Case Study: Damage to Ureter at Hysterectomy

Compensation: £38,000

Case study: Jenny, 40, Portsmouth

JMW has successfully acquired £38,000 compensation for a woman after she was left with damage to her ureter after a hysterectomy procedure.

Named Jenny, the woman had a long history of heavy painful periods and underwent a laparoscopically-assisted vaginal hysterectomy (LAVH). She had given birth to eight children and at surgery some abdominal adhesions were encountered, but otherwise the operation appeared to go according to plan. The immediate post-operative period was unremarkable, Jenny appeared to be passing urine normally and was discharged.

Sent home from A & E

Once home, Jenny began to experience increasing abdominal pain, distension, nausea and vomiting and attended the local A&E. A CT scan undertaken the same day showed clear, free fluid in the peritoneal cavity. Somewhat surprisingly, a handwritten note on the CT scan report states "Nil to do". Jenny refused to be examined, claiming it was too painful, and so it was suggested she might as well go home as nothing was being done for her in hospital.

During the three weeks Jenny remained at home, she attended her GP with a painful, distended abdomen, tachycardia (fast heart rate) and pyrexia (a temperature). The GP referred Jenny back to the hospital with what appeared to be an acute distended abdomen. An ultrasound scan showed "a large multicystic mass arising from the pelvis".

Surgical procedures

A laparotomy was performed and, as the cystic mass was thought to be a large ruptured ovarian cyst, the right ovary and tube were removed. Later it was realised that the mass was in fact an urinoma caused by leakage of urine into the peritoneal cavity, and a CT scan showed a possible right distal ureteric leak.

A guide wire was inserted into the right ureter but could not be passed, and at a subsequent uretoscopy the ureter was found to be necrotic (dead tissue) from 3cm, suggesting the damage had occurred at the time of the initial operation. A right nephrostomy tube was inserted to allow urine to drain directly from the kidney and Jenny was discharged home.

She underwent insertion of a ureteric stent to re-establish use of the ureter. However, a renal ultrasound scan suggested that the right kidney was now distended due to back pressure of urine from the ureteric obstruction (hydronephrotic). The right kidney is no longer functioning and will need to be removed in the near future.

Lack of care

There seems little doubt that the injury to the ureter occurred at the time of the initial surgery, and it is claimed that had the surgeon taken more care to identify and isolate the ureters before proceeding with the removal of the uterus, the damage could have been avoided. It is well known that there is an increased risk of ureteric damage during LAVH compared with other types of hysterectomy.

JMW Solicitors claimed that had Jenny received a higher standard of care from the hospital, she would have avoided weeks of pain, discomfort and anxiety, as well as an unnecessary laparotomy, invasive urological procedures and permanent renal damage.

Settlement

Despite only a partial admission of negligence, the claim settled and Jenny was awarded £38,000 compensation.

Have you also suffered poor medical care?

Would you like to find out more information about pursuing a claim of this type? You can do so by calling us for free on 0800 054 6512 or by filling in the enquiry form here

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