Damages for delay in diagnosis of appendicitis at Royal London Hospital
On 18 February 1996, Martin, a four year-old boy, was taken by his mother, Emily, to the Minor Injuries Unit at St. Bartholomew’s Hospital.
The history given was of vomiting, abdominal pain, fever and sore throat for 3 days. He was transferred to the Royal London Hospital.
An abdominal x-ray confirmed distension of the bowel. Preliminary diagnoses of urinary tract infection and gastroenteritis were made and Martin was transferred to the paediatric department.
Martin was seen by a general surgeon, who noted that he had not opened his bowels for four days. It was concluded there was a blockage in the colon and a secondary urinary tract infection and IV antibiotics were commenced later that night. Martin was discharged on 19 February.
On 23 February 1996, Martin was examined by his GP, who confirmed pyrexia and found Martin’s abdomen to be tender, with guarding. Martin’s GP referred him back to the Royal London Hospital.
Martin was seen at the accident and emergency department at the Royal London Hospital later that day. Appendicitis was excluded. Later, he was transferred to the Queen Elizabeth Hospital, where appendicitis was immediately diagnosed. An operation was performed that night and he was found to have a perforated appendix.
Martin’s post operative recovery was complicated by a wound infection, which required further surgery to drain pus from his wound.
Martin was allowed home on 14 March 1996 and was readmitted on 17 March 1996 when he had secondary suture of his abdominal wound. Martin had intermittent abdominal pain for several months following these procedures.
We were instructed to pursue a paediatrics negligence claim on Martin's behalf.
Our expert paediatric surgery evidence indicated that a diagnosis of appendicitis should have been made at the first admission on 18 February 1996.
There was also a delay in diagnosing appendicitis when Martin re-presented on 23 February. If the diagnosis of appendicitis been made on 18 February, Martin would have avoided the peritonitis that was present by the time of his operation on 23 February. Additional surgical procedures would have been avoided and Martin could have resumed normal activities within 6 weeks.
The defendant initially denied liability but the claim was settled on 20 September 2001 and Martin received £7,500 compensation for the delay in diagnosing appendicitis.
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