Swab left inside patient following episiotomy repair

This case study demonstrates the expertise of our Clinical Negligence team who recently recovered compensation for a patient who had a surgical swab left inside her following an episiotomy.

An episiotomy is usually a very simple operation. Local anaesthetic is given into the area around the vagina, or if an epidural anaesthetic (painkiller injected into the spine) has already been given, it may be topped up. A cut is made from the midline of the back of the vagina and directed diagonally down and out to one side. This is called a mediolateral incision.

After birth, the cut is repaired. Dissolvable stitches are used so they don’t need to be removed.

The claimant gave birth to her son at Pembury Hospital in August 2009. Forceps were used to assist delivery and the claimant underwent an episiotomy.

The next day, the patient and her son were discharged and returned to their home in Crowborough, East Sussex. She experienced pain when sitting down to the extent that she was taking eight paracetomol per day to control it. She had an unusual discharge.

She saw her GP for her six week post natal check who noted that the episiotomy site was still very sore and that she had some brownish-green discharge. She was prescribed antibiotics.

The claimant returned to her GP a few weeks later and advised that she was still suffering from heavy discharge and lower abdominal cramps. The GP performed a speculum examination and saw that there was a foreign body in the vaginal vault. The foreign body was removed and this was discovered to be a surgical pack which was not removed following the episiotomy repair.

The pack was sent for testing. The claimant had to continue with antibiotics. It was only when the claimant returned to the GP for her surgical smear three months later that she was able to be reassured that there was no infection.

The GP was sufficiently concerned to write to Maidstone & Tunbridge Wells NHS Trust about the incident. The claimant also made a complaint. However, due to the length of time she had to wait for a response, she decided to approach Thomson Snell & Passmore, as local clinical negligence specialists.

We were able to act for the claimant on a conditional fee agreement (no win no fee). We obtained copies of her GP and Hospital records. We obtained a copy of the assisted delivery note from the medical records and this indicated that the doctor had undertaken a swab count at the end of the surgery. This clearly was not the case.

We wrote a Letter of Claim to Maidstone & Tunbridge Wells NHS Trust setting out our client’s case. We alleged negligence on the part of the Trust for failing to undertake a swab count following the episiotomy repair. We asserted that this amounted to indefensible conduct. At the same time, we put an offer forward to the Trust to settle the claim in the sum of £3,000.

The offer was accepted by the Trust and the claimant received £3,000 in compensation plus payment of her legal costs.

This case is a typical example of retention of a foreign body following surgery.