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Birth Injury Case Studies

Blunt Episiotomy Causes Undiagnosed Tear

While giving birth, Paulina was subject to a blunt episiotomy. This directly contributed towards a third degree tear, an injury which was not diagnosed and repaired.

On 15th August 2009, Paulina went into labour with her first child. She became fully dilated but the labour did not progress so the registrar decided to perform an episiotomy. The registrar made one cut, which should be enough for an episiotomy.

However, the scissors were blunt and another two cuts were required. Furthermore, the cut was made straight downwards, rather than diagonally to the side. This is no longer accepted practice in the UK as midline episiotomies are known to increase the risk of perineal tears.

After the birth, the episiotomy wound was sutured together. Unfortunately a digital rectal examination was not performed, but if it had, it would have revealed that Paulina also had a third degree tear.

As it was, Paulina was discharged from hospital the following day with an undiagnosed and unrepaired tear. Due to the negligent episiotomy and third degree tear, she quickly began to develop physical complications.

The episiotomy wound did not heal very well. The scarring is unsightly and caused Paulina considerable pain. She also began to suffer faecal urgency and incontinence of flatus. She found that, upon needing to pass faeces, she had just minutes to reach a toilet, or she would experience an episode of faecal incontinence.

This caused Paulina to develop severe psychological problems. She became very depressed, was scared to resume sexual relations with her husband, and was afraid to leave the house. In the two years following the birth, her psychological condition deteriorated to such an extent that she suffered a serious psychotic episode and had to be admitted to hospital.

During this time, Paulina had also been seeking medical attention for her incontinence issues. She was eventually referred to a general surgeon who performed an endoanal ultrasound. Only then was it discovered that Paulina had a defect in her internal anal sphincter and scarring of the external anal sphincter. This amounted to a third degree tear.

Paulina has since undergone treatment for her missed third degree tear, including physiotherapy, biofeedback and medication. Unfortunately this has had little impact upon her symptoms and she continues to struggle with faecal urgency. This has had a terrible effect upon every area of her life, limiting her ability to work and socialise.

After contacting us to discuss her options, we advised Paulina that she had been subject to a negligent episiotomy, as it was a midline cut made with blunt scissors. This directly contributed towards her suffering a third degree tear, which should have been diagnosed shortly after the birth with a digital rectal examination. Failing to diagnose and repair a third degree tear also amounted to medical negligence.

This substandard level of medical care caused Paulina to experience terrible physical, emotional and financial injuries. We helped her pursue a claim against the negligent hospital. She was awarded over £65,000 compensation.

(Details which might identify our client have been changed.)

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"Before we contacted you we had no real idea that we had grounds for a medical negligence claim but after speaking to you if became clear that Wendy was indeed treated poorly. Chris took the time to explain what was happening and kept us to speed. Our deepest gratitude to you all and Chris in particular."

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