Decision Report 201401856

Summary

Ms C, who is an advice worker, complained on behalf of her client (Miss A) that the board failed to carry out her hysterectomy at Glasgow Royal Infirmary to an appropriate standard. She said this caused significant and irreparable damage to Miss A's bladder and ureter. Ms C said the surgeon who performed the operation unreasonably failed to identify the damage and remedy this during the operation. She said that as a result, repairs which might have prevented exacerbation of the damage were not carried out.

We obtained independent medical advice from a consultant in obstetrics and gynaecology. Our adviser explained that Miss A experienced an uncommon but recognised complication of hysterectomy. She said that injuries to the bladder and ureter could occur during surgery or it was possible for injuries as a result of surgery to be delayed. Our adviser said it was unlikely that the damage in Miss A's case occurred due to cutting or tearing during surgery and it was more likely to have been caused by compromised blood supply resulting in tissue/cells dying and a fistula (an abnormal passageway between two organs) forming after the surgery was complete. As such, the surgeon could not have reasonably been expected to rectify damage which was not immediately visible at the end of surgery and would only have become apparent some days later.

There was evidence that Miss A was made aware that damage to the bladder and ureter were recognised complications of the surgery she consented to receive. Our adviser said the records showed that the surgeon demonstrated a reasonable level of care during the surgery to avoid these complications and there was no evidence that Miss A's hysterectomy was performed unreasonably.