Legal action following negligent treatment during birth resulting in an unnecessary total hysterectomy.
The Claimant in this matter was around 40 weeks pregnant on 9 July 2012 when she had a membrane sweep in hospital. She returned on 11 July 2012 when the contractions were getting stronger; at this stage she was 2cm dilated.
On 12 July 2012 she had an artificial rupture of the membranes and was transferred to the delivery suite. At 5:55pm she was found to have pyrexia of 38.9 C with associated vomiting. At 6:10pm, the Claimant was fully dilated; the baby was lying in an occipitio posterior position with the head descended. At 6:25pm, the foetal heart rate was above 200bpm. A decision was made at 6:30pm to perform a forceps delivery.
The forceps were applied and an episiotomy was performed. At 6:43pm a baby girl was delivered via the forceps in an occipitio position. Syntometrine was given and the placenta delivered at 6:50pm.
It was noted from the obstetric registrar that there was bleeding from a vaginal wall tear. At 7:28pm she was in a shocked and compromised clinical condition due to hypovalaemia, with her BP at 44/27 and a pulse rate of 155bpm. The consultant obstetrician was called and fluid resuscitation started.
Further medication was given to contract the uterus but ongoing bleeding was noted. This resulted in a decision to take the Claimant to theatre for an examination under anaesthetic.
At 8:28pm she was transferred to the operating theatre and a consultant obstetrician undertook an EUA. The uterus was well-contracted to begin with, but the vaginal tear was bleeding profusely. It was sutured and there was a sudden gush of bleeding from above. The uterus was found to be atonic, resisting efforts to make it contract pharmacologically.
At 9:10pm due to persistent bleeding, a decision was taken to perform a laparotomy and a second consultant obstetrician requested to attend for support. A subtotal hysterectomy was performed. At 9:45pm she was still bleeding and a decision was made to convert the subtotal hysterectomy to a total hysterectomy; both the uterus and cervix was removed. The bleeding stopped and the abdomen was closed after an estimated blood loss of 4000mls.
Post-operatively she was transferred to the ITY at Southport Hospital where she remained for 3 days prior to her transfer back to Ormskirk Hospital on 16 July 2012. She was discharged on 23 July 2012.
The Claimant was asked to attend a meeting at the Southport and Ormskirk Hospital NHS Trust on 8 October 2016, where she was advised that she had been given an unnecessary total hysterectomy. The Claimant was not told this before as she was only told that she had a subtotal hysterectomy.
Proceedings have been issued and expert reports are required from experts in Obstetrics, Urology, Psychiatry and pain management.
As a result of the experience and of undergoing a total hysterectomy, the Claimant experiences severe psychological problems, bowel problems, urinary incontinence and vaginal scarring. She will have issues for life. The extent of these is still being investigated.