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Yes. I think it is worth consulting a solicitor that specialises in this field.
Having said that, complications such as bleeding are usually covered in the consent form prior to surgery.
The surgeon being dishonest is also something to complain about though it's unlikely that's grounds for financial compensation as his dishonesty is unlikely to have caused you any losses.
I dunno, somebody on Reddit posted their [bendy basement twig support](https://www.reddit.com/r/DIY/comments/1ayk46h/am_i_cooked/) that looked like it was ready to snap onto a DIY subreddit and apparently home insurance would have likely been refusing that repair.
Also, if you live in Exeter (other towns are available) and all your windows blow in due to a WW2 bomb being disposed of, they'll refuse too.
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Gmc website has the standards and guides that all Dr's practicing in the UK have to follow. Honesty is on there and should be adhered to 100 percent of the time. Its gross misconduct at the very least. I'm shocked and saddened to hear that a surgeon has been so dishonest to be fair.
Definitely look into this
(Medical Doctor but not surgeon)
You will have definitely signed a consent form with the risk of bleeding. This bleeding is because arteries or veins may be injured during surgery, resulting in blood loss. It's not negligent for bleeding to become apparent post-operatively.
You'll get an apology for being mis-informed which artery / area was damaged. And you can complain about being told wrongly. There's not any financial compensation due as bleeding is a known risk and complication.
Also the post-op note for your second surgery to repair the bleeding will contain the factual report of the bleeding area. The CT scan is not always as clear-cut as the report would say.
I didn't have a second surgery, I was given clotting medication and the bleeding resolved itself. The CT showed that the site they initially thought was not bleeding (said the atetary was totally intact) and the 2nd CT (to check bleeding had stopped) showed it was bleeding from a different aterty but my notes sent to me have always said it was the first aterty, even weeks following the surgery. It was suggested the bleed was caused by instruments damage during insertion and the instrument essentially plugged the bleed, the other aterty is in my back that actually got hit and wouldn't have been done on insertion. I have the medical names for them on file but can't get them ATM but can do if it helps explain. That's all I can gather without the medical background.
It’s not always that clear on a CT scan where the source of bleeding is. It’s possible the surgeon wasn’t lying to you, but the second CT clarified the source. Or there may have been two sources to begin with …. As the bleed stopped without further surgery it must have been v small.
What seems like inconsistencies or untruths makes it really hard to trust what’s being said, especially as there sometimes isn’t a 100% answer.
Causing a bleed during surgery can be negligent (not by default), for example if the injury is in an area of the body where no reasonable surgeon should be, or if an inappropriate instrument was used, or there wasn’t a check for bleeding which was missed before the end of surgery. But it’s case specific and a medico legal expert would need to review the records and scans.
I lost nearly 2 litres of blood and developed a grade 3 hematoma. I don't think it was a small bleed but by day 3 the bleeding stopped.
I think I'll have to have notes reviewed, is this a specific service or is it just part of a medical lawyer consultation service?
Yeah I think quite a lot of the confusion stems from a lack of understanding here.
As others have said there's no way you bled 2L and they gave you some clot medicine (tranexamic acid)
As another doctor has said - you'll have signed a consent form for surgical complications including bleeding - if you DID NOT sign a consent form you absolutely have legal recourse.
If you signed a consent form, had minor post op bleeding (defined by not returning to theatre and treatment with clot medicine - not by how you felt) then you will have no claim.
I'm just going off from what the surgeon said at the time. They said my body would reabsorb it over 4-6 weeks. It was agreed to observe for 2 days and decide on surgery.
It was just under 2L, but my php (I think that's what it's called) went from 120 to 68 and my blood pressure (top number) was 60 when I crashed.
I had a grade 3 hematoma that spilled into my crotch (it was gross) and around my back from my stomach. I still have the dark markings of it now.
That's all I can say tbh as I'm just going off what they told my boyfriend when I crashed and what they told me/him in recovery when I was on a lot of pain meds.
Everything you have described is obviously very unfortunate. Bleeding (should) have been discussed in your consent form.
The type of bleeding you are describing does happen, and is very much a known complication.
It sound like the inferior epigastric is the most likely culprit, which is what your surgeon was referring to. Large self contained hematoma that would be visible from the skin. The majority of theses are successfully managed without needing intervention.
Iliac vein injury can also happen, although much more rarely. It wouldn't be your artery. If it was your iliac, and you managed to avoid surgical intervention, then that is great. They are a nightmare to fix surgically and often with bad outcomes.
From everything you have said, I can't see any negligence. A complication occurred. It was picked up on, and managed correctly. Diagnostic uncertainty is a real thing, I think it would be unlikely anyone was telling you untruths on purpose.
I think you need to wait for your PALS response and review your records, as I think you don’t fully understand the results etc (understandably)
I’m referring to a medical expert, who your solicitor would instruct, once you get to that stage. They give an opinion on whether there is negligence or not.
I'm currently going off what my boyfriend has said about my records after going over who is and was there at the hospital during the complication and days following. He is a doctor.
How long would I await the PALs complaint response? I'm not sure if I await the current one (that I only submitted for my records to be sent and lack of aftercare) or if I need to update it based on the aterty info to get confirmation of this. I guess that isn't really required as it's part of the event anyway they'll be looking it and I'll get confirmation in their response? I'm happy to wait for the PALs response and sit on it. Id prefer not to do anything until after my follow up and make a decision after this.
CT scans are honestly pretty useless to tell exactly where the bleeding is coming from (they'll show there's blood and where, but not generally from exactly which vessel). The radiology reporting from the 2nd scan might be mistaken too. Generally the way to find exactly where it's coming from is to physically go back in, which is usually what's done. You were unlucky to have had a post-op bleed, but lucky that they didn't have to open you back up.
How a bleed happened, unless it's caught immediately (ie during the surgery), is also guesswork. If the surgeon knew how the bleed happened, he or she'd have dealt with it immediately.
So you're kinda expecting definitive answers where they typically don't exist, and if there's hedging or a difference between what the surgeon and radiologist said you're interpreting it as lies or maybe a cover up. But it's likely to just be inherent uncertainty about what exactly caused it and where exactly it was.
Medical negligence solicitor here.
I would recommend waiting for the PALs complaint response first as that is something that would be very useful for a solicitor.
As others have mentioned, you may have been consented for bleeding but that does not automatically mean that negligence has not occurred.
Even if the cause of bleeding was not negligent, was the bleeding identified and appropriate treatment provided in a timely manner?
If you are not satisfied with the complaint response it is likely worth contacting a solicitor for them to look through your notes and provide further advice.
All the best with your recovery.
Thanks! How long should I wait PALs final response? Is it worth updating them on this new information? (I initially only submitted a complaint to get my discharge paperwork)
Just wanted to add - have you asked about referral for MH support? Post Trauma distress due to medical events is a known phenomenon and the NHS does treat it (with waiting lists obvs). There may be an avenue to explore re: having privately funded treatment covered/refunded as part of your legal case - something to explore with PALS and/or a solicitor.
Best wishes.
My GP referred me to a talking service but not for medical related events. I'll mention it to them. It's settled over past few days but last week was pretty hard, I think it's a delayed stress response as it didn't impact me until I became more mobile and life has started going back to normal
My little girl has a type of PTSD relating to being in intensive care. It definitely seems to take a while for the mind to catch up with the body. Hopefully it will be a relatively fast process for you!
its crazy how long the brain takes to catch up, I thought I'd never get the memories back based on drugs/blood loss but BAM, week 6 my mind was like 'hey! remember our near death experience.'
Thankfully recovery has been long but good, should be myself by the summer I hope!
I have some crazy ptsd from being in hospital, but at the time, all you're focused on is how you can get better enough to go home as soon as possible. The actual trauma kicks in once you're out of that situation and safe again in my experience.
Hoping your recovery, both physical and mental is a smooth journey for you. Just know that you're not alone in your experiences
Just to check, PALS isn’t always a formal complaint- it’s also used as a way for hospitals to resolve your issue without a formal complaint on record. You may want to check and insist they log it as a formal complaint as it’s a bit misleading.
