Failure to diagnose, appropriately assess and treat a Bartholin's Cyst

Posted by Patricia Wakeford on

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Mrs D complained of a lump from early 2011 and was referred by her GP to her local trust. She had an initial assessment shortly after this. The GP had sent a comprehensive referral letter outlining the problems and the GP's concerns.

The trust clinician considered that Mrs D had endometriosis and recommended surgery. Mrs D was too tender to be internally assessed. Despite this, no further assessment was made and no colorectal input requested. The trust admitted that an MRI should have been performed pre-surgery. Mrs D's case was that if an MRI had been performed and colorectal input obtained pre-surgery; this would have diagnosed a Bartholin's cyst, which required over sewing only. Histology failed to identify endometriosis. Mrs D would have avoided the fistula, ileostomies, hernia and numerous subsequent surgeries.

Within three weeks of surgery Mrs D was leaking faeces through her vagina and a fistula was noted. She was provided with antibiotics and told to return in six weeks. During this time she suffered considerable psychological symptoms.

Three months after the leakage was noted Mrs D had an ileostomy formed. Unfortunately the fistula still did not heal. Over the next four years she had numerous examinations under anaesthetic and further attempts at operative intervention to repair the fistula.

Recently Mrs D was advised that the fistula had healed. Her ileostomy was reversed and she saw an end to surgeries. She was horrified to note further leakage within weeks. She returned to the Trust who confirmed that the fistula remained patent. She required the formation of another end ileostomy. She also has issues with a hernia.

She has been advised that either she can have surgery which may leave her faecally incontinent for life or have the ileostomy reversed and hope that the fistula will heal. She has opted for the latter being the lesser of what she terms two evils. Mrs D returned to work with very little rest after surgeries as her income helps to support her mother.

Mrs D suffered psychological issues which required counselling initially and will need more intensive treatment going forward. Expert evidence was obtained from a Gynaecologist, Colorectal surgeon and a Psychologist.

Negotiations commenced recently following a cost case management conference. Mrs D agreed to accept £70,000 as she wants to bring an end to the litigation. This will enable her to concentrate fully on her physical and psychological health.

For further information please contact Patricia Wakeford, Associate in the Clinical negligence team, contact details below.

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About the Author

Patricia is a Senior Associate, in our Clinical Negligence team, and is also a qualified midwife with many years of experience working in the NHS.

Patricia Wakeford
Email Patricia
023 8085 7310

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