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Case Study

£925,000 for missed third-degree obstetric tear at St Michael's Hospital, Bristol

Helen Thompson settled a claim on behalf of Mrs F in relation to care she received at St Michael's Hospital, Bristol for a missed third-degree obstetric tear.

In December, Mrs F gave birth to her second child. Following delivery, a midwife considered that Mrs F had suffered a second-degree tear, although adequate checks to determine the severity of the tear were not performed. The midwife proceeded to perform a very poor repair of the tear.

While Mrs F remained in hospital, other midwives and doctors raised concerns about the appearance of the sutured tear and queried a more severe third-degree tear, but no further action was taken. Mrs F began to suffer with incontinence of wind, faecal urgency and faecal incontinence. She also experienced severe perineal soreness.

Following investigations, in March the following year, Mrs F was diagnosed as having suffered a third-degree tear involving the internal and external anal sphincters that had not been adequately repaired, and extensive residual scar tissue.

Mrs F underwent physiotherapy and a trial of a sacral nerve stimulator (SNS), which did not help her symptoms. Nearly two years after the birth, Mrs F underwent surgery to repair the anal sphincter followed by a further SNS trial and fitting of a permanent SNS. This combination of treatments somewhat improved her bowel control.

However, the severe perineal soreness continued and interfered significantly in Mrs F's daily life, her ability to care for her children, undertake domestic chores and work. Sexual intercourse was also extremely painful. Mrs F was only able to work part-time due to the level of discomfort.

Mrs F has been advised against surgery to refashion the perineum due to significant risks that could make her soreness worse and/or cause injury to her anal sphincter and rectum. Her perineal soreness is likely to persist indefinitely. Despite surgery and the SNS, Mrs F is likely to suffer a deterioration in her bowel control in later life, particularly after the menopause.

The Trust admitted liability early in relation to failing to identify and adequately repair the third-degree obstetric tear and that if this had been done, Mrs F would have avoided all of her bowel and perineal symptoms. Some issues remained in dispute, particularly whether Mrs F's injuries reasonably rendered her unable to work full-time and the amount of care and assistance she required. Judgment was entered for Mrs F on this basis and soon afterward, the Trust sought to settle the claim with offers of settlement. It was only once expert evidence had been served that settlement was agreed. At the settlement meeting, Helen negotiated settlement of £925,000 with the Trust. The legal team also included Gabriella Gooday and Deborah Nadel.

At the end of her claim, Mrs F said:

"I initially approached two legal firms with the details of my injury.  I spoke with a different company at first who were of the opinion I didn’t have much of a case an therefore wouldn’t be interested in taking me on as a client. This knocked my confidence and I started to think that I wouldn’t get anywhere at all, but after a conversation with Helen at Fieldfisher, I knew she completely understood me. She made me feel like I was finally being listened to. She was extremely empathetic and was confident from day one that I did indeed have a strong case and should proceed with my claim. I’m so grateful to Helen and her team. To think that after taking advice from a different firm I nearly gave up on myself. Helen at has given me the means to live a life as full as possible and I can’t thank her enough".

Contact us

For further information about perineal tear claims and midwife negligence claims please call Helen Thompson on 03304606765 or email


All enquiries are completely free of charge and we will investigate all funding options for you including no win no fee. Find out more about no win no fee claims.

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