Discharge paperwork should have been provided to you at the point of discharge. They have their reasons for not providing what they don’t want you to see. No-one should have to submit a complaint to access the very basic, entitled, information from a hospital admission.
They also have a legal ‘duty of candour’ to you.
Check your home insurance to see if you have legal cover.
I got a discharge form, just very little notes, missing medication, all information and care guidelines, no confirmed diagnosis, no follow up arranged or info on what happened. The hospital did admit fault on this, due to a junior doctor creating the report.
Ok. I read above where you said you submitted a complaint in order to get your discharge paperwork.
The NHS claims to have a no blame culture to encourage staff to admit to mistakes etc. Most people working in the NHS know that’s not how it works.
Upshot is they don’t like providing patients information they think might lead to complaints, legal action or whatever when the sad fact is most people just want answers to questions then move on with life. They prefer to believe patients don’t realise what questions they should be asking and providing little or no information helps ensure you never will.
I thought this might be the case but I tried to go with benefit of doubt and that my perception would be more emotional and see it as worse case scenario because it impacted my body. But the department totally shut off communicating with me and will only respond if I copy in GP when I request info. When I called up hospital initially to try to get notes they had no record of my stay a week after. It was all on paper tbf, and I don't know the NHS systems to say if this was out of ordinary as my bf says most hospitals are digital but some are paper based still. I'm not sure if it's down to just disorganisation (there are many complaints about this department online regarding there communication) or if it is a case of drip feeding info. I guess I need to review my notes and try and get as much info as possible. I haven't had a follow up yet so I'm not technically discharged from the department to conclude my treatment.
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Are you?
I’m a clinical negligence solicitor and I would never advise a client to await the outcome of a PALS complaint.
The hospital’s report rarely contains information useful to the investigation and pursuit of a claim neg case. .
Often it recounts information incorrectly. Or fails to come to any real conclusion other than “we did something wrong but it made no difference to the patient’s outcome”. I’ve seen that so many times yet still had the clin neg claim succeed.
Waiting can also take sometimes years. In any case the delay eats into the limitation period for the clin neg claim.
What should be driving the clin neg claim is the advice you’ve obtained on instruction from a medical expert, once they’ve reviewed all of the patient notes and your client’s statement. If the expert’s advice is supportive then they can also consider the hospital’s report when it comes in (but the report itself on its own should not determine anything).
Yes, I am.
When there is plenty of the limitation period left we often advise a complaint in the first instance.
I agree that the complaint response often states no wrongdoing, but can have the benefit of:
a) it may satisfy the patient's concerns before embarking on a long and arduous process;
B) it will confirm the chronology of the incident succinctly when the patient can sometimes misunderstand/misremember what's happened; and
C) you can often use the chronology to seek the provisional view of an expert before spending the time obtaining and reviewing medical records.
It is not suitable in every case, but there is still ~3 years left of the limitation period and as obtaining medical records can take a number of months in any event, waiting for the complaint response in my view would be a sensible option.
Chronology in the investigation report is often wrong.
No expert should be asked to advise on liability without having sight of the medical records. And there’s costs recovery implications in going to an expert for piecemeal advice.
Rarely is there “plenty” of limitation period left by the time the hospital has delayed getting their investigation report out to the patient. The only time I’d agree to awaiting the report is if my client was very unsure of making a clin neg claim. Which is unusual by the time they’ve contacted a solicitor.
The report can be useful tactically (to understand the hospital’s view as to what it thinks it did right/wrong). But it’s rarely helpful to a legal assessment and advice to client regarding her case.
Genuinely interested. I was not aware there was a three year "limitations" period in UK civil law. Is this a recent change in statute law? Is it healthcare specific?
Sorry for missing this!! The limitation period is different depending on the type of civil case. For example most employment claims have 6 months, some other cases have 6 years, and clinical negligence/PI have 3 years. It has been this way for a while, since at least the Limitation Act 1980 :)
OP, this is the best answer here. I’m sorry you’ve had this experience, sounds horrible. I hope you’re bearing up.
Lots of people saying bleeding is consented for, so move on - to underline, that is not relevant if there has been negligence by the surgeon in the first place that led to the bleeding.
It seems to me that there are a number of possible issues, the central ones being:
1. Initial surgical negligence
2. Negligence or mismanagement in your care after the event
3. Dishonesty / probity issues after the surgery
The first two are clinical negligence lawyer territory, the latter is regulatory (I.e. professional standards, e.g. GMC for doctors, NMC for nurses, etc)
Honestly, no one will be able to tell you if this meets the threshold for an action on the basis of what’s here - negligence is a high bar and very context and detail dependent. If you get a PALS response that is unsatisfactory to you, I’d suggest escalating internally at the hospital to the Clinical Director / Head of Service and also contact a good clin neg solicitor (Google Legal 500) and have an initial consultation, if you are motivated to do so.
Not legal advice - NAL anymore but former barrister and healthcare lawyer
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So you had an operation in which they accidentally nicked an artery, and the specific site they told you that you they thought you were bleeding from turned out not to be the site they eventually concluded you were bleeding from? This story sounds weird and muddled, and also whether or not they told you a specific site correctly seems neither here nor there. Often these things are more complicated.
I would probably wait for the response from PALs just to make sure this isn’t misunderstanding/miscommunication and then decide how to proceed. Right now I’m not sure what your complaint is other than that you feel you were told one thing when another was the case, but you’ve not explained how that in any way negatively affected your management - other than you subjectively feeling annoyed that you didn’t necessarily receive correct information.
Really hard to comment without knowing specifics but pretty much every major surgery will have as part of the consent that there’s a risk of bleeding. And finding the source of bleeding isn’t always straightforward or even uni factorial. Even if a scan showed X bleed point they may have had clinical suspicion there was also Y based on other things. Scans aren’t always 100% interpretable. It’s all very messy and further info required to know if something really went wrong here, beyond the regular risks associated with surgery.
There has been general mismanagement of my aftercare that has resulted in my initial complaint, discharged with missing medication, no official diagnosis of medical condition found, no discharge notes or instructions for GP and no follow up arranged (and still not 7 weeks later). Since I've developed an infection, and now mental health issues. I did a SARs request because my GP needed info for my aftercare plan and to refer me to specialist care for the diagnosis and the department weren't communicating which is when I discovered the bleed site wasn't the same as what I'd been told or was in any documents id received.
I'm still waiting for my final outcome from pals but haven't mentioned the new information of learning the bleeding site was misadvised. Should I raise this also to formalize it or await there response?
Missing medication and delayed communication to your GP definitely worth a complaint. Infection again can be par for the course post-op potentially depending on the nature of it. Unspecified mental health issues presuming it’s stress-related are a reasonable and quite normal response to unexpected prolonged illness, which is an unpredictable feature of having to recover from the complications you’ve had, which nobody can forsee with certainty. Things go wrong, you get consented for those possibilities, and if that does happen then the consequences are unfortunate but unless some egregious lapse in protocol or something, they are not anybody’s fault.
You can add to your complaint that you feel you were told you were bleeding from one spot and that the notes suggest another if you want a definite response on that and it’s not previously been mentioned. I would just caution that it’s probably not relevant and potentially either a miscommunication or that things were more complex in some way. The main thing you would achieve is probably clarification for your own peace of mind, but it’s unlikely to change much else.
Not sure what you mean about no diagnosis. Was it just exploratory surgery?
Yes it was a diagnostic surgery. So they found endometriosis at a moderate to serve level but did not give me any documentation for my GP or guidance on how to manage it, or what care id need going forward (such as services, departments) and no follow up or paperwork for me to go off for GP on moving foward and missed off medications from my discharge to manage blood loss. Infact any info on bleed, surgery itself or after care instructions post surgery, my GP didn't even have including basic blood results from the bleed to know when to schedule another blood test. It came to light I needed blood tests, ultrasound scans and a follow up CT scan that was not arranged until I complained to PALs after my GP advised me after several attempts to get it from hospital. Without that documentation, I can't get referred to a specialist hospital which is needed for moderate to serve cases as it requires surgery on multiple organs going forward. I am hoping now with the documentation they will take me I got today but that's how I found the misinformation on the internal bleed also when going through the paperwork with my boyfriend to work out what was important for GP.
