A.B V  HSE

October 2022

Background facts

The Plaintiff is now a 60 year old woman who for some time had been suffering from

severe  menorrhagia (excessive vaginal bleeding)  she came under the care of a

Consultant gynaecologist in a midland hospital.

The gynaecologist  was not certain as to whether the patient had actually reached menopause but actually, by the time she was treating her in 2017, the plaintiff  was already five years or so past the average menopausal age. Excessive bleeding had previously been managed quite well with medication.

The plaintiff also had a very difficult life, as her first child now aged 30, was born with Cerebral Palsy and Turner’s Syndrome.  The plaintiff was her child’s full time carer for the past 30 years providing devoted loving daily care for her child.

Initially, the plaintiff underwent an ultrasound scan on the 19^th February 2018 and at that time, her uterus was ante verted and measured 134mm in longitudinal and 70 x 67mm in transverse diameter.  The ultrasound report confirmed that there was a 50 x 48mm fibroid noted with a second that could not be excluded measuring 33 x 23mm.

She then underwent a hysteroscopy in August 2018 to rule out uterine malignancy.

On 25^th September 2018 she had a further ultrasound scan and this showed that her uterus by now had expanded to 160.7mm by 52.6mm.  However, of relevance, the ultrasound scan on the 25^th September 2018 report, confirmed that there were no significant changes in the size and appearance of the fibroid.  Nevertheless her abdomen had now swollen to  the equivelent of a five month gestational foetus.

A palpable mass was found in October 2018 but assumed to be her uterus, although the fibroids had not increased in size.  It was recommended by her gynaecologist that she should have a hysterectomy. She received no further scanning in October 2018, despite the fact that she was feeling unwell, and she proceeded straight into a hysterectomy on the 18^th January 2019.

On opening the abdomen, the surgeon moved the uterus and found there was an abscess adhering to the uterine wall involving the bowel which was a diverticular abscess. In the course of surgery the abscess burst emitting puss.   The hysterectomy was abandoned and wash out carried out. Subsequently, the plaintiff developed septicaemia and was transferred as an emergency transfer to St James’ Hospital  on the 21^st January 2019.

She then underwent a Hartman’s procedure which involves the bowel being closed off and faecal content is discharged through a stoma on the left side of the stomach.

Subsequently, Yvonne also developed post operative lesions around the area of the operative opening and  hernias both below the stoma and behind the stoma.

Legal proceedings

According to the expert evidence from  a Colorectal Surgeon commissioned by this firm, a CT scan should have been performed in October 2018, prior to proceeding to hysterectomy. Consequently it  would have realised that the reason why the abdomen had swollen so markedly was that the plaintiff had developed a diverticular abscess. Had this been properly diagnosed in October 2018, it would have likely have been successfully treated by way of antibiotic treatment, with no surgery required.  According to our expert evidence, antibiotic treatment for such an abscess is 95% successful and even if she had to undergo operative treatment, it is most likely that it would not have been as traumatic as had occurred.  In summary there was a high degree of certainty that the plaintiffs condition could have been successfully treated with antibiotics, thus hysterectomy avoided and this in turn would have prevented all of the surgical complications which occurred. Thus proceedings were issued in 2019.

The Defendants in their defence and expert evidence sought to assert that that the plaintiff was suffering from progressive fibroid disease and thus the treatment provided was justifiable. However the fact that the fibroid remained the same size in two scans (7 months apart), yet her stomach continued to expand would be strongly against the defendants case.

Naturally, this had serious negative effect on the plaintiff’s health and wellbeing, at times she  became almost housebound due to social embarrassment she associated with her stoma bag. On occasion, she would go to the garden shed at night to change her stoma bag, rather than change it in the house with her husband present.  She had one or two accidents while out shopping which were catastrophic for her psychologically and physically.

Settlement

This case is listed and specially fixed for Thursday 13^th October 2022 but settled at mediation last Friday 7^th October for €1.1million plus costs of the action. The settlement was a good one which reflected the full value of the plaintiffs claim although no formal admission of liability was made. The settlement included a large sum allocated towards the cost of providing paid care for the plaintiffs disabled adult daughter as given the plaintiffs own health issues she could no longer provide the care required at the same level.

Source: https://michaelboylan.com/success-stories