Failed laparoscopic surgery

Medical history

A 36-year-old woman was referred to a consultant gynaecologist for laparoscopic sterilisation. Before the operation the patient was seen by a clinical assistant who explained the procedure and also warned that there was a failure rate of around 1:200. The sterilisation was performed two days later. In his notes the surgeon recorded '...bilateral tubo-ovarian adhesions – uterus retroverted – bilateral fallope ring application...' The patient was discharged the following day.

Ten months later the patient consulted her GP about headaches. The GP thought these were migraine and prescribed propranol. Two weeks later the patient again visited her GP complaining of nausea and vague colicky pains, which had started since taking the propranol. The GP prescribed maxolon and noted that the patient's period was ten days late. A pregnancy test was arranged, which proved to be positive. After further consultation, the patient decided to go on with the pregnancy and the baby was born approximately seven months later.

The following year the patient was admitted to hospital for a further sterilisation. At this operation it was noted that there was no evidence of scarring on either Fallopian tube. The fimbrial ends were healthy and the round ligaments normal, as were the uterosacral ligaments. One of the Fallopian rings was found attached to the posterior aspect of the uterus, just above the attachment of the left uterosacral ligament. The other was found lying free in the Pouch of Douglas. A dye test showed both Fallopian tubes were patent, while the histology report found that both Fallopian tubes were complete.

Negligence alleged

The patient alleged that the sterilisation had been carried out negligently. As a result she had become pregnant and had the strain of an unplanned pregnancy. She had suffered from postnatal depression and this had affected her promotion prospects. The patient also claimed compensation for the additional expense associated with bringing up another child.

Expert opinion

The MDU obtained expert opinion from an independent consultant gynaecologist. He felt that while detachment of the Fallope rings was a recognised problem with laparoscopic sterilisation, the case would be difficult to defend as both Fallopian tubes had remained '...apparently normal without any signs of constriction on either side...' It would therefore be '...difficult to say that the Fallope rings had been properly placed initially...'

Outcome

After discussion with the member the case was settled out of court by a payment of £55,000. Payments for failed sterilisations have generally reduced since the Macfarland case which ruled that compensation cannot be claimed for the costs of raising a normal child.

This page was correct at publication on 01/01/2002. 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.