Failure to detect and treat perforated colon

The senior house officer identified surgical emphysema (gas in the tissues beneath the skin which is indicative of a bowel perforation) and requested a senior review. The Registrar reviewed Mrs Dodd later that morning and concluded that everything was stable and the drain could be removed.

Mrs Dodd was then not reviewed until the afternoon of January 21st where she was found to be short of breath, had a chesty cough, low blood pressure and a distended and tender abdomen. A surgical specialist registrar reviewed a few hours later and suspected a bile leak with biliary peritonitis.  Mrs Dodd was taken for emergency surgery that evening where she was found to have a perforated colon and by January 23rd had developed sepsis. 

Mrs Dodd underwent further emergency surgery on January 24th where she was found to have a bile leak. This was repaired but her condition ultimately continued to deteriorate and she passed away on February 9th as a consequence of multi-organ failure.

It was alleged that although the perforation of the colon was a recognised complication of the cholecystectomy, it was negligent to fail to detect and subsequently treat the perforation until January 21st.  It was further alleged that had the perforation been detected on January 19th or 20th then Mrs Dodd would have made a full recovery.

We were contacted by Mrs Dodd’s daughter and started court proceedings against Mid Cheshire Hospitals NHS Foundation Trust. An out of court settlement for Mrs Dodd’s Estate and Mrs Dodd’s surviving husband was agreed. This was on the basis that it was admitted that had the perforation been detected on 19th or 20th then Mrs Dodd would have made a full recovery. However the Trust denied that there were any signs prior to January 21st to indicate that Mrs Dodd had suffered a perforation.