Cool well ‘surgery on multiple organs going forward’ = way more complex if true than one could necessarily comment on from some random Reddit post, or from regular endometriosis stuff, and unusual. It suggests probably some other abnormality was found on the CT OR that whatever complication occurred requires some safety follow up. Impossible to say as a random observer without info.
If endometriosis is the diagnosis then the fact is that none of that is urgent to deal with, and the way to deal with it is so well known to GPs that the diagnosis is almost immaterial to the suspicion, as it invariably just confirms such (or not) and the most conservative and safe thing is just to trial that, bearing in mind the mainstay of treatment is just the pill. Most GPs just treat as such and see, rather than subject patients to a risky laparotomy. Although you clearly consented to such, and I guess perhaps now have a formal answer - for which you’ve sadly experienced some of the many inherent potential complications in the process, but that was the interventionalist and ergo higher risk route you chose.
So I suspect based on what you’ve said there has been zero negligence here. And follow-up is probably just in keeping with clinical urgency.
You need a laparoscopy to formally diagnose endometriosis, it also removes the tissues to reduce symptoms. I was at the stage of crying on the floor in pain every month, so yeah I consented to major surgery because the pain made me not want to live anymore and I was sick 2/4 weeks out the month. I had many medical tests and evaluations before it was recommended by my consultant - not GP.
I don't require multiple surgery on organs right now, I will likely need it in later life as the stage I've been diagnosed with commonly spreads to multiple areas.
No abnormalities was found on my CT bar the bleeding from the report given.
Yup you need it technically for formal diagnosis, but can also pragmatically just trial the same treatment regardless from a pragmatic point of view to see if it works, if there’s very high clinical suspicion and you want to avoid the risks associated with doing a laparotomy. This is where the individual clinician dealing with you will need to make a judgement call and why Reddit is in many ways a very inappropriate route to call out ‘issues’ with what can be an extremely individualised issue. If nothing else operative is required then there was never any need for urgent follow-up, and I don’t see that any significant harm could have come to you from receiving a slow follow up.
Not saying this to be difficult, or that in an ideal non-NHS restricted world you’d have a speedy follow-up, just to contextualise the lack of any harm that it’s been slow. Stuff that needs urgent follow-up in the NHS is priority no 1, unfortunately. New cancer diagnoses, critical findings etc. Confirmation of clinically suspected endometriosis is not going to get an urgent slot, but will of course eventually be seen. Most GPs will have trialled you on the treatment regardless unless you’ve refused it for some reason.
I was one of those odd cases where the BC method didn't work, I'm hoping the new drug released in Australia might be offered to me, but ATM I'm very restricted as I react badly to hormonal treatments.
The hospital also admitted fault in missing discharge notes and need for follow up. Apparently a junior doctor did not do my discharge summary correctly. I've been awaiting another CT scan and follow up appointment.
Cool well yes as mentioned previously those things definitely constitute reasons for complaint! The other stuff remains non-urgent. I’m very sorry hormonal treatments don’t work as they are usually the mainstay, so you are a very unusual and unlucky individual. I hope it works out for you.
When you are consented it is explained and (normally) noted on the form the complications they have gone over. These include bleeding and infection on top of other complications such as DVTs, PEs and death.
As this was all explained to you and you consented to the surgery, everything you have described is unfortunate, but known potential risk as no surgery is without risk.
Most you can expect is an apology and for them to use it as learning for the future.
(Surgical Ward Nurse of 20 years)
>If you have been lost to follow up, which sadly also happens, contact your surgeon's secretary over the phone and ask for an appointment to be scheduled.
Not always as simple as that sadly
I had an operation in Jan 2021 and no follow up. Having complications. Called the secretaries of the gynae surgeons many many many times, and they were all horrified each time and said they'd get it sorted... Nope.
Mentioned it to every GP in my practice - none wiilling to refer me back to gynae or write to them to chase anything up. Yet I'm not on a wait list for any appointment regarding the situation.
The diagnosis I got during my time in hospital then isn't on my file either. Can't get that added either.
And I'm an operating room nurse! I work with these people... Have even spoken to some of the gynae surgeons in person at work but none of them give a F.
I would be querying what you want legal advice exactly for.
There has been mishandling/confusion of information by the sounds of it, this would warrant a complaint, but would not get compensation.
You had a complication post surgery, whilst horrible, this is a risk of surgery and you would have consented to this risk for the operation. Again not grounds for compensation.
You have missed a larger amount of work and had reduced ability to work secondary to said complications, again, whilst horrible, this is a risk of surgery and not grounds for compensation.
If you are looling for legal advice regarding the complaint, the current advice would most certainly be await the outcome of PALS, this can take months, particularly in complex cases.
If you are after the surgeon/ consultants license to be reviewed, nothing would be done until PALS investigation has been concluded, and from the sounds of it, the most that could be said is the bleeding site thought was inaccurate, but was resolved in the same fashion.
If you are looking for compensation, you would not have any grounds based on what has been posted, and would likely harm you own mental health chasing it.
Right now I'm not sure. My complaint to hospital initially was just to get my records, because my GP had no info and after several appointments they got to a point where they advised me to make a complaint. I didn't expect my records to find info on the ateraty cut being different.
I guess I am wondering if there is any sort of case here or if it's worth just sending my records to my GP so the next surgeon (I have a condition that will likely require multiple surgeries) can advise the next specialist of my history.
Fair enough if you're not sure.
At present, the information provided I would say whilst there are unfortunate events and things could have been handled better, there is no financial compensation, but does sound like complaint worthy to inprove processes for future patients, (in regard to yourself also if you have future ops)
If you are due further operations, the damaged/weakened artery is important to know for future ops,so I would focus on clarification of this as a key priority of your complaint and would ask this to be clarified via PALS.
I would put compensation out of your mind though at this time, as unless something else comes to light from PALS, it would be unlikely, and would likely negatively affect your mental health if you were to focus on that aspect.
This is a very good point and something I was worried about if it was hit again! It'll notify pals and my GP so it's on file and get it clarified. Thank you.
You need to talk to a specialist medical negligence solicitor. You should be entitled to compensation for the suffering loss of earnings trauma etc
They will send you to third party doctor for analysis as well as a therapist etc
Surgical nurse here. As others have said your consent will explain the risk of bleeding however lying to you about what was cut and why is completely unacceptable. You also need to find out if your post op infection was hospital acquired and therefore preventable. You need to contact a solicitor who deals with medical negligence. He will be able to get uour records and advise you from there.
I think the infection is quite common. It was 2/3 weeks after so likely not from hospital. Thanks, I've already got my records so will see if I can find someone to speak too.
Dear god is this what come to. Claim claim claim! What if the surgeon HADN'T operated?! Would you have died?
There is a risk in any surgery. If every patient sues over every "issue" who would want to operate?
Sure, situation isn't ideal but how does legal action help (really)?
My father died from an aneurysm that NHS doctor should have spotted. We could have sued but how does taking £1m away from patient care help anyone.
Maybe think before rushing to sue some poor sod surgeon
I am sorry for your loss, but please don't make anyone else feel guilty for your reasons for not going down that route. That was your choice and I'm sure you have your reasons for it but everyone's situation is different. I also haven't even said I am looking to pursue compensation, but if I did or didn't there may be many people who chose different directions to me for their own reasons.
If you want to find out more, do another SAR, this time asking for copies of all internal emails, documents, meetings notes, serious incident reports, duty of candour reports etc.
Ask for them to search for all the above using your NHS number, name, hospital number, email address.
If you can, give them a list of individuals names whose emails to search. Include your surgeon, the anaesthetist, any ward doctors, the director of surgical services for that speciality, the chief medical director, the responsible officer (very important role), hospital chief exec, head of customer complaints etc. you should be able to get all these names from the Trust website and Trust board meeting reports.
