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Hull man accepts £40,000 compensation following serious surgical error at the Hull Royal Infirmary.

Mr Wagstaff, who was aged 23 at the time of the operation, was admitted to the Hull Royal Infirmary with stomach pains on 24.12.06. After undergoing investigations he was diagnosed with acute cholecystitis (inflammation of the gallbladder). On 27.12.06, he underwent a laparoscopic cholecystectomy (removal of the gallbladder by keyhole surgery), performed by Mr Tilsed, Surgeon. As soon as he came round from the operation, he experienced excruciating pain and this continued for a number of days. On 2.1.07, an ERCP scan was performed and this revealed the earlier surgical error, which had resulted in bile flowing freely into the abdominal cavity for a period of 7 days. It was therefore necessary for Mr Wagstaff to be transferred to St James’s Hospital, Leeds to see a specialist for extensive bile duct reconstruction surgery.

As a result of the surgical error, Mr Wagstaff suffered ongoing unpleasant physical and psychological symptoms. These included abdominal pains, excessive bowel sounds, nausea, vomiting, depressive episodes and he could not lift any heavy objects. He was left with a 12-inch operative scar, as a result of the unnecessary second operation.

Following detailed investigations by Williamsons Solicitors, expert medical evidence identified negligent treatment in respect of the manner in which the first operation had been performed. A detailed Letter of Claim was sent to the Hospital Trust, the response to this denied liability, based on the operating surgeon’s evidence only. It was therefore necessary to commence court proceedings, at this stage the Hospital finally decided to obtain their own independent expert evidence. Shortly thereafter an out-of-court settlement of £40,000 was agreed, to represent Mr Wagstaff’s pain and suffering plus a sum in respect of all his past and future financial losses, attributable to the alleged negligence.

Laparoscopic cholecystectomy: Background information

Laparoscopic cholecystectomy was introduced into regular surgical practice from the USA in 1989. If this is performed appropriately most patients can expect to be discharged within 48 hours and return to a sedentary occupation within 1 week of discharge.

Mr Wagstaff’s gallstones were causing acute cholelecystitis. The majority (95%) of such patients will settle with conservative treatment and eventually undergo an elective cholecystectomy about six weeks later, when the inflammation has settled. However, some do not and require an earlier operation. The bile duct injury caused is the classical injury that occurs when the surgeon mistakes the common bile duct for the cystic duct, thereby removing an incorrect part of the anatomy. In order to prevent such damage, the crucial step is to identify the Y-shaped junction between the common hepatic duct and the cystic duct forming the common bile duct. If a surgeon is having difficulty displaying this then he/she should consider performing a cholangiogram (type of scan) to assist. Alternatively, the surgeon should convert to an open procedure, this lowers the risk of bile duct injury. Literature suggests that it is often the “easy” cholecystectomy where this type of injury is inflicted.

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