlement Meeting was held on the 28 January 2014 at which the Claimant accepted the sum of £360,000 plus her reasonable costs of the action.

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