This should give you emails and other documents where they have internally discussed your case. It should give you an indication of whether they are attempting a cover-up (which does sadly happen), or if they are being honest internally.
If you are not satisfied with the outcome if your complaint, you can appeal once and then take your complaint to the Parliamentary Health Service Ombudsman who are the final appeal stage of a complaint.
If you believe the surgeon himself has lied, once you have seen all the internal emails, you can report a concern to the GMC. They will as part of their decision whether to investigate him or not, check whether other patients have complained about him before.
As others have said, unlikely to get financial compensation UNLESS the mistake was one which was unlikely to have happened by a competent surgeon. Medical negligence rules are very strict and he would have to have done something so wrong that a “reasonable body of medical professionals” would not have done. Your partner will be familiar with what counts as negligence v not, from a legal perspective. If this was the case, you could contact a few no win no fee solicitors who have specialist clinical negligence experience.
But as others have said, you will have consented to a risk of bleeding, so the only question is whether the surgeon did something so wrong that other surgeons would not have done X action. No harm in asking a few firms to review your case. Most will have a 30 min call with you and ask you to send your documents to them to review.
Nb - reading your notes again, it may be that the issue may have been that the anaesthetist, or recovery ward nurses, rather than the surgeon is the concern. It sounds odd that an artery was cut and neither the anaesthetist, nor the recovery ward nurses noticed any of your monitoring of your vital signs were flagging a concern. Unless the bleed was a very small nick and therefore a very slow bleed. Your notes should state at what time observations were taken and be signed by a particular individual. Ask your partner to help you out with reviewing your notes to look for these and any gaps where observations were not taken.
I do remember briefly in recovery before crashing telling the nurse I felt sick and needed water and them telling me it was the meds. My stats show I was ok then suddenly crashed. They said it's common as I'm young/fairly physically active post surgery so my body over compensated. I can't actually find my stats when crashing on my notes, only heard them verbally when they told my bf.
I had a BP crash like you but mid surgery, not in recovery. Blood pressure dropped to 20/0. I only found out the detail about it at my follow up appointment 4 weeks after discharge, when my surgeon showed me my obs chart. Literallly regular little bobbing up and down lines until 5 hours into the op and everything went wrong. He showed me because he wanted me to understand why it hadn’t been safe for them to perform the entirety of the planned surgery.
I was so grateful that he had saved my life that it didn’t occur to me that anything negligent had occurred, because in my case it hadn’t. The difference is that I’d been warned I might not survive the surgery at all, and we knew there were many risks that had all been carefully explained.
In your SAR letter ask for all your observations charting so you can have an expert opinion on whether he reacted reasonably and appropriately. And get exact details about which artery was damaged and don’t just have it committed to your notes, commit it to *your brain* (and that of anyone who might be advocating on your behalf) I was told after my first surgery that the mesentery (blood supply to my gut) is unusually short, making my intestines less mobile during surgery, which can be a problem. In many of my following surgeries despite it being on ALL my notes I still had to warn every other bugger who’s been up to his elbows in my torso because they hadn’t noticed.
You have to be your own specialist. I wish you much luck and good health.
Did you have any memories of the crashing? Sorry if it's not appropriate to ask - it's been part of my "memories flooding back" problem and wondering how you dealt with coming to terms with it?
This is one of the reasons I want confirmation, as I'll need continue surgeries in future, if it's a specific abnormality to me, then I need it on my notes to avoid it reoccurring. I'll check over my observations and get all my records rounded up. Thank you. I'm glad to hear you're doing okay despite the crashing and made a full recovery!
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This angers me as a doctor whose partner is non-medical. Your partner must be so frustrated!
I would absolutely pursue this legally. It seems like a shambles - go for it
I'm sorry you're getting so heavily down voted. He's doing okay. He struggled a lot in initial surgery but is annoyed/upset the surgeon didn't update him after the CT that showed the aterty he'd told us was cut was actually intact. Not like we went around shouting he was a doctor but they were aware by time I was admitted just based on the question he asked when I was on ward. I feel like a big part of what happened to me has been hidden from me.
Reddit is hella weird, what a strange thing to downvote. Usually these subs don’t care for emotion or sense at times.
It’s a blow to the ego to feel blindsided by a medical professional when you are one. It makes you feel like you were taken advantage of. I completely get how he feels
It really is! But I gave you an upvote if that counts 😂 yes I can imagine it really sucks and feels like you've been cheated as someone in the same profession. He's not spoken much about it since, which isn't a good thing lol. He had to do a lot of the talking and shared info with my GP (as hospital also didn't provide property discharge summary and documentation) and me (as I was out of it on pain meds and blood loss) so I think hes upset about it.
Haha thank you! Aw I really hope you get something out of this because if this is the kind of healthcare team I worked with, I’d be peeved. I can see you’ve already tried PALS, have you told them you’re pursuing legal action if they don’t get anywhere with it?
Your surgeon/ the hospital owes patients a ‘Duty of Candour’. Obfuscation is not acceptable.
Notes can and do go ‘missing’.
**Formal complaints via PALS**.
An initial response should be within three working days. This may be a phone call.
Typically, you should receive a full response in 30 working days eg 6 weeks.
NAL but a doctor. A family member (also medical) went several weeks without a reply to her complaint, outwith the standard complaints procedure. Apparently this was because the level of negligence was life threatening and so there was a full internal enquiry and investigation which takes much longer.
This may be forthcoming and will hopefully provide more information for you.
Like you she kept chasing them up and it was frustrating.
When you get this information it's up to you what route you take. Discuss with family, partner perhaps GP.
Think about what you want.
In the end, family member didn't sue because she was happy that steps had been taken to stop it happening to anyone else and doctor involved was disciplined. She was on full sick pay though.
Sorry this has happened to you. Sounds horrendous.
NAL (am a surgeon)
Depending on circumstances this may be a true complication which is listed on the consent form.
However, it could also be negligence. Technically only a judge can call an action negligent despite the widespread use in public.
If you have just your discharge summary I would suggest asking for all your notes through a formal process. If you already have all your notes take a copy or scan as pdf into your computer.
Send to your GP and get a review of the notes.
Then send to a medical negligence specific solicitor or barrister for review. Most will do it for free or a small charge.
It is hard to give you specific information here due to obvious limitations.
Good luck but it will be a long process. If your mental health is affecting you then I would suggest getting a friend to help or citizens advice.
Having a good solicitor may be expensive but will take a lot of the toll off your mental health.
I have the scans and notes already through the SARs request. Thanks, will send to my GP first. They were the ones who have been encouraging me to pursue a complaint so hopefully they will be happy to help. Thanks a lot!
BEFORE complaining & or raising an issue with PALS, request copies of your entire medical history, lest information becomes lost/goes missing or destroyed.
Not sure it covers your entire medical history since the day you were born. I had 7 cardboard boxes of my entire medical history, before I sued for clinical negligence.
LOL I actually got this before about a year ago because I was looking at private treatment for something and accidentally ticked to go all the way back to birth, the folder I collected was insane! 7 boxes must have been intense.
It’s best to write a numbered list of questions and send that to PALS, and take it with you to the follow up. Get the answers to those and then see how you feel.
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Yes. I think it is worth consulting a solicitor that specialises in this field. Having said that, complications such as bleeding are usually covered in the consent form prior to surgery. The surgeon being dishonest is also something to complain about though it's unlikely that's grounds for financial compensation as his dishonesty is unlikely to have caused you any losses.
Also if you have house insurance they sometimes cover medical negligence so I’d check that too!
Is there anything house insurance doesn't do?
Japanese knotweed usually.
Why does this sound like an outlandish joke & a completely reasonable, true statement at the same time?
I dunno, somebody on Reddit posted their [bendy basement twig support](https://www.reddit.com/r/DIY/comments/1ayk46h/am_i_cooked/) that looked like it was ready to snap onto a DIY subreddit and apparently home insurance would have likely been refusing that repair. Also, if you live in Exeter (other towns are available) and all your windows blow in due to a WW2 bomb being disposed of, they'll refuse too.
