'Emily’, 44

A delay in diagnosis and subsequently treatment of a caesarean scar ectopic pregnancy (CSP) left Emily infertile after having to undergo an emergency hysterectomy.

Rachael Heyes, senior associate in JMW’s clinical negligence team helped Emily secure a settlement of £135,000 to help her recovery.

Symptoms and early findings

Emily presented to hospital with vaginal bleeding, after a pregnancy test confirmed she was pregnant. Blood tests were taken at the hospital, and it was estimated she was approximately six weeks pregnant. These results led the medical team to believe the pregnancy could be a threated miscarriage.

However, an ultrasound scan was performed the following day, and it revealed a sac in Emily’s caesarean scar, so she was transferred to a different hospital for treatment. Emily was advised of her treatment options, and she opted to have methotrexate, an injection which stops the cells from rapidly growing and ends the pregnancy.

Misreporting and diagnostic confusion

On arrival to the other hospital an MRI scan was performed, however this was misreported as showing a threated miscarriage. The scan actually showed a caesarean scar ectopic pregnancy (CSP) which was originally reported on the ultrasound scan taken at the previous hospital.

This meant there were three possible diagnostic suggestions: cervical pregnancy, CSP and threated miscarriage, due to this, clarity was essential, and an early pregnancy lead should have been sought which was not actioned.

As a result, there was a failure to reconsider Emily’s diagnosis and instigate definitive treatment. Instead, she was discharged and advised to attend the Gynaecology Assessment Unit in four days’ time to check her hormone levels.

Emergency treatment

Emily went on to suffer a rupture of the CSP, which resulted in massive blood loss and the need for a laparotomy and emergency hysterectomy, which would have been avoided had the MRI scan been reported correctly.

JMW’s investigation

Emily was understandably upset and concerned that she had been left infertile and that it was at the error of the hospital.

Rachael Heyes listened to Emily’s concerns and was able to establish that had the earlier diagnosis of her caesarean scar ectopic pregnancy been treated by way of methotrexate injection she would have avoided the rupture and hysterectomy, as the pregnancy would have ended.

A settlement of £135,000 was agreed. This will help Emily with her recovery and support with ongoing therapy since her ordeal.