Clinical Negligence

Negligent prostatectomy and Argus sling surgeries

Our client, Mr K, suffered from incontinence, infections, severe pain and psychiatric harm after a number of failures by his urology consultant including the performance of a procedure which had been unauthorised and not licenced by the PCT.

Mr K was 65 years old when he was diagnosed with prostate cancer and underwent a laparoscopic radial prostatectomy (removal of the prostate) for cancer of the prostate.

During the surgery Mr K’s bowel was perforated and he required a loop colostomy (where the bowel is bought up to the surface of the abdomen, in essence redirecting the faeces into a pouch).  Mr K was then not allowed out of bed for a week despite making repeated requests to be allowed to walk around.  He was not referred to a physiotherapist for 8 days and throughout this period suffered with chest problems.

A CT scan was not carried out until 2 weeks after his surgery which revealed that Mr K was suffering from a pulmonary embolism (a blockage in the pulmonary artery).  He was placed on antibiotics and blood thinners but unfortunately was given an overdose of this and suffered a bleed as a result.

There was a delay of an extra week before Mr K’s urinary catheter was removed.  Mr K stated that this delay led him to become incontinent of urine as he was not able to start his pelvic floor exercises until this was removed.

4 months after his original surgery the colostomy was reversed.  However, Mr K continued to suffer with urinary incontinence.  4 months later he underwent a procedure whereby an Argus sling was fitted.  This is an implant which allows adjustment of the bulbar urethra, allowing the urethra to remain closed during the filling phase, thus stopping any leakage.  Once the bladder is full contraction of the detrusor muscle is stimulated and the patient can voluntarily and consciously pass urine.

However, after the procedure Mr K was left in excruciating pain, to such an extent that he was unable to sit in a chair.  There was some improvement in his incontinence initially but this rapidly worsened.  6 weeks later Mr K went for his follow up and the consultant found that part of the implant was exposed through the surface of the skin.  He recommended that Mr K undergo another surgery to adjust the sling.

Mr K underwent two pre-operative assessments and was due to undergo the adjustment surgery when he was informed that the original Argus sling surgery was unauthorised and not licensed by the Primary Care Trust.  He was told the consultant could do nothing further for him.

Mr K’s GP complained on his behalf and the adjustment surgery was rescheduled.  During the procedure Mr K was found to have an infection; despite this the consultant left the implant in place.  After the surgery Mr K remained in pain.  Later the implant had to be removed which relieved Mr K’s pain but left him grossly incontinent again.

He later underwent the insertion of an artificial urinary sphincter device (AUS) at a different hospital.  It took some time but after a few adjustments this made a big difference to Mr K’s incontinence.

Unfortunately he then developed an infection and the AUS had to be removed.  He was once again grossly incontinent.  He had to wait a further 5 months for things to settle before he could attempt to have a further AUS fitted.  Because of the level of scarring from the previous infection the device was not as successful at managing his incontinence this time.

Within 6 months it was clear that the 2nd AUS had also become infected and was removed.  Mr K’s gross incontinence returned causing him considerable distress.

The team acting on behalf of Mr K, had a particularly difficult time instructing an expert with the right expertise to report on the Argus sling surgery.  Finally an expert was found and his report found a number of breaches of duty by the original surgeon.

Reports were also obtained from a psychiatrist who confirmed Mr K was suffering from chronic mild to moderately severe adjustment disorder characterised by anxiety and depressive symptoms.

The team were able to successfully negotiate a settlement of £140,000 for Mr K to compensate him for his considerable pain and suffering and to pay for any future treatment he may require.

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