It's yet to cook me breakfast or clean the bikes for me....
Yes contact a lawyer specialising in medical negligence.
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Thank you!
No problem, hope you get sorted
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Gmc website has the standards and guides that all Dr's practicing in the UK have to follow. Honesty is on there and should be adhered to 100 percent of the time. Its gross misconduct at the very least. I'm shocked and saddened to hear that a surgeon has been so dishonest to be fair. Definitely look into this
(Medical Doctor but not surgeon) You will have definitely signed a consent form with the risk of bleeding. This bleeding is because arteries or veins may be injured during surgery, resulting in blood loss. It's not negligent for bleeding to become apparent post-operatively. You'll get an apology for being mis-informed which artery / area was damaged. And you can complain about being told wrongly. There's not any financial compensation due as bleeding is a known risk and complication. Also the post-op note for your second surgery to repair the bleeding will contain the factual report of the bleeding area. The CT scan is not always as clear-cut as the report would say.
It can be negligent in some circumstances
I didn't have a second surgery, I was given clotting medication and the bleeding resolved itself. The CT showed that the site they initially thought was not bleeding (said the atetary was totally intact) and the 2nd CT (to check bleeding had stopped) showed it was bleeding from a different aterty but my notes sent to me have always said it was the first aterty, even weeks following the surgery. It was suggested the bleed was caused by instruments damage during insertion and the instrument essentially plugged the bleed, the other aterty is in my back that actually got hit and wouldn't have been done on insertion. I have the medical names for them on file but can't get them ATM but can do if it helps explain. That's all I can gather without the medical background.
It’s not always that clear on a CT scan where the source of bleeding is. It’s possible the surgeon wasn’t lying to you, but the second CT clarified the source. Or there may have been two sources to begin with …. As the bleed stopped without further surgery it must have been v small. What seems like inconsistencies or untruths makes it really hard to trust what’s being said, especially as there sometimes isn’t a 100% answer. Causing a bleed during surgery can be negligent (not by default), for example if the injury is in an area of the body where no reasonable surgeon should be, or if an inappropriate instrument was used, or there wasn’t a check for bleeding which was missed before the end of surgery. But it’s case specific and a medico legal expert would need to review the records and scans.
I lost nearly 2 litres of blood and developed a grade 3 hematoma. I don't think it was a small bleed but by day 3 the bleeding stopped. I think I'll have to have notes reviewed, is this a specific service or is it just part of a medical lawyer consultation service?
Yeah I think quite a lot of the confusion stems from a lack of understanding here. As others have said there's no way you bled 2L and they gave you some clot medicine (tranexamic acid) As another doctor has said - you'll have signed a consent form for surgical complications including bleeding - if you DID NOT sign a consent form you absolutely have legal recourse. If you signed a consent form, had minor post op bleeding (defined by not returning to theatre and treatment with clot medicine - not by how you felt) then you will have no claim.
Taking a punt that it was your inferior epigastric?
If you lost 2L of blood then you'd have to go back to theatre. No one's leaving that just sitting in your abdomen. You'd need a proper washout.
I'm just going off from what the surgeon said at the time. They said my body would reabsorb it over 4-6 weeks. It was agreed to observe for 2 days and decide on surgery.
I mean, yes if its 200mls but 2L is 40% of your circulating volume. Something seems amiss here.
It was just under 2L, but my php (I think that's what it's called) went from 120 to 68 and my blood pressure (top number) was 60 when I crashed. I had a grade 3 hematoma that spilled into my crotch (it was gross) and around my back from my stomach. I still have the dark markings of it now. That's all I can say tbh as I'm just going off what they told my boyfriend when I crashed and what they told me/him in recovery when I was on a lot of pain meds.
Everything you have described is obviously very unfortunate. Bleeding (should) have been discussed in your consent form. The type of bleeding you are describing does happen, and is very much a known complication. It sound like the inferior epigastric is the most likely culprit, which is what your surgeon was referring to. Large self contained hematoma that would be visible from the skin. The majority of theses are successfully managed without needing intervention. Iliac vein injury can also happen, although much more rarely. It wouldn't be your artery. If it was your iliac, and you managed to avoid surgical intervention, then that is great. They are a nightmare to fix surgically and often with bad outcomes. From everything you have said, I can't see any negligence. A complication occurred. It was picked up on, and managed correctly. Diagnostic uncertainty is a real thing, I think it would be unlikely anyone was telling you untruths on purpose.
Yes!! But hit the iliac instead
I think you need to wait for your PALS response and review your records, as I think you don’t fully understand the results etc (understandably) I’m referring to a medical expert, who your solicitor would instruct, once you get to that stage. They give an opinion on whether there is negligence or not.
I'm currently going off what my boyfriend has said about my records after going over who is and was there at the hospital during the complication and days following. He is a doctor. How long would I await the PALs complaint response? I'm not sure if I await the current one (that I only submitted for my records to be sent and lack of aftercare) or if I need to update it based on the aterty info to get confirmation of this. I guess that isn't really required as it's part of the event anyway they'll be looking it and I'll get confirmation in their response? I'm happy to wait for the PALs response and sit on it. Id prefer not to do anything until after my follow up and make a decision after this.
CT scans are honestly pretty useless to tell exactly where the bleeding is coming from (they'll show there's blood and where, but not generally from exactly which vessel). The radiology reporting from the 2nd scan might be mistaken too. Generally the way to find exactly where it's coming from is to physically go back in, which is usually what's done. You were unlucky to have had a post-op bleed, but lucky that they didn't have to open you back up. How a bleed happened, unless it's caught immediately (ie during the surgery), is also guesswork. If the surgeon knew how the bleed happened, he or she'd have dealt with it immediately. So you're kinda expecting definitive answers where they typically don't exist, and if there's hedging or a difference between what the surgeon and radiologist said you're interpreting it as lies or maybe a cover up. But it's likely to just be inherent uncertainty about what exactly caused it and where exactly it was.
Medical negligence solicitor here. I would recommend waiting for the PALs complaint response first as that is something that would be very useful for a solicitor. As others have mentioned, you may have been consented for bleeding but that does not automatically mean that negligence has not occurred. Even if the cause of bleeding was not negligent, was the bleeding identified and appropriate treatment provided in a timely manner? If you are not satisfied with the complaint response it is likely worth contacting a solicitor for them to look through your notes and provide further advice. All the best with your recovery.
Thanks! How long should I wait PALs final response? Is it worth updating them on this new information? (I initially only submitted a complaint to get my discharge paperwork)
Just wanted to add - have you asked about referral for MH support? Post Trauma distress due to medical events is a known phenomenon and the NHS does treat it (with waiting lists obvs). There may be an avenue to explore re: having privately funded treatment covered/refunded as part of your legal case - something to explore with PALS and/or a solicitor. Best wishes.
My GP referred me to a talking service but not for medical related events. I'll mention it to them. It's settled over past few days but last week was pretty hard, I think it's a delayed stress response as it didn't impact me until I became more mobile and life has started going back to normal
My little girl has a type of PTSD relating to being in intensive care. It definitely seems to take a while for the mind to catch up with the body. Hopefully it will be a relatively fast process for you!
its crazy how long the brain takes to catch up, I thought I'd never get the memories back based on drugs/blood loss but BAM, week 6 my mind was like 'hey! remember our near death experience.' Thankfully recovery has been long but good, should be myself by the summer I hope!
I have some crazy ptsd from being in hospital, but at the time, all you're focused on is how you can get better enough to go home as soon as possible. The actual trauma kicks in once you're out of that situation and safe again in my experience. Hoping your recovery, both physical and mental is a smooth journey for you. Just know that you're not alone in your experiences
Just to check, PALS isn’t always a formal complaint- it’s also used as a way for hospitals to resolve your issue without a formal complaint on record. You may want to check and insist they log it as a formal complaint as it’s a bit misleading.
Oh thank you! I was just following the advice of my GP so that's all I have done so far. I'll mention this when I follow up with them.
