Mrs P was a 60 year old female patient who underwent laparoscopic cholecystectomy and developed post operative pancreatitis which resulted in multi organ failure, removal of the majority of her colon and a permanent ileostomy. She had previously undergone an MRCP to determine the cause of her abdominal pain prior to her being operated on. The MRCP showed stones in the common bile duct and accordingly it was not appropriate for a laparoscopic cholecystectomy to be carried out.
Unfortunately the results of the MRCP were not placed in Mrs P's notes nor were the results cross referenced to any patient waiting on the theatre list. On the day of the planned surgery for the laparoscopic cholecystectomy the Consultant Surgeon was not available and his diary did not have a theatre list schedule for that date. The particular Consultant had two diaries which had not been updated. Mrs P was admitted to the day unit at another hospital and another surgeon from the team was contacted to go to the Churchill to operate upon her. He was encouraged to operate quickly as the list was running late. The Surgeon did review Mrs P's notes but there was no mention in the clinical care plan of the MRCP results. Accordingly the surgery was carried out.
Mrs P was sent home that evening but gradually began to feel unwell. She was eventually re-admitted to hospital on the 28th October with a diagnosis of acute pancreatitis. She was subsequently in intensive care for 4 months where she underwent a tracheostomy. She contracted C-difficile and required major surgery including removal of a substantial part of her colon and required a stoma. Following her discharge from hospital she had numerous hospital admissions to deal with low potassium levels. In February 2009 she was readmitted to hospital for further removal of intestine. Whilst in hospital she suffered cardiac problems from which she recovered. When she returned home she needed full time care which was provided by her husband. Mrs P remained with her husband in the marital home until September 2009 when they separated and she moved out to live with her son.
At the time of the injury at the time of the injury Mrs P had been working as a programme administrator at Oxford University but was unable to return to work and took early retirement. Her quality of life was turned upside down. She continued to suffer with reduced energy level and fatigue. She had permanent scarring and an inoperable incisional hernia. She suffers from short bowel syndrome and therefore has to follow a restricted diet of bland food. She suffered a major depressive episode as a consequence of her experiences in hospital and describes herself as turning into an old woman overnight. She had major difficulties with managing her ileostomy bag and stoma particularly in the early period following the surgery when the bag was leaking repeatedly and the stoma became red raw and painful.
Liability evidence was obtained from Hepatobiliary Surgeon. Causation evidence was obtained from an expert in colorectal surgery to deal with the condition short bowel syndrome. Medical reports on condition and prognosis were obtained from a Psychiatrist, Plastic Surgeon, Stoma Nurse and a care expert. The care expert was instructed after all the condition and prognosis reports were in because they were very relevant to the issues of long term care needs. A care expert was instructed in March 2010 and was received in May 2010. The Defendants sent a Letter of Response on the 29th January 2010 in which they admitted liability. They made a Part 36 Offer on the 1st February 2010 which was rejected. A letter of apology was sent to the Claimant on the 9th March 2010.
A meeting between the lawyers for both parties was arranged for December 2011 following which a settlement was achieved.