Horrendous symptoms for mother whose fourth degree obstetric tear was classed as minor
Helen Thompson secured an admission of liability for a woman whose fourth-degree obstetric tear was misdiagnosed as only first-degree following failures in the maternity unit at Royal Cornwall Hospital.
While delivering her second child, the baby's shoulders became stuck, and an emergency was declared for shoulder dystocia. But with manoeuvres performed, Miss A was able to deliver her baby vaginally. The baby was large, weighing 4.2kg.
Following delivery, a senior midwife examined Miss A and diagnosed a first-degree tear - a minor tear involving only the skin of the perineum. Despite factors of a large baby and shoulder dystocia which increase the risk of more severe tears, the midwife did not reconsider the diagnosis. Miss A was told that no stitches were required for the tear.
While Miss A remained on the postnatal ward, she complained repeatedly to midwives of severe pain in her perineal area such that she could barely walk, heavy bleeding and wind 'falling out' via her vagina (all indications of a more severe tear) but midwives did not examine her and reassured her that she only had a first degree tear.
Before being discharged from hospital, Miss A also raised her concerns about extremely severe pain on passing a bowel motion (another symptom of damage to the anal sphincter muscles with a more severe tear) but she was still not re-examined and was discharged.
At home, Miss A continued to experience heavy bleeding, severe pain and soreness in her perineal area, faecal urgency and incontinence of wind. Her genitalia did not feel right and so she examined herself. She noticed that there was no skin (perineum) between her vagina and anus and that she was split/ripped from vagina to her back passage.
The day after leaving hospital, Miss A contacted the community midwives to raise her concerns about the appearance of her genitalia. She was again told that she had only had a first-degree tear. There was no offer to have her reviewed. Miss A did not receive the community midwife follow up appointments she was supposed to.
At one month after giving birth, Miss A was still experiencing the same symptoms. Once again, she contacted the community midwives, only to be told that she now needed to be signed off from their care and that she should see her GP.
Miss A was examined by her GP two days' later and immediately referred to gynaecology due to concerns that a more severe tear had been missed.
Nearly five months after delivery, Miss A was seen in the in the obstetric tear clinic at the hospital. Following examination and tests, it was confirmed that Miss A had in fact sustained a fourth-degree tear (the most serious type) during her delivery and this had been missed. The hospital commenced an internal investigation.
Nine months after delivery, Miss A underwent surgery to reconstruct the perineum and repair the anal sphincter muscles, but the repair broke down and she required further surgery to create a colostomy.
Miss A suffered multiple complications with the colostomy which significantly impacted her mental health. She underwent further surgery 9 months later to reverse the colostomy. As a result of the missed diagnosis and delayed repair, Miss A has been left with ongoing symptoms of faecal leakage, faecal urgency and perineal pain. She will require interventions for the rest of her life to manage her symptoms.
A Letter of Notification of Claim based on the Trust's internal investigation findings was sent to the Trust which made an admission of liability. It admitted that following delivery, the tear should have been categorised as fourth-degree which would have led to earlier repair surgery.
Helen secured an interim payment of damages for Miss A to enable her to start accessing private input and therapy to help with her ongoing symptoms.
The claim will now be quantified and hopefully a swift settlement will be agreed with the Trust.
Contact us
For further information about perineal tear claims and midwife negligence claims please call Helen Thompson on 03304606765 or email helen.thompson@fieldfisher.com.
Alternatively
- You can speak to our medical negligence solicitors on freephone 0800 358 3848
- email us: personalinjury@fieldfisher.com
- Complete the short online enquiry form
All enquiries are completely free of charge and we will investigate all funding options for you including no win no fee. Find out more about no win no fee claims.