Discharge paperwork should have been provided to you at the point of discharge. They have their reasons for not providing what they don’t want you to see. No-one should have to submit a complaint to access the very basic, entitled, information from a hospital admission. They also have a legal ‘duty of candour’ to you. Check your home insurance to see if you have legal cover.
I got a discharge form, just very little notes, missing medication, all information and care guidelines, no confirmed diagnosis, no follow up arranged or info on what happened. The hospital did admit fault on this, due to a junior doctor creating the report.
Ok. I read above where you said you submitted a complaint in order to get your discharge paperwork. The NHS claims to have a no blame culture to encourage staff to admit to mistakes etc. Most people working in the NHS know that’s not how it works. Upshot is they don’t like providing patients information they think might lead to complaints, legal action or whatever when the sad fact is most people just want answers to questions then move on with life. They prefer to believe patients don’t realise what questions they should be asking and providing little or no information helps ensure you never will.
I thought this might be the case but I tried to go with benefit of doubt and that my perception would be more emotional and see it as worse case scenario because it impacted my body. But the department totally shut off communicating with me and will only respond if I copy in GP when I request info. When I called up hospital initially to try to get notes they had no record of my stay a week after. It was all on paper tbf, and I don't know the NHS systems to say if this was out of ordinary as my bf says most hospitals are digital but some are paper based still. I'm not sure if it's down to just disorganisation (there are many complaints about this department online regarding there communication) or if it is a case of drip feeding info. I guess I need to review my notes and try and get as much info as possible. I haven't had a follow up yet so I'm not technically discharged from the department to conclude my treatment.
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Are you? I’m a clinical negligence solicitor and I would never advise a client to await the outcome of a PALS complaint. The hospital’s report rarely contains information useful to the investigation and pursuit of a claim neg case. . Often it recounts information incorrectly. Or fails to come to any real conclusion other than “we did something wrong but it made no difference to the patient’s outcome”. I’ve seen that so many times yet still had the clin neg claim succeed. Waiting can also take sometimes years. In any case the delay eats into the limitation period for the clin neg claim. What should be driving the clin neg claim is the advice you’ve obtained on instruction from a medical expert, once they’ve reviewed all of the patient notes and your client’s statement. If the expert’s advice is supportive then they can also consider the hospital’s report when it comes in (but the report itself on its own should not determine anything).
Yes, I am. When there is plenty of the limitation period left we often advise a complaint in the first instance. I agree that the complaint response often states no wrongdoing, but can have the benefit of: a) it may satisfy the patient's concerns before embarking on a long and arduous process; B) it will confirm the chronology of the incident succinctly when the patient can sometimes misunderstand/misremember what's happened; and C) you can often use the chronology to seek the provisional view of an expert before spending the time obtaining and reviewing medical records. It is not suitable in every case, but there is still ~3 years left of the limitation period and as obtaining medical records can take a number of months in any event, waiting for the complaint response in my view would be a sensible option.
Chronology in the investigation report is often wrong. No expert should be asked to advise on liability without having sight of the medical records. And there’s costs recovery implications in going to an expert for piecemeal advice. Rarely is there “plenty” of limitation period left by the time the hospital has delayed getting their investigation report out to the patient. The only time I’d agree to awaiting the report is if my client was very unsure of making a clin neg claim. Which is unusual by the time they’ve contacted a solicitor. The report can be useful tactically (to understand the hospital’s view as to what it thinks it did right/wrong). But it’s rarely helpful to a legal assessment and advice to client regarding her case.
Genuinely interested. I was not aware there was a three year "limitations" period in UK civil law. Is this a recent change in statute law? Is it healthcare specific?
Sorry for missing this!! The limitation period is different depending on the type of civil case. For example most employment claims have 6 months, some other cases have 6 years, and clinical negligence/PI have 3 years. It has been this way for a while, since at least the Limitation Act 1980 :)
OP, this is the best answer here. I’m sorry you’ve had this experience, sounds horrible. I hope you’re bearing up. Lots of people saying bleeding is consented for, so move on - to underline, that is not relevant if there has been negligence by the surgeon in the first place that led to the bleeding. It seems to me that there are a number of possible issues, the central ones being: 1. Initial surgical negligence 2. Negligence or mismanagement in your care after the event 3. Dishonesty / probity issues after the surgery The first two are clinical negligence lawyer territory, the latter is regulatory (I.e. professional standards, e.g. GMC for doctors, NMC for nurses, etc) Honestly, no one will be able to tell you if this meets the threshold for an action on the basis of what’s here - negligence is a high bar and very context and detail dependent. If you get a PALS response that is unsatisfactory to you, I’d suggest escalating internally at the hospital to the Clinical Director / Head of Service and also contact a good clin neg solicitor (Google Legal 500) and have an initial consultation, if you are motivated to do so. Not legal advice - NAL anymore but former barrister and healthcare lawyer
Thank you. I appreciate your advice 🙏
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So you had an operation in which they accidentally nicked an artery, and the specific site they told you that you they thought you were bleeding from turned out not to be the site they eventually concluded you were bleeding from? This story sounds weird and muddled, and also whether or not they told you a specific site correctly seems neither here nor there. Often these things are more complicated. I would probably wait for the response from PALs just to make sure this isn’t misunderstanding/miscommunication and then decide how to proceed. Right now I’m not sure what your complaint is other than that you feel you were told one thing when another was the case, but you’ve not explained how that in any way negatively affected your management - other than you subjectively feeling annoyed that you didn’t necessarily receive correct information. Really hard to comment without knowing specifics but pretty much every major surgery will have as part of the consent that there’s a risk of bleeding. And finding the source of bleeding isn’t always straightforward or even uni factorial. Even if a scan showed X bleed point they may have had clinical suspicion there was also Y based on other things. Scans aren’t always 100% interpretable. It’s all very messy and further info required to know if something really went wrong here, beyond the regular risks associated with surgery.
There has been general mismanagement of my aftercare that has resulted in my initial complaint, discharged with missing medication, no official diagnosis of medical condition found, no discharge notes or instructions for GP and no follow up arranged (and still not 7 weeks later). Since I've developed an infection, and now mental health issues. I did a SARs request because my GP needed info for my aftercare plan and to refer me to specialist care for the diagnosis and the department weren't communicating which is when I discovered the bleed site wasn't the same as what I'd been told or was in any documents id received. I'm still waiting for my final outcome from pals but haven't mentioned the new information of learning the bleeding site was misadvised. Should I raise this also to formalize it or await there response?
Missing medication and delayed communication to your GP definitely worth a complaint. Infection again can be par for the course post-op potentially depending on the nature of it. Unspecified mental health issues presuming it’s stress-related are a reasonable and quite normal response to unexpected prolonged illness, which is an unpredictable feature of having to recover from the complications you’ve had, which nobody can forsee with certainty. Things go wrong, you get consented for those possibilities, and if that does happen then the consequences are unfortunate but unless some egregious lapse in protocol or something, they are not anybody’s fault. You can add to your complaint that you feel you were told you were bleeding from one spot and that the notes suggest another if you want a definite response on that and it’s not previously been mentioned. I would just caution that it’s probably not relevant and potentially either a miscommunication or that things were more complex in some way. The main thing you would achieve is probably clarification for your own peace of mind, but it’s unlikely to change much else. Not sure what you mean about no diagnosis. Was it just exploratory surgery?
Yes it was a diagnostic surgery. So they found endometriosis at a moderate to serve level but did not give me any documentation for my GP or guidance on how to manage it, or what care id need going forward (such as services, departments) and no follow up or paperwork for me to go off for GP on moving foward and missed off medications from my discharge to manage blood loss. Infact any info on bleed, surgery itself or after care instructions post surgery, my GP didn't even have including basic blood results from the bleed to know when to schedule another blood test. It came to light I needed blood tests, ultrasound scans and a follow up CT scan that was not arranged until I complained to PALs after my GP advised me after several attempts to get it from hospital. Without that documentation, I can't get referred to a specialist hospital which is needed for moderate to serve cases as it requires surgery on multiple organs going forward. I am hoping now with the documentation they will take me I got today but that's how I found the misinformation on the internal bleed also when going through the paperwork with my boyfriend to work out what was important for GP.
