£40,000 damages for complications following appendicectomy at University College London Hospital

Helen Thompson recovered £40,000 damages for a 47-year-old woman who suffered serious complications following an operation to remove her appendix.

On 27 April 2012, Mrs S attended University College London Hospital (UCLH) with right-sided abdominal pain. An ultrasound scan confirmed appendicitis and the following day she underwent an appendicectomy.

A few hours after the operation, Mrs S collapsed and was found to be hypotensive (low blood pressure) and with low haemoglobin levels, suggesting internal bleeding. However, doctors incorrectly diagnosed a vasovagal episode as the cause of the collapse and negligently missed the possibility of a significant bleed into the abdomen. As a result the doctors failed to perform an urgent CT scan on the evening of 28 April.

The next day, Mrs S continued to be very unwell with nausea, a raised temperature, abdominal pain and diarrhoea. Doctors noted a large bruise on her abdomen. Again, they failed to undertake a CT scan which would have revealed a large collection of blood within her abdominal cavity. Instead, they incorrectly diagnosed a bleed within the abdominal wall and decided to treat Mrs S conservatively. On 1 May, Mrs S was discharged from hospital despite being very unwell.

At home, her condition deteriorated and on the evening of 3 May, she was readmitted to UCLH by ambulance. A blood test confirmed that her inflammatory markers (an indication of severe infection and sepsis) were significantly elevated. Again, doctors negligently failed to undertake a CT scan of her abdomen and she was incorrectly diagnosed with a urine infection. Mrs S remained in hospital until 6 May, still without a CT scan of her abdomen. She was sent home with an outpatient appointment for two days’ later.

At this outpatient, still severely unwell, she finally had a CT scan of her abdomen and blood tests were performed before she was sent home again. Later that day, a doctor phoned Mrs S and confirmed that the CT scan had shown a large, infected collection in her pelvis and that she should return to A&E immediately.

On 9 May a drain was inserted to drain the infected collection and around one litre of infected blood was drained. By 12 May, Mrs S was diagnosed with an ESBL infection and was put onto an isolation ward.

Two days later, doctors decided that the remaining abdominal collections were unsuitable for drainage and Mrs S was discharged home.

On 21 May, Mrs S saw a nurse who noted that her abdomen was swollen and tender, she was having difficulties urinating, was constipated and had a fever. She was advised that the pain and symptoms were normal and could take eight weeks to resolve. She was prescribed pain killers and laxatives.

By 25 May, Mrs S noticed vaginal bleeding and she was unable to pass urine. She went back to A&E at UCLH and was diagnosed as passing infected blood clots from the abdominal collection through a fistula which had formed with her vagina. Surgery was performed to widen the fistula and drain the remaining collection of infected blood. Two litres of infected blood were removed during surgery, along with a large amount of faeces. Mrs S had to have a PICC line inserted for intravenous antibiotics and she was diagnosed as also having contracted C. difficile.

Mrs S made a gradual recovery but still suffers a lack of energy plus ongoing abdominal discomfort. In 2016, Mrs S was diagnosed as suffering with a hydrosalpinx (a blockage and swelling of a fallopian tube) which was also attributed to the abdominal infection following the appendectomy. She requires further surgery in this respect.

Mrs S instructed Fieldfisher to investigate the care that she had received at UCLH. An expert in the discipline of General and Laparoscopic Surgery was instructed to comment on the case and was highly critical of the care provided to Mrs S. The Trust, however, refused to admit liability and defended the claim in full until just before trial, when they agreed to settle the case for £40,000.

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