Our client was a teenager at the time of the events in question and developed symptoms of right sided abdominal pain and vomiting. She attended her local out-of-hours GP who suspected a ruptured ovarian cyst, or in the alternative, possible appendicitis and referred her to her local paediatric hospital Emergency Department. At the hospital, our client was triaged and waited a number of hours to be seen by the Paediatric Registrar On-Call. She was given pain relief and was noted to be in severe pain. On examination, she was pale looking and had guarding and she also had a raised white cell count. Our client was then seen by the Consultant Surgeon who carried out an abdominal examination and recorded that her abdomen was soft and non-tender and discharged her.
A few days later our client was brought back to the hospital with severe abdominal pain. She was assessed there by the Paediatrician who noted that there had been an increase in the severity of abdominal pain and her pain score was 10/10, sharp in the left iliac fossa radiating to the back and worse when she moved and when she was lying flat. She was noted to feel nauseous and was not eating. On examination, she was noted to be very unwell, and in pain, although her vital signs were stable and she had left ileac fossa tenderness with guarding. The surgical team was contacted and indicated that they would not be accepting her into their care as she did not have a tortured cyst. An ultrasound was performed at 09.35 pm which recorded that the right ovary and uterus were normal, the left ovary had a cyst measuring 5 x 5 x 4 cm and there was internal debris suggestive of haemorrhage. Our client’s parents were advised that there was not a lot the hospital could do except give her pain relief. It appeared that the hospital was concerned that the cause of her symptoms may have been gynaecological in nature and the hospital did not feel equipped to deal with this despite the fact that she was still a child. Attempts were made to refer her to a nearby maternity hospital but this was unsuccessful due to her young age. An out-patient’s appointment was eventually made with a Consultant Gynaecologist on a private basis who saw her almost three months later and who arranged for a pelvic ultrasound which indicated a significantly tortured ovary. Surgery was carried out in the form of a laparotomy and a left ovarian cystectomy with a left oophorectomy and partial left salpingectomy.
Our client’s parents were concerned about the standard of care that their daughter received and instructed Augustus Cullen Law to investigate whether she had a stateable case. An expert opinion was obtained from a Consultant Paediatric Surgeon which raised a number of criticisms of the care afforded to our client. In summary, his conclusions are that there was a breach of duty on the part of the surgical team when they failed to consider a diagnosis of ovarian pathology at her first presentation. An ultrasound scan should have been organised and on the balance of probabilities, this would have demonstrated an ovarian cyst. At this stage, a reasonable surgeon would have carried out a surgical exploration by way of laparoscopy and detorted the cyst, and on the balance of probabilities, the ovary and tube would have been salvaged. Our expert opinion also raised criticisms in relation to the failure of the hospital to have a treatment pathway for a teenage girl presenting with gynaecological symptoms and that if the necessary expertise is not present in the hospital, then there should be a safe system of referral to a hospital where a patient such as our client could receive appropriate treatment.
Proceedings were issued based on the expert opinion received and ultimately Defendant admitted liability in the Defence delivered. A trial date was fixed to assess the quantum of damages and shortly before the trial date, the medical negligence case was successfully resolved with a significant six figure sum to be paid to our client together with her legal costs.
For more information please contact Jamie Hart, Partner Augustus Cullen Law.