Helen's baby was born in a position that made it more likely that she would suffer a vaginal tear. After delivery, the midwife examined Helen and diagnosed that she had suffered a second degree perineal tear that would require stitches. The midwife did the procedure, and mother and baby were then discharged. Helen believed that all was well.
Shortly after discharge, Helen began to suffer from faecal incontinence, leakages of faeces and uncontrolled flatus daily. This was, understandably, extremely difficult for her. She became increasingly depressed and anxious about her condition, and was not able to obtain medical help until some time had passed.
Helen eventually came under the care of a colorectal surgeon at Southampton General Hospital. Over the years, her condition had become worse and she had tried to moderate her symptoms by controlling how much she ate, which made her unwell. Helen underwent a series of colorectal tests, and a diagnosis of an extensive anal defect was made.
Helen then underwent a number of surgical and other procedures over the next few years, but unfortunately these have not improved her condition and she continues to suffer incontinence daily. Surgery has been very difficult, unpredictable, and stressful. There are currently no further surgical options available, as Helen understandably does not wish to undergo further surgery to have a colostomy fitted. In addition to the physical symptoms, Helen has suffered, and continues to suffer, significant psychological harm as a result of the misdiagnosis.
Helen contacted us in relation to bringing a claim as a result of the midwife's misdiagnosis. She had undergone the NHS complaints procedure, as a result of which a helpful letter had been provided which indicated that the tear had, in fact, been of a third rather than second degree.
We investigated the case, and medical expert reports were obtained from a midwife, obstetrician and gynaecologist, colo-rectal surgeon and psychiatrist.
The allegations of negligence were that the midwife had:
- Failed to put sufficient weight on the baby's position during delivery which increased the risk of a tear;
- Failed to do a proper examination and rectal examination after delivery;
- Failed to recognise that the perineal skin had torn to the anus and would need further investigation to confirm the extent of the injury; and
- Failed to seek assistance from a doctor (an obstetrician)
In relation to causation of injury, our case was that if the third (rather than second) degree tear had been diagnosed and treated at the time, Helen would have had a good prognosis. She would not have suffered incontinence, although may have been incontinent of flatus.
In the Defence, the hospital admitted that the treatment by the midwife had been negligent, in that Helen had not had the correct diagnosis and treatment. The hospital also agreed that Helen would have had a good prognosis if she had had the correct diagnosis and treatment, but she would have had some faecal urgency for a year and there was still a prospect of her experiencing some faecal incontinence in any event. Judgment was entered on the basis of the Defence, with remaining causation and quantum issues to be explored by the parties.
At an early stage in the case, the hospital offered £20,000 compensation in full and final settlement of Helen's case. However, after we had done thorough investigations, we subsequently settled the claim for £750,000 compensation - an increase of £730,000 - plus legal fees.
The compensation included an amount for the severe impact that Helen's condition had on her ability to live a normal life, and for her to have a personal bathroom, a cleaner, and psychological assistance to help her learn to live a full life, despite her difficulties.
At the end of the case, Helen said that:
"I do not think I can express how much Fieldfisher has helped me and my family. The settlement will change our lives and make it so much easier to live with my condition … . I never thought when the case began that I would be able to see it through as I was so scared, but because Fieldfisher was so understanding and easy to talk it made it so much easier for me.
"I had spoken initially to a number of solicitors before deciding who to instruct, and Fieldfisher was the only one who really listened to me."
Fieldfisher commented:
"Settling Helen's case was hugely rewarding and the money will enable her to have the continued psychological support to help her come terms with living with incontinence. It will also enable her to make some relatively small changes that will have a big impact, such as adapting her home so she can have her own bathroom."