This heartbreaking case of medical negligence following a delay in an operation meant that Julian* left behind him a family and his death could have been prevented.
The failure of staff to identify signs of an anastomic leak lead to mass infection and multi-organ failure. Sandra*, Julian’s wife, contacted Blake Morgan’s medical negligence lawyer Patricia Wakeford, who also had partner John White representing them during the inquest.
Julian attended hospital due to severe stomach pains and was initially diagnosed with diverticulitis, which would mean food had become trapped in pockets in his bowel, causing infection. He was admitted as an inpatient and had to be operated upon a few days later as his position did not seem to improve with antibiotics.
After the operation, Julian was informed that his bowel had become twisted and 50cm of his bowel had died. As such, a colostomy was performed: a procedure in which an opening, known as a stoma, is formed by bringing a section of the bowel out through an opening on a patient’s stomach. Bowel movements are then collected in a bag attached to the skin around the stoma. Julian was informed that the stoma would be reversed in 4-6 months.
A patient who has made a good recovery after initial surgery, as Julian did, who then goes on to manifest serious problems due to a high stoma output should be prioritised for a stoma reversal, ideally within 6-8 weeks. Julian never accepted the stoma bag, which would leak and burn his skin, and had to be changed and emptied often. He waited 16 weeks for his reversal however, during which time his condition deteriorated resulting in significant loss of protein, fluid imbalance and extreme weight loss.
Following the stoma reversal surgery, the patient became significantly more fatigued each day, became flushed and sweaty with intermittent tachycardia and low blood pressure, suffered pain in his abdomen, began vomiting after food, was unable to open his bowels, and had bile stains appear on his wound dressing. There were numerous failures by the surgical team to raise concerns despite this clinical presentation.
Four days after this surgery, due to his deteriorating condition, Julian was taken for further surgery where it was discovered that his bowel contents had leaked through the join where the stoma was reattached during the reversal procedure, which had caused a substantial infection.
Julian passed away during the early hours of the following day as a result of multi-organ failure following this anastomic leak and subsequent infection.
Sandra was left feeling very lonely and physically very isolated upon her husband’s death as she was unable to drive and perform chores such as gardening and DIY herself, and her daughters lived some distance away. She planned to move closer to her daughters but had concerns about affording a property in that area.
An expert surgeon was instructed who highlighted signals that were missed by staff: namely Julian’s loss of weight following the stoma reversal surgery, and drop in levels of protein. He commented that a CT scan should have been ordered by the third post-operative day due to these signals and this would have spotted the leak and subsequently enabled Julian to have had surgery a day earlier. It would then have been more likely than not that he would have survived as the leak would not yet have spread.
The case was settled for £70,000 prior to the service of court proceedings: an amount of which will assist Sandra to move closer to her family where she can be better supported.
Please contact Patricia Wakeford, Legal Director, or another member of our Clinical and Medical Negligence team if you would like to discuss this summary or any other clinical negligence concerns.
* Names have been changed in this article to protect client confidentiality.
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