Settlement against Pennine Acute Hospitals NHS Trust for negligent insertion of transvaginal tape

We have recently settled a claim against the Rochdale Infirmary for a client who was not properly informed of the risks associated with the use of transvaginal tapes (TVTs).

Immediately following surgery, our client suffered from an extremely overactive bladder, and shooting pains in her groin and experienced pain upon sexual intercourse.

Our client, who was aged 35 at the time of the operation, first visited her GP with symptoms of mild stress incontinence that had been present ever since giving birth to her children. She found that she would leak when taking part in any strenuous exercise, such as running. Her GP referred her to a consultant gynaecologist at the Rochdale Infirmary.

On 4 November 2015 our client was seen at the Rochdale Infirmary and informed that she would need a TVT. However, she was not informed of any other treatment possibilities for her stress incontinence, or of the potential risks associated with the procedure. She was not given any information leaflets about how the procedure worked, nor any information about the permanent nature of the TVT procedure. Possible risks of TVT insertion include pain due to erosion, dyspareunia (pain during intercourse), an overactive bladder, and voiding difficulties as well as the risk that potential further surgeries may be needed due to the permanence of the mesh used. Our client was not informed of any of these risks.

Prior to surgery, our client was advised to attend a few sessions of pelvic floor physiotherapy. She was also due to undergo urodynamic studies; however, when she attended her appointment, the urodynamics machine did not work properly. The consultant told our client that he did not need to see the results of this study to know that she needed a TVT.

On 4 November 2016, our client underwent the fitting of a TVT. A consent form was given to her after she had been prepped for theatre, which she signed without having had any discussion with the consultant about the risks stated on the form. The consent form did not include many of the risks known to be associated with the insertion of a TVT.

Unfortunately, after surgery our client experienced immediate shooting pains in her groin, an overactive bladder and pain above her right hip. Her recovery was complicated by regular urinary tract infections and she was extremely uncomfortable.

Shortly after the surgery, our client returned to see her consultant who informed her that her mesh had eroded. Our client visited another consultant and was told that due to the level of TVT erosion, she required surgery to have the mesh removed.

Investigations were carried out as part of a clinical negligence claim, led by our specialist team, and it was alleged that there were failures by the Pennine Acute Hospitals NHS Trust to properly inform our client of the risks associated with her surgery. Additionally, expert evidence outlined that our client did not need TVT surgery and would have instead benefitted from continued courses of pelvic floor physiotherapy and less invasive treatments. Had our client understood the risks and known of the alternative possibilities, she would have considered these instead of TVT insertion and therefore avoided the unnecessary pain and suffering she experienced following her surgery.

The defendant accepted that our client was not appropriately informed of the risks associated with the surgery and was therefore unable to give her full and informed consent. However, the trust sought to argue that even if our client had been advised of the risks associated with the procedure, she would have proceeded with the surgery in any event.

Following further discussions with the defendant and negotiations, we are pleased to have reached a settlement for our client and to have achieved a resolution which compensates her for the unnecessary procedure she underwent and the unfortunate symptoms that followed.

Our client was pleased that the defendant acknowledged the failings in respect of the information she was given regarding her surgery and it is hoped that, going forward, the defendant trust will ensure that patients undergoing any form of urogynaecological procedure are given the appropriate information regarding the proposed procedure so that they can make a well-considered and informed decision as to whether or not to proceed.

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