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Settlement for woman with fourth-degree tear after childbirth

Posted on 25th May 2021
Catherine Henry Lawyers
Catherine Henry Lawyers

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Settlement for woman with fourth-degree tear after childbirth

Our team of health lawyers successfully gained compensation for our client who experienced a fourth-degree tear during the birth of her first child at a public hospital in regional NSW.

Our client was a young, healthy, Indigenous woman who was supposed to be experiencing the joy of having her first child. After a rapid delivery of her baby boy, a midwife diagnosed that she had a second-degree tear. Several hours later, the obstetrics and gynaecology registrar discovered it was a fourth-degree tear – a tear that extends through the vaginal skin, the underlying tissue, the pelvic floor muscles and completely through to the anus.

The registrar expected the tear would be repaired in the operating theatre. This did not happen because the anaesthetic department were concerned that our client had been given something to eat and drink. So, the registrar repaired the tear in the birthing suite.

When she was to be discharged from hospital, our client had not had a bowel movement and was not given a starter pack of antibiotics. The hospital expected that the Active Mothers Postpartum (AMP) service would follow up with our client.

The AMP’s records show the hospital did not tell them that our client’s tear was more severe than originally diagnosed.

It wasn’t until the AMP’s second visit that the nurse realised our client had experienced a fourth-degree tear. This meant that she was started on antibiotics one week later than she should have started taking them.

The repair of our client’s tear was not successful. Our client endured more than four attempts to repair the tear, including two by a colorectal surgeon. That surgeon then attempted a colostomy, but it was reversed because our client could not tolerate it.

Our case for justice

We argued that the hospital failed in its duty of care in several ways.

  • It failed to have someone who was trained in the detection of anal sphincter injuries given her rapid delivery.
  • Staff performed the repair using an ‘end to end’ technique rather than an ‘overlapping’ technique. That repair should have been performed by a more senior obstetrician and gynaecologist who was there and able to perform it.
  • The refusal to perform the repair of the tear in the operating theatre was not valid.
  • It failed to administer intravenous antibiotics in hospital and failed to update records/inform the AMP of a fourth-degree tear.
  • Hospital staff failed to inform our client of the increased risk of infection from a fourth-degree tear. She wasn’t told that she had to purchase and take antibiotics when she got home and wasn’t given a starter pack.

Our expert witness said that if the repair had been done with the proper technique by an experienced surgeon in an operating theatre – and if she had been properly treated with antibiotics and aperients – her rectovaginal fistula would probably have been avoided.

Another expert witness reported that without a colostomy our client’s injuries (fistula) will be an ongoing problem. Even then, some of her symptoms are likely to be permanent. It is likely she will need two operations with an 80 – 90% chance of success.

Our clinical psychologist observed that our client is burdened by chronic and at times debilitating pain which affects her energy levels and motivation. She is reluctant to take pain relief medication and fears constipation, as such episodes act as a trigger and reminder of the original trauma, and she fears a further tear. She was unable to have sex for two years.

Given our client’s young age, the nature and extent of her injuries, the ongoing pain, interference with her enjoyment of life and her work, and the prospect of further surgery and its uncertain outcome, we argued for significant damages for non-economic loss.

The settlement

We were able to obtain a settlement for our clients to help with her losses due to medical negligence.

Let us fight for you or your loved one

If you or a loved one suspect you have experienced medical negligence before, during or after giving birth, please do not hesitate to talk to one of our caring, expert, health lawyers about the options available to you. To confidentially discuss your needs call us on 1800 874 949 or fill in the form below, and we will be in touch.

Taking legal action can also help change health care practices and hold health care professionals to account so other people do not have to experience what you went through.

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