The medical negligence team at McElhinney & Associates solicitors recently represented the family of a young child Plaintiff who was brought to the Emergency Department on referral from his GP with a 3 day history of abdominal pain, vomiting and diarrhoea. At review by an A & E doctor, the Plaintiff was noted to be lethargic and dehydrated with a diffusely tender abdomen and noted impression was of likely gastroenteritis with a differential diagnosis of appendicitis.
Following review by a Paediatrician at later that evening and a Surgeon that night, the noted impression was of perforated appendicitis or mesenteric eadenitis.
A CT scan performed and reported findings in keeping with an acute appendicitis and a plan was made for the Plaintiff to be transferred to theatre if his condition deteriorated, otherwise he would be transferred the next morning.
At around 09.30 the next morning, the child underwent laparoscopic appendectomy at the hospital. During the course of the surgical procedure, damage was caused to the Plaintiff’s bladder which was not noticed or detected at the time or at any time prior to completion of the surgical procedure.
The surgery was completed with the records noting a standard procedure with no untoward incidents. Later that night the child still had not passed urine.
An ultrasound was planned and the Robinson drain was removed. There was clear straw coloured fluid from the drain site noted, suspicious for a bladder injury although not noted to be the case by the medical personnel involved.
A Urostomy bag was placed over the drain site.
Following an ultrasound performed the next day, a plan was made to transfer the Plaintiff to Dublin, the reason for which was noted in the medical records to be urinary retention and query bladder injury but this reason was not stated to the child’s parents at the time.
The child was transferred via ambulance and following assessment a confirmed the diagnosis of bladder injury was made.
A plan was made for conservative management however days later the child Plaintiff underwent laparotomy and repair of the bladder wall pre-operative diagnosis being identified as Iatrogenic bladder injury during laparoscopic appendectomy.
The procedure was primary repair of the bladder wall, the inter operative findings including a bladder wall injury at the urachal remanent and sub-serosal fluid collection observed opposite to the skin incision both sides on bladder filling.
The hole was prepared and the bladder injury site was excised and repaired in two layers.
The child Plaintiff spent three weeks in hospital in Dublin which was a very difficult time for the entire family with family at home and rental costs incurred whilst in Dublin.
The child required six weeks off school.
We obtained the expert evidence from a consultant paediatrician in the UK who identified particulars of negligence, breach of duty and breach of statutory duty as against the HSE under 13 headings, including the following:-
Failed to advise, treat and care for the Plaintiff in a proper skillfull, diligent and careful manner.
Failed to carry out the surgical procedure in a proper careful and skillfull manner.
Caused the Plaintiff to suffer and sustain bladder damage in the form of a hole situate at the base of the urachal remnant during the course of the surgical procedure.
Failed to properly describe in the medical records the surgical technique performed and failed to employ an adequate surgical technique.
Delayed in placement of the catheter post-operatively.
The Defendant has entered a full Defence denying liability for the Plaintiff’s injury, and putting the Plaintiff on full proof of his claim. In particular, the Defendant has pleaded that the Plaintiff was treated with reasonable skill, care and diligence by the Defendant and that the Plaintiff’s injury was a well-described complication in the setting of laparoscopic repair of acute gangrenous appendicitis.
In order to fully investigate the Plaintiff’s ongoing injuries and prognosis, additional reports were secured from Paediatricians, Psychiatrists, Consultant Plastic Surgeons and Care Consultants.
In light of the excellent expert opinion procured on behalf of the plaintiff, The solicitors for the HSE requested mediation, and a substantial settlement was reached. Compensation was awarded for the infant plaintiff and the parents recovered their out of pocket rental expense and loss of income.
As the plaintiff in this case was an infant the matter the settlement was ruled before the court, with the Judge noting that it was a vert significant and satisfactory settlement.
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This information is for guidance purposes only. It does not constitute legal or professional advice. Professional or legal advice should be obtained before taking or refraining from any action as a result of the contents of this publication. No liability is accepted by McElhinney & Associates for any action taken in reliance on the information contained herein. Any and all information is subject to change.
About the Author
Jolene McElhinney, BBLS, Principal Solicitor
Jolene McElhinney is the founding principal of McElhinney & Associates, renowned for her expertise in employment law and personal injury claims across the North West of Ireland. With a distinguished academic background and over a decade of experience, Jolene is dedicated to providing personalised, expert support to her clients, ensuring they navigate the complexities of the legal landscape with confidence and clarity.