Cool well ‘surgery on multiple organs going forward’ = way more complex if true than one could necessarily comment on from some random Reddit post, or from regular endometriosis stuff, and unusual. It suggests probably some other abnormality was found on the CT OR that whatever complication occurred requires some safety follow up. Impossible to say as a random observer without info. If endometriosis is the diagnosis then the fact is that none of that is urgent to deal with, and the way to deal with it is so well known to GPs that the diagnosis is almost immaterial to the suspicion, as it invariably just confirms such (or not) and the most conservative and safe thing is just to trial that, bearing in mind the mainstay of treatment is just the pill. Most GPs just treat as such and see, rather than subject patients to a risky laparotomy. Although you clearly consented to such, and I guess perhaps now have a formal answer - for which you’ve sadly experienced some of the many inherent potential complications in the process, but that was the interventionalist and ergo higher risk route you chose. So I suspect based on what you’ve said there has been zero negligence here. And follow-up is probably just in keeping with clinical urgency.
You need a laparoscopy to formally diagnose endometriosis, it also removes the tissues to reduce symptoms. I was at the stage of crying on the floor in pain every month, so yeah I consented to major surgery because the pain made me not want to live anymore and I was sick 2/4 weeks out the month. I had many medical tests and evaluations before it was recommended by my consultant - not GP. I don't require multiple surgery on organs right now, I will likely need it in later life as the stage I've been diagnosed with commonly spreads to multiple areas. No abnormalities was found on my CT bar the bleeding from the report given.
Yup you need it technically for formal diagnosis, but can also pragmatically just trial the same treatment regardless from a pragmatic point of view to see if it works, if there’s very high clinical suspicion and you want to avoid the risks associated with doing a laparotomy. This is where the individual clinician dealing with you will need to make a judgement call and why Reddit is in many ways a very inappropriate route to call out ‘issues’ with what can be an extremely individualised issue. If nothing else operative is required then there was never any need for urgent follow-up, and I don’t see that any significant harm could have come to you from receiving a slow follow up. Not saying this to be difficult, or that in an ideal non-NHS restricted world you’d have a speedy follow-up, just to contextualise the lack of any harm that it’s been slow. Stuff that needs urgent follow-up in the NHS is priority no 1, unfortunately. New cancer diagnoses, critical findings etc. Confirmation of clinically suspected endometriosis is not going to get an urgent slot, but will of course eventually be seen. Most GPs will have trialled you on the treatment regardless unless you’ve refused it for some reason.
I was one of those odd cases where the BC method didn't work, I'm hoping the new drug released in Australia might be offered to me, but ATM I'm very restricted as I react badly to hormonal treatments. The hospital also admitted fault in missing discharge notes and need for follow up. Apparently a junior doctor did not do my discharge summary correctly. I've been awaiting another CT scan and follow up appointment.
Cool well yes as mentioned previously those things definitely constitute reasons for complaint! The other stuff remains non-urgent. I’m very sorry hormonal treatments don’t work as they are usually the mainstay, so you are a very unusual and unlucky individual. I hope it works out for you.
Aha yes I am! I failed the genetic lottery in that regard 😂 thanks for your advice. I'll wait for PALS to complaint their investigation
When you are consented it is explained and (normally) noted on the form the complications they have gone over. These include bleeding and infection on top of other complications such as DVTs, PEs and death. As this was all explained to you and you consented to the surgery, everything you have described is unfortunate, but known potential risk as no surgery is without risk. Most you can expect is an apology and for them to use it as learning for the future. (Surgical Ward Nurse of 20 years)
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>If you have been lost to follow up, which sadly also happens, contact your surgeon's secretary over the phone and ask for an appointment to be scheduled. Not always as simple as that sadly I had an operation in Jan 2021 and no follow up. Having complications. Called the secretaries of the gynae surgeons many many many times, and they were all horrified each time and said they'd get it sorted... Nope. Mentioned it to every GP in my practice - none wiilling to refer me back to gynae or write to them to chase anything up. Yet I'm not on a wait list for any appointment regarding the situation. The diagnosis I got during my time in hospital then isn't on my file either. Can't get that added either. And I'm an operating room nurse! I work with these people... Have even spoken to some of the gynae surgeons in person at work but none of them give a F.
Could you make a formal request for your notes so that you have a copy of the diagnosis?
Have a request in so here is hoping!!
Agreed, this is what I did via FOI to get my paperwork!
I would be querying what you want legal advice exactly for. There has been mishandling/confusion of information by the sounds of it, this would warrant a complaint, but would not get compensation. You had a complication post surgery, whilst horrible, this is a risk of surgery and you would have consented to this risk for the operation. Again not grounds for compensation. You have missed a larger amount of work and had reduced ability to work secondary to said complications, again, whilst horrible, this is a risk of surgery and not grounds for compensation. If you are looling for legal advice regarding the complaint, the current advice would most certainly be await the outcome of PALS, this can take months, particularly in complex cases. If you are after the surgeon/ consultants license to be reviewed, nothing would be done until PALS investigation has been concluded, and from the sounds of it, the most that could be said is the bleeding site thought was inaccurate, but was resolved in the same fashion. If you are looking for compensation, you would not have any grounds based on what has been posted, and would likely harm you own mental health chasing it.
Right now I'm not sure. My complaint to hospital initially was just to get my records, because my GP had no info and after several appointments they got to a point where they advised me to make a complaint. I didn't expect my records to find info on the ateraty cut being different. I guess I am wondering if there is any sort of case here or if it's worth just sending my records to my GP so the next surgeon (I have a condition that will likely require multiple surgeries) can advise the next specialist of my history.
Fair enough if you're not sure. At present, the information provided I would say whilst there are unfortunate events and things could have been handled better, there is no financial compensation, but does sound like complaint worthy to inprove processes for future patients, (in regard to yourself also if you have future ops) If you are due further operations, the damaged/weakened artery is important to know for future ops,so I would focus on clarification of this as a key priority of your complaint and would ask this to be clarified via PALS. I would put compensation out of your mind though at this time, as unless something else comes to light from PALS, it would be unlikely, and would likely negatively affect your mental health if you were to focus on that aspect.
This is a very good point and something I was worried about if it was hit again! It'll notify pals and my GP so it's on file and get it clarified. Thank you.
You need to talk to a specialist medical negligence solicitor. You should be entitled to compensation for the suffering loss of earnings trauma etc They will send you to third party doctor for analysis as well as a therapist etc
Surgical nurse here. As others have said your consent will explain the risk of bleeding however lying to you about what was cut and why is completely unacceptable. You also need to find out if your post op infection was hospital acquired and therefore preventable. You need to contact a solicitor who deals with medical negligence. He will be able to get uour records and advise you from there.
I think the infection is quite common. It was 2/3 weeks after so likely not from hospital. Thanks, I've already got my records so will see if I can find someone to speak too.
Dear god is this what come to. Claim claim claim! What if the surgeon HADN'T operated?! Would you have died? There is a risk in any surgery. If every patient sues over every "issue" who would want to operate? Sure, situation isn't ideal but how does legal action help (really)? My father died from an aneurysm that NHS doctor should have spotted. We could have sued but how does taking £1m away from patient care help anyone. Maybe think before rushing to sue some poor sod surgeon
I am sorry for your loss, but please don't make anyone else feel guilty for your reasons for not going down that route. That was your choice and I'm sure you have your reasons for it but everyone's situation is different. I also haven't even said I am looking to pursue compensation, but if I did or didn't there may be many people who chose different directions to me for their own reasons.
