The Plaintiff, a woman in her 30s, suffered sudden onset of abdominal pain in her upper right quadrant associated with vomiting. She called her local out of hours GP service who directed her to attend the Emergency Department of her local regional hospital. The Plaintiff duly attended the Hospital where she was triaged and admitted under the care of the surgical team. She was noted to have severe abdominal pain, vomiting and raised white cell count and raised CRP levels. A working diagnosis of acute cholecystitis (inflammation of the gallbladder) was made and a pelvic ultrasound was organised for the following day. At no time during her admission did any of her treating doctors query whether she might be suffering appendicitis. She was also prescribed a course of intravenous antibiotics without any apparent reason set out in her records. The ultrasound was noted to be normal and a further ultrasound arranged. This demonstrated a large pelvic mass which was assumed (incorrectly) to be a large ovarian cyst and the Plaintiff was referred to the Gynaecology team.
The Plaintiff remained under the care of the gynaecology team for a number of days before being discharged with an outpatient’s appointment for 6 weeks’ time. 2 days later the Plaintiff was re-admitted to the hospital, again complaining of severe abdominal pain. She was also noted to be running a slight temperature. She was again admitted under the care of the gynaecological team who decided to carry out a laparoscopic investigation of the mass in her pelvis as there was a concern that she may have been suffering from ovarian torsion. The Plaintiff was brought to theatre the next day and the procedure commenced. It became apparent though that there was a significant pathology involved in the Plaintiff’s abdomen and the surgical team were called in and the procedure converted to an open laparotomy. A large gangrenous mass was seen involving loops of the bowel which required extensive dissection. Approximately 2 litres of pus was also required to be drained and an extensive peritoneal washout required. Unfortunately, the Plaintiff required a colostomy due to the damage caused to a portion of her colon. The Plaintiff spent a further 7 days in hospital before being discharged. She was re-admitted some 3 months later and her colostomy was reversed. The Plaintiff continued to suffer from chronic pain as well as having an unsightly and extensive scar on her abdomen. It transpired that the Plaintiff had in fact been suffering from appendicitis and that her appendix had in fact ruptured a few days following her first admission to the hospital.
The Plaintiff instructed Augustus Cullen Law who obtained supportive expert opinion from a Consultant General Surgeon based in Liverpool which criticised a number of aspects of the Plaintiff’s care in the hospital including the failure to consider a diagnosis of appendicitis when she was first admitted to the hospital as well as the decision to discharge her from the hospital in the face of a number of raised inflammatory markers. Further, he was of the view that had appropriate care been provided, the Plaintiff would have undergone a laparoscopic appendectomy within 2 days of her first attendance at the hospital which would have prevented the rupture and requirement for extensive abdominal surgery.
The case was progressed to trial within 16 months of issuing proceedings and settled on the day of trial for the sum of €325,000 and costs without admission of liability.
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09 November 2013