A claim comes out of the past

A 30-year-old married man with seven children decided in discussion with his wife that their family was complete and that the most practical course was for him to undergo a vasectomy.
 
The patient, who lived in Ireland, was referred to a GP and MDU member who had a particular interest in this field. After discussion of what the operation entailed the patient gave consent and the procedure was carried out two weeks later.
 
The patient later described pain during and after surgery which persisted and three days later he went to his regular GP who could find nothing abnormal.
 
The pain continued and two weeks later, the patient attended the GP who had carried out the vasectomy. On this occasion the doctor's notes showed that he simply prescribed a mild to moderate painkiller. He did not record any sign of infection or haematoma and advised the patient to return in the event of any further difficulty.
 
Subsequent negative sperm tests revealed that the vasectomy had been a success.
 
In April of the following year the plaintiff attended hospital where a senior clinician diagnosed granuloma. An operation for sperm granuloma was carried out but did not improve the pain. A year later, the patient was diagnosed with congestive epididymitis for which he underwent an epididymectomy in the United States. Two years after this, an orchidectomy was carried out and a prosthesis was inserted. However, the prosthesis was rejected and subsequently removed.
 
During this time, the patient began to drink heavily and made an attempt on his life. Nearly six years after the orchidectomy, the patient took further advice and was diagnosed with sperm granuloma of the spermatic chord. Reversal of the vasectomy was suggested as a way of relieving the pain.
 
Two years after the vasectomy was performed the MDU member received notification of a claim alleging that he had failed to give any warning as to the risk of pain, specifically long-term pain and that if he had the patient would never have consented to the operation.
 
The patient alleged that he asked the defendant whether there were any potential problems with the procedure and was told, "there are no problems whatsoever". He claimed that as the procedure was performed his back was arching up with pain.

The outcome

 

The case eventually reached court fifteen years after the claim was first submitted.
 
The GP accepted that after seventeen years he had no specific recollection of the plaintiff or the consultations. He was however able to rely upon a written checklist in an aide memoire written at the time of the consultation. Importantly the GP had initialled each heading/sub-heading on the document, which included reference to the risk of residual pain.
 
The MDU sought advice from an expert who has carried out some 10,000 vasectomies. He considered the aide memoire form used by the defendant was "both extremely useful and thorough".
 
His view was that it would be hard to say that it missed out any of the risks associated with the procedure.
 
He was not critical about the form of warning which the doctor described, as to risk of short, medium and long-term pain.
 
At trial the judge commented on the difficulty of establishing disputed facts so long after the events. He referred to the need to look at contemporaneous written records in order to ascertain which version given to the court was more probable. He concluded that the patient had not satisfied the court that his version of events was more probable and that there was no reason to suspect that the doctor had deviated from his usual practice of warning the patient about the risks of the operation.
 
On the issue of causation, the judge said he was not persuaded that the patient would not have undergone the procedure if he had been warned about the risk of residual pain.
 
While he expressed deep sympathy with the patient and his wife for the series of operations, the effects of which were both painful and distressing, the judge concluded that on the evidence the doctor was entitled to a finding that negligence had not been established and dismissed the case.

This page was correct at publication on 01/05/2009. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.