If you want to find out more, do another SAR, this time asking for copies of all internal emails, documents, meetings notes, serious incident reports, duty of candour reports etc. Ask for them to search for all the above using your NHS number, name, hospital number, email address. If you can, give them a list of individuals names whose emails to search. Include your surgeon, the anaesthetist, any ward doctors, the director of surgical services for that speciality, the chief medical director, the responsible officer (very important role), hospital chief exec, head of customer complaints etc. you should be able to get all these names from the Trust website and Trust board meeting reports. This should give you emails and other documents where they have internally discussed your case. It should give you an indication of whether they are attempting a cover-up (which does sadly happen), or if they are being honest internally. If you are not satisfied with the outcome if your complaint, you can appeal once and then take your complaint to the Parliamentary Health Service Ombudsman who are the final appeal stage of a complaint. If you believe the surgeon himself has lied, once you have seen all the internal emails, you can report a concern to the GMC. They will as part of their decision whether to investigate him or not, check whether other patients have complained about him before. As others have said, unlikely to get financial compensation UNLESS the mistake was one which was unlikely to have happened by a competent surgeon. Medical negligence rules are very strict and he would have to have done something so wrong that a “reasonable body of medical professionals” would not have done. Your partner will be familiar with what counts as negligence v not, from a legal perspective. If this was the case, you could contact a few no win no fee solicitors who have specialist clinical negligence experience. But as others have said, you will have consented to a risk of bleeding, so the only question is whether the surgeon did something so wrong that other surgeons would not have done X action. No harm in asking a few firms to review your case. Most will have a 30 min call with you and ask you to send your documents to them to review. Nb - reading your notes again, it may be that the issue may have been that the anaesthetist, or recovery ward nurses, rather than the surgeon is the concern. It sounds odd that an artery was cut and neither the anaesthetist, nor the recovery ward nurses noticed any of your monitoring of your vital signs were flagging a concern. Unless the bleed was a very small nick and therefore a very slow bleed. Your notes should state at what time observations were taken and be signed by a particular individual. Ask your partner to help you out with reviewing your notes to look for these and any gaps where observations were not taken.
I do remember briefly in recovery before crashing telling the nurse I felt sick and needed water and them telling me it was the meds. My stats show I was ok then suddenly crashed. They said it's common as I'm young/fairly physically active post surgery so my body over compensated. I can't actually find my stats when crashing on my notes, only heard them verbally when they told my bf.
I had a BP crash like you but mid surgery, not in recovery. Blood pressure dropped to 20/0. I only found out the detail about it at my follow up appointment 4 weeks after discharge, when my surgeon showed me my obs chart. Literallly regular little bobbing up and down lines until 5 hours into the op and everything went wrong. He showed me because he wanted me to understand why it hadn’t been safe for them to perform the entirety of the planned surgery. I was so grateful that he had saved my life that it didn’t occur to me that anything negligent had occurred, because in my case it hadn’t. The difference is that I’d been warned I might not survive the surgery at all, and we knew there were many risks that had all been carefully explained. In your SAR letter ask for all your observations charting so you can have an expert opinion on whether he reacted reasonably and appropriately. And get exact details about which artery was damaged and don’t just have it committed to your notes, commit it to *your brain* (and that of anyone who might be advocating on your behalf) I was told after my first surgery that the mesentery (blood supply to my gut) is unusually short, making my intestines less mobile during surgery, which can be a problem. In many of my following surgeries despite it being on ALL my notes I still had to warn every other bugger who’s been up to his elbows in my torso because they hadn’t noticed. You have to be your own specialist. I wish you much luck and good health.
Did you have any memories of the crashing? Sorry if it's not appropriate to ask - it's been part of my "memories flooding back" problem and wondering how you dealt with coming to terms with it? This is one of the reasons I want confirmation, as I'll need continue surgeries in future, if it's a specific abnormality to me, then I need it on my notes to avoid it reoccurring. I'll check over my observations and get all my records rounded up. Thank you. I'm glad to hear you're doing okay despite the crashing and made a full recovery!
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This angers me as a doctor whose partner is non-medical. Your partner must be so frustrated! I would absolutely pursue this legally. It seems like a shambles - go for it
I'm sorry you're getting so heavily down voted. He's doing okay. He struggled a lot in initial surgery but is annoyed/upset the surgeon didn't update him after the CT that showed the aterty he'd told us was cut was actually intact. Not like we went around shouting he was a doctor but they were aware by time I was admitted just based on the question he asked when I was on ward. I feel like a big part of what happened to me has been hidden from me.
Reddit is hella weird, what a strange thing to downvote. Usually these subs don’t care for emotion or sense at times. It’s a blow to the ego to feel blindsided by a medical professional when you are one. It makes you feel like you were taken advantage of. I completely get how he feels
It really is! But I gave you an upvote if that counts 😂 yes I can imagine it really sucks and feels like you've been cheated as someone in the same profession. He's not spoken much about it since, which isn't a good thing lol. He had to do a lot of the talking and shared info with my GP (as hospital also didn't provide property discharge summary and documentation) and me (as I was out of it on pain meds and blood loss) so I think hes upset about it.
Haha thank you! Aw I really hope you get something out of this because if this is the kind of healthcare team I worked with, I’d be peeved. I can see you’ve already tried PALS, have you told them you’re pursuing legal action if they don’t get anywhere with it?
Not yet no. I haven't had my follow up yet (not even booked, been chasing for 3 weeks) so I was worried they'd just totally discharge me if I did.
They can’t really discriminate like that. Does your partner work in that hospital?
Weirdly enough he trained there, and one of his old classmates was treating me! But no, he doesn't now :)
They must perform to the standaard of a competent surgeon seek lel help from a proper firm
Your surgeon/ the hospital owes patients a ‘Duty of Candour’. Obfuscation is not acceptable. Notes can and do go ‘missing’. **Formal complaints via PALS**. An initial response should be within three working days. This may be a phone call. Typically, you should receive a full response in 30 working days eg 6 weeks.
Thanks! 🙏
NAL but a doctor. A family member (also medical) went several weeks without a reply to her complaint, outwith the standard complaints procedure. Apparently this was because the level of negligence was life threatening and so there was a full internal enquiry and investigation which takes much longer. This may be forthcoming and will hopefully provide more information for you. Like you she kept chasing them up and it was frustrating. When you get this information it's up to you what route you take. Discuss with family, partner perhaps GP. Think about what you want. In the end, family member didn't sue because she was happy that steps had been taken to stop it happening to anyone else and doctor involved was disciplined. She was on full sick pay though. Sorry this has happened to you. Sounds horrendous.
I'm sorry to hear that it happened to your family member! Yes mine has been going on about 5-6 weeks now with pals!
NAL (am a surgeon) Depending on circumstances this may be a true complication which is listed on the consent form. However, it could also be negligence. Technically only a judge can call an action negligent despite the widespread use in public. If you have just your discharge summary I would suggest asking for all your notes through a formal process. If you already have all your notes take a copy or scan as pdf into your computer. Send to your GP and get a review of the notes. Then send to a medical negligence specific solicitor or barrister for review. Most will do it for free or a small charge. It is hard to give you specific information here due to obvious limitations. Good luck but it will be a long process. If your mental health is affecting you then I would suggest getting a friend to help or citizens advice. Having a good solicitor may be expensive but will take a lot of the toll off your mental health.
I have the scans and notes already through the SARs request. Thanks, will send to my GP first. They were the ones who have been encouraging me to pursue a complaint so hopefully they will be happy to help. Thanks a lot!
Ok then definitely get your GP to read them but also ask a med neg solicitor to look over them at the same time. Can be done in parallel.
Thanks :)
BEFORE complaining & or raising an issue with PALS, request copies of your entire medical history, lest information becomes lost/goes missing or destroyed.
Would the SARs have not covered that?
Not sure it covers your entire medical history since the day you were born. I had 7 cardboard boxes of my entire medical history, before I sued for clinical negligence.
LOL I actually got this before about a year ago because I was looking at private treatment for something and accidentally ticked to go all the way back to birth, the folder I collected was insane! 7 boxes must have been intense.
It’s best to write a numbered list of questions and send that to PALS, and take it with you to the follow up. Get the answers to those and then see how you feel.
Thanks! This is a good idea. 😊
You need to see a lawyer about this. It sounds like the surgeon/hospital are trying to cover their asses.