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Case Study

Settlement for GP suffering severe incontinence following missed third-degree tear

Jonathan Zimmern achieved settlement of £465,000 on behalf of a client who suffered a third-degree tear that was missed following the birth of her daughter, and for the incontinence that followed. These ongoing issues have seriously disrupted her life and particularly her ability to work.

Katie, now 37, a qualified GP, was admitted to the Royal Surrey County Hospital, part of the defendant Royal Surrey NHS Foundation Trust. The treating team performed an episiotomy and delivered her daughter using Neville Barnes forceps.

Following Katie's delivery, the treating team examined Katie and incorrectly concluded that she had suffered a second-degree tear. A second-degree tear includes damage to the posterior vaginal walls and perennial muscles, but the anal sphincter remains intact. A third-degree tear extends to the anal sphincter. Following this incorrect diagnosis, a second- degree tear repair was performed, leaving the anal sphincter unrepaired.

In fact, Katie had suffered a 3c vaginal tear – a complete tear through her internal and anal sphincter muscles. This was undiagnosed and was not appropriately repaired. She suffered infection, perineal breakdown and incontinence.

Katie instructed Fieldfisher to investigate her claim for negligence. Following a review of Katie's medical records and instruction of a colorectal expert for evidence, our investigation suggested that there was a negligent failure to identify and repair the third-degree tear Katie sustained during childbirth. Had the adequate repair been performed, Katie would have avoided the symptoms of faecal urgency and incontinence she now suffers.

Katie has undergone repeated and invasive investigations and therapies in relation to the injury. She has also become anxious at work and has been forced to reduce her working hours. Katie has also been advised that she will need a caesarean section for any future pregnancies.  She may also require future surgeries such as an overlapping sphincter repair and may develop complications arising from these procedures. It is also likely that her incontinence will worsen with age.

We served detailed evidence to the defendant, but they denied liability. While they accepted that Katie's third-degree tear was missed as fact, they did not accept it was negligent to have done so. They argued that the treating team had performed a thorough and competent check before and after the repair and that it was reasonable to have missed this tear.

Jonathan and his team continued to work on Katie's case and to quantify the losses Katie suffered as a result of her injury.

The Defendant appeared unwilling to move from their refusal to accept liability but, after some careful negotiations which resulted in a Round Table Meeting, Jonathan was able to negotiate a £465,000 settlement.

While no amount of money can save Katie from the ordeal she has been through, settlement gives her some financial support for the pain and suffering, loss of earnings, other past losses and future losses that she may incur as a result of the injury.

Following the settlement, Katie said, 'it has been a pleasure to work with Jonathan throughout my case. I found him extremely empathetic, approachable and supportive and he was able to guide me through the legal process with ease.  I would recommend him highly to others without reservation.'

Contact us

For further information about birth injury claims, please call Jonathan Zimmern on 020 7861 4218 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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