Andrew McLaughlin successfully defended a claim on behalf of Cwm Taf Health Board on the alleged negligent performance of gynaecological surgery resulting in damage to a ureter and ultimately the complete loss of function of a kidney. The critical aspect of the case was to identify where the damage had occurred during the hysterectomy and oophorectomy. A laparoscopic approach was used down to the taking of the uterine pedicles.
HHJ Beard accepted that at this point the ureter was not visible due to being concealed within the cardinal ligament and that on reflection the bladder, although upward movement of the uterus mitigated the risk of inadvertent damage, it was not foolproof. There remained a very small residual risk of thermal injury to the ureter due to its proximity to the uterus. The claimant failed to prove the damage was caused by substandard surgical technique.
The court could not infer that the surgeon had not exercised reasonable care merely because damage occurred. Breach of duty was admitted in relation to a failure to take full informed consent but she was aware the procedure carried risks to important structures other than the ureter and agreed the claimant would have had it anyway. Accordingly the claim was dismissed.
Andrew undertakes complex clinical negligence work involving difficult issues surrounding breach of duty and causation primarily on behalf of NHS Trusts in England and Local Health Boards in Wales. Find out more here.