Case study: Damages recovered following negligently performed ureteroscopy
Vanessa Harris, C recovered damages of £65,000 for a client who suffered injury to her urethra during ureteroscopy.
Clarke Willmott were instructed by the Claimant to investigate a claim following injury she sustained during ureteroscopy.
On 9 March 2019 the Claimant was admitted to hospital for ureteroscopy. Unfortunately, the ureter was found to be narrow and therefore a stent had to be inserted to allow the ureter to dilate to allow the stones to pass and the plan was for the stent to be removed after six weeks. This was planned to be a simple stent removal. The further ureteroscopy took place. No injury to the ureter was recorded at this time but it later became clear that an injury had occurred during the surgery.
After the procedure, our client woke in a significant amount of pain. Following discharge she continued to be in agony. She was readmitted to hospital by ambulance that evening. She was seen in Urology in the early hours of the following morning (26 April) with severe left sided pain. CT scan revealed a urinoma adjacent to the ureter. The leak was confirmed at cystoscopy and retrograde pyelography. A left ureteric stent then had to be inserted via radiological kidney puncture with a covering nephrostomy put in place. She subsequently had a blockage of the nephrostomy which was removed on 18 May 2019. She suffered a C. Difficile infection on 29 May 2019. The nephrostomy was removed and a subsequent stent needed repositioning in June 2019. Further internal stones were removed by percutaneous nephrolithotomy in September 2019.
It was alleged that making a perforation indicated substandard technique; There was a failure to record the mechanism of injury. On the balance of probabilities, the perforation was caused due to excessive forcing of the ureteroscope through a ureter which was too tight, causing a split. There was a further failure to recognise the injury at the time of the procedure. The damage went unnoticed and therefore corrective treatment could not be undertaken at the same time or in the immediate post-operative period. The Trust disputed that the perforation itself indicated substandard technique. However, they accepted that there was a failure to recognise the injury at the time of the procedure.
As a result of the negligence the Claimant suffered a urinoma leading to severe pain and symptoms afterwards. She required further unnecessary procedures, catheterisation and 5 emergency admissions to hospital thereafter, an episode of c-difficile infection, additional scarring and recovery time & a psychiatric injury.
The Claimant was unable to return to work until after the nephrolithotomy in September 2019. The Claimant had previously been employed as a nurse at the Defendant Trust. She found returning to work extremely difficult and in 2020 emigrated to New Zealand. Due to the ongoing psychological symptoms she felt unable to return to fulltime employment and therefore continues to work reduced hours.
Future losses were disputed. The claim was valued by the Claimant’s Solicitor at around £100,000 however, on receiving the Defendant’s offer of £65,000 the client decided to accept this sum.
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