Decision Report 201400288

Summary

Mrs C complained about the care and treatment provided when she underwent surgery at Wishaw General Hospital to remove several adhesions (where organs are stuck to each other and/or the pelvic wall).

Mrs C had surgery. The following day she became unwell and a CT (computerised tomography - a special type of x-ray using computerised images) scan was done to eliminate the possibility that her urinary tract had been damaged during surgery. No evidence of this was seen. When her condition continued to deteriorate and bilious fluid (from the digestive system) was seen in her surgical drain, she underwent further surgery three days after the first operation. A perforation of the bowel was discovered and repaired. Mrs C's condition continued to deteriorate and she was operated on again three days later. A second perforation was found, and Mrs C's appendix and part of her bowel were removed. Mrs C was admitted to the adult critical care unit following the third operation and spent two months in hospital in total. She then had a six-month recovery at home.

Our investigation included taking independent advice from three of our medical advisers: a gynaecologist (specialist in disorders of the female reproductive system); a general surgeon; and a radiologist (specialist in imaging). No evidence of any failures was found in the original surgery, or the post-operative care. Although the CT scan did not reveal the perforations, the radiologist stated that this was reasonable in the circumstances. Similarly, the general surgeon considered that it was appropriate to have repaired only the visible perforation at the second operation. Inspecting the whole length of the bowel would have needed more invasive surgery and risked creating more adhesions. The fact that Mrs C required a third operation was not, in the view of the advisers, due to any failings in Mrs C's care and treatment.