News

A NHS Trust is to pay damages to a client who suffered a perforated appendix due a delayed diagnosis.

The Duncan Lewis client was incarcerated at the time he complained of abdominal pain over a period of approximately two weeks. Prison health professionals examined him three times during that time.

Unfortunately, nothing was done and he later collapsed. He was taken to a nearby hospital where a CT scan revealed the need for open surgery to remove the appendix (which had perforated with an abscess having formed). The post-operative course was slow and protracted, complicated by a breakdown of the wound with an infection.

Following discharge, our client required nursing care assistance with dressings to be applied to the open wound. Unfortunately, the wound became infected which required a further hospital attendance.

Following receipt of supportive expert evidence, Duncan Lewis Solicitor’s clinical negligence solicitor Amy Bennett, prepared a Letter of Claim, which was met with a full admission.

Breach of Duty

The team obtained supportive evidence from a nurse, arguing that the appendix would not have perforated if the client had been referred to a GP or hospital in a timely manner. The failure to escalate the case fell below the expected standard of care and, as such, constituted a breach of duty.

Causation

A Consultant General Surgeon provided expert opinion on causation, concluding that due to the delay in diagnosis, the client required extended nursing assistance with dressings, which took several months to heal. He also experienced significant pain, requiring painkillers.

Had the condition been diagnosed and treated promptly, the client would have undergone either keyhole surgery or, at worst, open surgery with a 5-6cm incision. Instead, he was left with a 30cm scar. Additionally, he required a prolonged hospital stay—whereas recovery should have taken just 48-72 hours post-surgery, the client spent nearly three weeks in hospital. Without the negligence, he would have resumed normal activity within 2-3 weeks after discharge, but instead, he suffered wound-related issues for approximately six months.

The delay in diagnosis also led to a long-term restriction in physical activity, particularly with exertion, heavy lifting, and prolonged standing.

Condition and Prognosis

By the time a Condition and Prognosis report was obtained, the client had moved back home abroad. A subsequent CT and ultrasound scan revealed a large abdominal wall incisional hernia, which the expert advised would require surgical repair. The General Surgeon also highlighted intra-abdominal adhesions causing bloating.

While some adhesions would likely have developed even with timely treatment, they had significantly worsened because:

1. The prolonged period in which the client suffered from a perforated appendix and developed a large retroperitoneal abscess.
2. The need for a major laparotomy to address complications from the appendicitis.

Further scans confirmed the presence of a hernia on the anterior abdominal wall.

The expert also advised that the client faced a 10% lifetime risk of developing acute small bowel adhesive obstruction. If this occurred, he would require emergency hospital admission, intravenous fluids, and nil-by-mouth management. There was a 90% probability that the obstruction would resolve within 72 hours, allowing for hospital discharge. However, in 10% of cases, the obstruction would not resolve or could be complicated by bowel strangulation, necessitating emergency surgery.

As the client wished to improve the appearance of the 30cm scar, a Consultant Plastic Surgeon was consulted for potential future surgical options.

The case was successfully settled for £65,000.

About Solicitor Amy Bennett:

Amy Bennett is a solicitor in Duncan Lewis’ Clinical Negligence department. She has worked exclusively in this field for over 15 years. Her claims expertise includes stillbirth and neonatal death, childbirth injury, gynaecological related, missed or delayed diagnosis of cancer or surgical delays.  She also assists clients who have suffered negligence because of surgical errors, pressure sores and wrongful death. If you have been affected by any of these issues please call Amy for confidential, expert advice on 020 3114 1127 or email her at amyl@duncanlewis.com or telephone 020 3114 1147.

Duncan Lewis Solicitors

Duncan Lewis is an award-winning Times Top 250 law firm, which is ranked as Top Tier by both the Chambers and Partners and Legal 500 directories. The company represents clients in more than 25 practice areas across 13 key offices nationwide. This year the company was crowned Law Firm of the Year at the Lexis Nexis awards 2024 and has been noted for its commitment to diversity and inclusion.