Post-operative catheter care in private hospital injury leads to five-figure settlement

The woman, who we will call Rebecca, underwent surgery at a London hospital to investigate and treat suspected endometriosis and uterine fibroids. Before the operation, she was a healthy woman with no prior history of bladder problems.  

During the procedure, a urinary catheter was inserted to allow the medical team to monitor urine output and drain the bladder after surgery.

In the hours following the operation, Rebecca experienced increasing pain and repeatedly reported feeling that she urgently needed to empty her bladder.  

Rebecca states that nursing staff reassured her that her symptoms could not be related to her bladder since she already had a catheter in place. She was given pain relief on several occasions, but no meaningful investigation of the catheter appears to have been undertaken. 

Later, another nurse manipulated the catheter tubing and a significant volume of urine drained, suggesting that there may have been a problem with the catheter’s function.

The following morning, after the catheter was removed, Rebecca stated that she continued to report bladder fullness, discomfort and an inability to pass more than a very small amount of urine. Despite these complaints, no bladder scan was performed and there was no documented assessment of whether Rebecca was emptying her bladder properly. She remained in hospital for an additional night and was discharged the next day without any formal assessment of her bladder function.

Over the next few days, Rebecca’s symptoms worsened. She developed increasing urgency, hesitancy, weak urinary flow and an inability to empty her bladder normally. She sought medical advice and was advised to try home measures including laxatives and warm compresses.

Soon after, Rebecca attended A&E. A bladder scan revealed severe urinary retention. After a catheter was inserted, almost two litres of urine was drained from her bladder, with the average normal bladder capacity being around 500ml.

Rebecca continued to suffer urinary problems in the months that followed, including urgency, frequency, hesitancy, disturbed sleep and a sensation of incomplete emptying. She also developed urinary tract infections and required lengthy treatment and specialist review. 

Although her symptoms gradually improved, Rebecca’s recovery took many months and was accompanied by considerable anxiety about her future health and quality of life.

Independent expert evidence obtained during the claim criticised several aspects of the post-operative care. It concluded that there were failures to adequately monitor fluid balance, failures to investigate Rebecca’s reports of pain and bladder symptoms, failures to check and manage the catheter appropriately, failures to carry out a bladder scan following catheter removal, and failures to recognise the signs of acute urinary retention when she sought advice after discharge. The experts considered that these omissions led to the bladder injury that Rebecca ultimately suffered.

Rebecca instructed Michael Roberts, senior associate solicitor in Leigh Day’s medical negligence team, to investigate and pursue a claim against the hospital. The defendant formally denied liability for Rebecca’s injuries, but following a period of negotiation, a five-figure settlement was agreed.

Counsel was Rajkiran Arhestey of One Crown Office Row Chambers.  

Michael Roberts said:

“Rebecca’s case serves as an important reminder that safe healthcare depends not only on successful surgery, but also on careful monitoring, good communication and prompt recognition of warning signs after an operation, even where the operation has gone well. Post-operative urinary retention is a recognised complication and, when detected early, can often be treated before debilitating injury occurs. Rebecca unfortunately sustained an injury that, in our view, was entirely avoidable. We are glad that her pain, suffering, and losses have been recognised through this settlement.”