‘Carol’, 56

Carol had a history of Crohn’s disease and underwent surgery to remove a recurrent Crohn’s mass. During the procedure, her bowel was perforated, leading to faecal peritonitis and a prolonged and difficult recovery.

Carol experienced respiratory and cardiac arrests during her hospital admission and sustained damage to her brain. She was eventually discharged after spending 347 days in hospital but sadly passed away three years after the original surgery.

Carol’s husband instructed JMW to investigate the care she had received. Although the hospital denied liability, JMW secured £90,000 in compensation for him.

The Illness and Surgery

Carol had a history of Crohn’s disease and had previously undergone a right colectomy. By the time she was 56 years old, doctors noted that there was a recurrent Crohn’s mass in the right iliac fossa and decided to proceed with surgery to resect the bowel.

Carol underwent an excision of the recurrent Crohn’s mass, with an anastomosis between the ileum and descending colon, at her local hospital. Minor adhesions were noted from the previous operation. No difficulties were described.

Ten days after the original surgery, Carol underwent a CT scan that indicated a massive abdominal collection.

The next day, she underwent a laparotomy. The operation note recorded the presence of faecal peritonitis, which was secondary to a perforation of the terminal ileum 20 centimetres proximal to the anastomosis.

It was noted that the perforation was at the site of a Vicryl suture. The surgeon presumed that, during the previous surgery, a hole had been made at the site and closed with a Vicryl suture.

Postoperative Problems

After the operation, Carol had a difficult recovery. She was discharged back to the intensive care unit at her local hospital two weeks after the laparotomy.

A month later, Carol was found unresponsive and unconscious and had to be resuscitated.

Two months later, Carol again required resuscitation and was transferred to the High Dependency Unit. In the weeks that followed, she experienced two respiratory arrests and a cardiac arrest. She received cardiopulmonary resuscitation and was intubated and ventilated.

Almost five months after the original surgery, Carol was discharged from the High Dependency Unit back to the ward. She was eventually discharged from hospital after a period of 347 days.

A CT scan revealed two areas of damage to Carol’s brain, which were thought likely to be due to infarction.

Three years after the surgery, Carol was admitted to hospital with increasing shortness of breath and collapsed. Her condition suddenly declined and she became unresponsive. Sadly, Carol passed away. Her cause of death was recorded as bronchopneumonia.

JMW’s Investigation

JMW investigated the surgery carried out to remove the recurrent Crohn’s disease mass.

The medical negligence claim alleged that the surgery had been performed negligently. In particular, Carol’s bowel had been perforated at a site approximately 20 centimetres from the anastomosis.

It was also alleged that the subsequent misplacement of a nasogastric tube led to Carol experiencing a respiratory arrest and cardiac arrest, causing damage to her brain.

Although the hospital denied liability, JMW secured £90,000 in compensation for Carol’s husband.