Although surgery always carries an element of risk, misdiagnosis or a delay in diagnosis can cause further complications during a surgical procedure or a course of treatment.
Here are some of the procedures and failings that can occur and may amount to negligence.
Endometriosis is a condition where pieces of womb lining appear outside of the womb cavity, causing discomfort and possible fertility problems. A course of hormonal tablets may be prescribed for a mild condition to reduce tissue growth but in severe cases of endometriosis, scar tissue may need to be removed by a type of keyhole surgery known as laparoscopy.
A common procedure to stop excessive menstrual bleeding. The procedure involves destroying the womb's inner lining by scarring the tissue using a laser beam or other methods, such as heat, fluid, electricity, freezing or microwaves.
Failure to diagnose cervical, ovarian or vaginal cancer
Early symptoms are often difficult to detect. Abnormal bleedin
from the womb should alert the suspicions of a GP to make an immediate referral to a specialist. A complete physical examination and inspection of the vulva, anus, vagina, and cervix is necessary to confirm the presence and spread of the cancer, including analysis of tissue samples (biopsy) and CT scans of the abdomen and pelvis.
Unnecessary hysterectomy (removal of the womb)
A hysterectomy is nearly always necessary if there is a confirmed diagnosis of:
• Cancer of the cervix or uterus (womb)
• Fibroids - fibrous tissue that can develop in the wall of the womb causing painful and excessive bleeding
• Pelvic inflammatory disease
• Prolapse of the womb
The procedure is also usually recommended when ovarian cancer is diagnosed.
Many hysterectomies are still performed even if cancer is not present. A doctor may strongly advise the procedure where bleeding or pain from the womb is causing increasing difficulties.
A hysterectomy is irreversible and a woman should only consent to the operation if she does not wish to have children in the future. Complications can include:
• Heavy bleeding during surgery
• Post-surgery infection involving the wound or bladder
• Damage to the bladder or tubes that carry urine from the kidneys to the bladder.
Cervical cerclage (stitch)
A cervical cerclage or stitch may be needed to close the cervix:
• If a woman has an abnormal cervix, which can cause a ‘cervical insufficiency’.
• When the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth.
Bladder or bowel damage caused during removal of an ovarian cyst
Ovarian cysts are fluid-filled sacs, which can grow inside or on the surface of the ovaries and are usually removed by keyhole surgery. Standard surgery will be required if cancerous ovaries are to be removed.
Risks of ovarian surgery include:
• Bowel or bladder may be damaged during surgery
• Ovarian cysts may return
• Pain may not be controlled
• Scar tissue may form on the ovaries, fallopian tubes or in the pelvis
• Infection may develop.
Errors in fitting a contraceptive device
Errors made during the insertion of a contraceptive coilcan cause a tear to the uterus.
Hysteroscopy or Laparoscopy errors
Hysteroscopy (an internal examination of the womb) and Laparoscopy (keyhole surgery) are common minor procedures that should present no difficulty. Poor or negligent technique can cause tears or rips to organ tissue, bleeding and further complications.
A failed sterilisation can lead to an unplanned pregnancy.
A claim for gynaecological negligence can involve any stage during the diagnosis, investigation and treatment of disorders of the female reproductive system.
Gynaecological claims can fall into one of two categories:
• Failure to treat or diagnose a gynaecological complication
- a failure to carry out appropriate tests, or
- misreading test results after having carried out the correct tests
• Positive action by a doctor which causes a gynaecological injury
- carrying out an incorrect procedure in response to a certain set of circumstances, or
- carrying out the procedure in an incorrect manner after selecting the correct
procedure in a certain set of circumstances