Successful gynaecology negligence claim for the failure to detect a third degree tear
Wendy became pregnant for the first time in April 1995. On 10 February 1996, Wendy went into spontaneous labour and was admitted to King’s College Hospital.
After a long labour, a ventouse delivery was attempted. This failed and a generous episiotomy was performed and followed by forceps delivery. The episiotomy was later repaired and a final inspection of the perineum performed.
Following discharge from hospital, Wendy suffered from frank incontinence, faecal leaking and loss of bowel control. She was referred to a colorectal surgeon who suspected a third degree tear.
An ultrasound was carried out, which confirmed extensive disruption to the external anal sphincter. This was repaired in November 1996. Though largely successful, Wendy continued to experience problems with faecal leakage. She also suffered anxiety and depression.
Wendy instructed us in January 1999, shortly before limitation expired and protective proceedings were issued on 10 March 1999.
Expert evidence confirmed that the obstetrician who performed the episiotomy should have suspected damage to the external anal sphincter and performed a rectal examination. This would have revealed the injury.
Repair of the injury at this time would have avoided the 8 months of incontinence Wendy suffered and the consequent depression. She would also have had a better long term result in terms of complete continence.
The hospital alleged that third degree tears in childbirth are frequently missed by responsible clinicians and therefore there was no negligence.
The action was fixed for trial on November 2000 and conducted on a no win, no fee basis. The amount of compensation was agreed subject to the claimant (Wendy) establishing liability. The trial lasted 5 days and, after 4 weeks, Wendy received judgment in her favour.
The Judge found that a proper examination after delivery would have revealed an extension of the episiotomy into the external anal sphincter and would have led to a diagnosis of the third degree tear.
An immediate repair would have been carried out. However the learned Judge felt that in the long term there had been no difference in outcome in terms of ongoing problems. Nevertheless, he awarded Wendy £25,000.
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For further information about birth injury claims and third degree perineal tear claims, please call Paul McNeil on 03304606804 or email paul.mcneil@fieldfisher.com.
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