This case concerned the surgical management of a fourth degree tear following the delivery of U’s first child on 22 July 1999. 

On 20 July 1999, the Claimant was admitted to hospital for induction of labour. 

At 7:00am on 22 July 1999, U was fully dilated and she was transferred to a small theatre.  Forceps were applied and at around 7:45am a baby girl was delivered.

U was diagnosed as having a tear through the anal sphincter extending into the rectal mucosa.

Later that day the Claimant had an accident when her bowels opened.  She was attended to by the nurse and she was unable to walk to the toilet.  She also passed faeces through her vagina.  She was subsequently discharged on 26 July 1999.

On 27 July 1999, the Claimant was re-admitted and her perineum was noted to be gaping and looked infected.  U was complaining of passing flatus through the vagina. 

She was transferred for advice from a colorectal surgeon at another hospital where she underwent an examination under anaesthetic on 29 July 1999.  The operation note recorded that there was a complete disruption of the perineum, third degree tear through all the sphincter and anal mucosa to the level of the lower rectum.  There was no possibility of reconstruction and the repair had to be delayed.

As a result of her injuries U underwent in excess of 15 additional procedures and investigations, including perineal repair, a mucosa flap operation and fistula repair.

U was left with residual bowel symptoms and she suffered post traumatic stress disorder of moderate severity and a depressive adjustment disorder.

Supportive expert evidence was obtained on the issue of liability from an Obstetrician and a Colorectal Surgeon. 

We contended that there had been an inadequate repair of the tear which led to the incontinence and subsequent problems.

The Defendant Trust denied liability and argued the Claimant’s wound became infected for non-negligent reasons which would have led to wound breakdown and subsequent incontinence.

A negotiated settlement was reached in October in the sum of £65,000 by Samantha Critchley who also conducted the case on a “no win no fee” basis 


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