Claim for failure to implement patient consent rules before removing appendix

We recently settled a substantial claim for damages for a client who was not given appropriate options when consenting for surgery for removal of his appendix.

Unusually this case proceeded on the issue of lack of informed consent alone. There was no criticism made of the decision to recommend surgery or of the technical performance of the surgery.

Our client attended East Surrey Hospital having been referred by his GP who suspected possible appendicitis. After assessing the claimant, the hospital doctor concluded that appendicitis was the most likely diagnosis and that he needed surgery. Our client gave consent for an open appendectomy. According to his evidence, he specifically asked this doctor about the option of a laparoscopic (keyhole) approach as he understood the surgery and recovery to be less extensive. He was due to get married shortly and wanted to ensure that he would be fit for his wedding.

After being advised that a keyhole approach was unsuitable for him because he was ‘too big’ and an open approach was the only option, our client consented to the open approach to remove his appendix and surgery went ahead.

Following the surgery, our client suffered significant and ongoing problems including wound infection, extensive scarring and recurrent incisional hernias. These difficulties had an impact on his wedding and honeymoon and he required multiple additional surgical procedures. He has been left with long-term pain and restriction in his day to day life.

Our client initially instigated a complaint but was unhappy with the response and then instructed us to look into a claim for him. Investigations and expert evidence ascertained that the decision for surgery and the performance of the surgery were appropriate and that all the problems that he had suffered were recognised complications of the open procedure that he had.

However, expert evidence obtained by our clinical negligence team was that he should have been given the option of a laparoscopic approach and that this was a credible option for him at that time. We therefore pursued the case on the basis that our client was not given appropriate information about the options available to him and the relative risks and benefits. It was his case that had he been given the option, he would have had a laparoscopic approach, and that while this would have carried a risk of complications, on the balance of probabilities, he would not have had the same outcome.

The trust denied any failings in the care and argued that an open procedure was more appropriate. Court proceedings were issued and the case proceeded on to within weeks of a High Court trial. Eventually the defendant engaged in negotiations and the matter was settled for a substantial sum.

Return to case studies