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Ruptured appendix payout after client's symptoms ignored and dismissed by hospital

Client left with persistent health problems after her appendix burst

Posted on 13 November 2013

Clinical negligence lawyer and Leigh Day partner Suzanne White has secured a substantial sum of compensation for her client who has been left with fertility problems, anxiety, pain and scarring following a ruptured appendix.

Ruptured appendix: background to the case

Suzanne’s client (X) woke with extreme abdominal pain which she endured for two days before visiting her GP who after examining her concluded that her patient was suffering either from appendicitis, or another abdominal problem. The GP contacted St Mary’s Hospital in London, and spoke to the surgical Senior House Officer (SHO), who agreed that X should be admitted to the hospital’s rapid assessment unit.

The GP sent a referral letter to the SHO stating that she believed X was suffering with appendicitis and X duly attended the hospital’s accident and emergency department at 14:50.

X was seen by the SHO at 16:00 who examined her but considered that she was suffering from abdominal pain of an uncertain cause. The SHO considered that X should have an abdominal and pelvic ultrasound, but X was unable to be seen before 17:00. By 18:25 she was in extreme pain and was unable to walk.  She underwent an ultrasound scan, but not having been told that she should have a full bladder during this procedure, her appendix was not seen.

At 20:00 X was seen by a Specialist Registrar (SR) in the presence of six other doctors and students. X was told that she was definitely not suffering from appendicitis.  X was by this stage extremely distressed having found the consultation overwhelming, she was still in pain and worried about what was wrong with her.  She asked to be examined by another doctor and was seen by a Surgical SHO at 21:00 when she was reassured that it was extremely unlikely that she had appendicitis based on the examination, her history, blood tests and ultrasound scan results. She was advised to take paracetamol and was discharged home.

X continued to suffer with excruciating pain which became much worse three days later when it subsequently emerged her appendix perforated. She attended the accident and emergency department of another hospital and was finally diagnosed with appendicitis.  X then underwent a laparoscopy, with a plan to perform an interval appendectomy three months later.

Unfortunately X continued to suffer from abdominal pain and had to attend the accident and emergency department several times for treatment and pain management and underwent further procedures and operations

Medical negligence claim

Suzanne argued that X had received negligent treatment at St Mary’s Hospital.  X should not have been discharged and the Special Registrar should have known that some 50% of appendicitis cases present atypically.  Additionally the SR should have considered her client’s CRP level (C-reactive protein level, indicating there could have been appendicitis). Suzanne claimed that if X had been kept in overnight on the day she first visited St Mary’s Hospital it was likely that a correct diagnosis would have been made, and that X’s appendix would not have ruptured, could have been removed through laparoscopic procedure, and that X would have made a full recovery, with no long-term problems.

Imperial College Healthcare NHS Trust agreed to pay a six-figure sum of compensation to X to settle her claim.

Suzanne said of the case:

“Despite concerns from my client’s GP and a letter of referral to St Mary’s stating that X was probably suffering from appendicitis, X’s symptoms were ignored and dismissed by a number of medical staff. X was discharged in terrible pain and distress and suffered a ruptured appendix which has left her with on-going pain, fertility problems and scarring.  My client made a complaint to the Trust who refused to accept that she had received substandard care. I am pleased that my client has received compensation for the poor care she received, but disappointed that yet again an NHS Trust refused to admit that one of its hospitals had provided negligent care. It took a medical negligence compensation claim to prompt the Trust to finally pay my client the compensation to which she was entitled.”