Summary
Ms C had been referred to a consultant plastic surgeon then to a consultant general surgeon to undergo a surgical procedure on her buttocks. She has suffered from internal and peri-anal abscesses for a number of years and had previously undergone treatment to drain these on a number of occasions. Ms C said that she had been assured that she would not suffer from any issues with continence following the operation, as this was a significant concern for her prior to undergoing surgery. Following the operation, Ms C found that she was incontinent. As a result she had to undergo a colostomy procedure, which has had a significant impact on her personal life, resulting in her having to give up work.
I took independent advice from a consultant colorectal surgeon, who said that incontinence was a well-recognised side-effect of the procedure Ms C had. Ms C said that she would never have consented to the procedure had she been made aware of this risk. I found Ms C's medical notes documented that this was an area of great concern to her, therefore I consider that it was unreasonable that this was not discussed with her and documented prior to surgery, nor did the consent form that she signed mention this as a possible risk of the surgery.
The board accepted that the forms Ms C signed had not documented incontinence as a risk of the surgery. However, they did dispute whether Ms C was ever given an assurance that there was no risk of this complication from the procedure. I do not accept that this removes the responsibility from the board in this regard. Under General Medical Council guidelines, the medical staff responsible for her care had an obligation to ensure that Ms C was able to give informed consent, particularly as she had identified a particular concern before the operation.
I also found that the board failed to respond appropriately to Ms C's complaint about the cause of her incontinence. Whilst it is possible that the incontinence is a result of a progression of Ms C's on-going condition, it is also possible that it was a result of a complication of the surgery. Given this, the board's failure to provide adequate information to her before the procedure and later in their complaints responses was unreasonable, so I upheld the complaint.
Redress and recommendations
The Ombudsman recommends that the Board:
- review the consent forms used for this type of surgery to ensure they accurately reflect the potential complications;
- remind staff of the importance of identifying and documenting that issues of importance to patients have been discussed during the consent process; and
- apologise unreservedly to Ms C for the failings identified in this report.