Abdominal Hysterectomy and bladder injuries: CW -v- CWM TAF Morgannwg University Health Board

The Claimant (C), female aged 51, instructed Mr Andrew Taylor, Solicitor and Head of the Healthcare and Clinical Risk team at Birchall Blackburn Law, to investigate a claim for Clinical Negligence following an iatrogenic injury against CWM TAF Morgannwg University Health Board.

The client suffered with unbalanced hormones and pain. She was under the care of a Gynaecologist for 12 years. The client had several gynaecological appointments to attempt to alleviate her symptoms of heavy menstrual periods and pain. Her symptoms were not improving and as such, she was put forward for a total abdominal hysterectomy and a bilateral salpingo oophorectomy. The client had this operation on 20^th July 2017.

The operation notes state that there was a pin hole leak of urine from the apex of the bladder and that this was stitched up during the procedure.  On the day of the operation, a catheter was inserted. This was removed a day later.

After the operation, the client complained of pain, and she suffered with several water infections. On 30^th August 2017, our client attended hospital with urine leaking from her vagina. A CT abdomen and pelvic contrast identified a small 1mm vesico vaginal fistula at the apex of the client’s bladder. The client was subsequently listed for a fistula repair.

On 21^st April 2018, the client underwent a fistula repair. Following the procedure, the client continued to suffer with urinary tract infections, and she was in continuous discomfort and pain.

Evidence was obtained from a Urogynaecologist, and Andrew Taylor argued that following the client’s operation, the catheter should have remained in situ for 7-10 days rather than being removed, a day after the surgery. Had the catheter remained in situ for 10 days, the fistula formation would have been avoided and C would not have required the fistula repair surgery.

The Defendant admitted to breach and causation in respect of injuring the bladder during the operation and removing the catheter prematurely. The Defendant admitted that had the catheter remained in situ for 10 days then the fistula formation would have been avoided and the client would not have required the fistula repair surgery.

C suffered frequent urine infections and pain and was becoming extremely distressed. C subsequently underwent a cystoscopy bilateral JJ stent and repair of vesico vaginal fistula. Unfortunately C continued to suffer with frequent urine infections and was left in continuous discomfort and pain and an over active bladder OAB.  Damages were recovered that included loss of earnings, handicap on the open labour market, and future losses.

The C was assisted in valuation of her claim by considering the JC Guidelines 16th Edition Section 6(J)(d) Injuries to Internal Organs – Bladder – Complete recovery but some long term interference with natural function. General damages between £23,410 and £31,310.

From the JC Guidelines 16th Edition Section 4(A)(c) Psychiatric and Psychological Damage – Psychiatric Damage Generally – Moderate. General damages between £5,860 and £19,070.

Proceedings were issued in July 2020. The matter was settled in June 2023 by way of a Part 36 offer in the sum of £170,000. General damages were agreed on a without prejudice basis and Past losses were awarded at £48,159.08 and future losses were awarded at £100,127.82, to include future private treatment costs, investigations and some loss of earnings.  The D failed to pay damages in a timely manner and as such, an Order was made confirming that the Defendants must pay a further interest sum of £557.12 to C on account of late payment.

Head of the Healthcare & Clinical Risk Team

Partner at Birchall Blackburn Law