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Fistula After Poor Repair of 4th Degree Tear

Fistula After Poor Repair of 4th Degree Tear

An incompetent repair of a 4th degree tear has left a new mother with distressing and life-limiting on-going bowel symptoms.

During the course of the delivery of Anna' s first baby, her medical practitioners decided that an instrumental delivery would be necessary. A suction cap did not achieve the delivery of the baby so forceps were used with an episiotomy. Thankfully, a healthy baby was born.

Immediately after the birth, however, Anna' s consultant told her that she had suffered a small 4th degree tear, affecting her perineum and anus. Unusually, a colorectal surgeon was called to undertake the repair instead of an obstetrician.

The following day, sadly, Anna became aware that she was having difficulty controlling her bowel. Within another two days, she began to experience faecal leakage via her vagina. This was extremely distressing and worrying for her. An examination revealed that Anna had a rectovaginal fistula. This is an abnormal hole between the vagina and bowel which allows waste matter which is normally dealt with by the bowel to leak out unnaturally via the vagina.

A further examination by a different surgeon was followed a week later by secondary surgery - lasting six hours - to repair Anna's injuries. This procedure identified that, in fact, Anna had a large fistula between her rectum and vagina as well as damage to both her internal and external anal sphincter muscles, which control her bowel movements.

This suggested that Anna's original surgeon - the colorectal surgeon - had carried out a substandard repair of her 4th degree tear which had allowed the development of a fistula to occur.

Despite the secondary surgery, Anna continued to experience severe pain in the perineum and had to return to hospital again where it was discovered that she still had a defect in her perineum and that she would need to have a temporary colostomy bag fitted while her injuries resolved.

Anna understandably found this development extremely distressing. As it turned out, in fact, her 'temporary' colostomy bag remained in place for two years which had a significant impact on Anna' s quality of life.

Anna still continues to suffer distressing and debilitating symptoms which would very probably not have happened had her initial tear repair been competent.

Most significantly, Anna continues to suffer with great urgency when needing the toilet as well as wind incontinence. As a result, she has not been able to return to her previous area of employment which involved regular contact with the general public.

Additionally, Anna has had to restrict her social activities drastically and has become increasingly limited in her confidence in leaving her home, meaning that she is unable to support her child in the social activities desirable to his development.

We supported Anna in her claim for compensation for her substandard care and she was awarded in excess of £500,000 in compensation.

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

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