Mrs C who at the time of the accident was aged 63 had a mildly complicated medical history manifesting signs of gallbladder pathology such as to warrant keyhole surgery for removal of a gall stone. The consent for the procedure “bleeding, infection, injury to the bile duct, bile leak, deep venous thrombosis and pulmonary embolism” was procured somewhat inadequately. It neglected to mention some relatively significant complications and the possibility of changing to open surgery after commencement of the procedure. The operation resulted in an inadvertent misidentification of the right hepatic artery and the common bile duct which were both wrongly cut necessitating an urgent salvage procedure by a more specialised hepatobiliary vascular surgeon. The consequence of the surgical error led to Mrs C having a protracted and incomplete recovery, painful leakage of bile into the abdomen necessitating drainage, and the exposure of Mrs C to a prognosis which included long term ongoing pain and discomfort, as well as several possible adverse outcomes over the remainder of her lifetime.

The defendant Trust admitted breach of duty but denied causation. The joint experts meeting established that as a consequence of the breach Mrs C had sustained an anastomotic stricture which require ongoing surgery and would have a good chance of abating Mrs C’s cholangitis by the insertion of a stent to keep the bile duct open. Other residual issues included the treatment of an incisional hernia, and adhesions risk which carried a chance of failure and a return to a state of fatigue and abdominal pain related disabilities.

Mesh repair of the hernia was made more problematic by the fact that the hernia obstructed access to the bile ducts and was also prone to failure especially if there was a re-operation and a need to preserve access to the abdomen for hepatobiliary surgery.

Following mediation the claim was eventually settled in the sum of £167,500 based on a valuation of the following heads of claim:-