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Undiagnosed 4th Degree Tear Causes Rectovaginal Fistula

An undiagnosed 4th degree tear has left a woman with the appalling on-going symptoms of a rectovaginal fistula.

When Sophia gave birth to her second child, it was decided that an instrumental delivery with vacuum assistance would be necessary.

An instrumental delivery introduces an increased risk that a woman will suffer an anal tear during the delivery and, when Sophia was examined after the birth of her baby, she was diagnosed with a 3rd degree tear.

She subsequently underwent a surgical repair of a 3b tear, affecting her external anal sphincter.

However, there appears to be no record of an internal examination either before or after Sophia's surgery. As a result, the fact that she had actually suffered a 4th degree tear was missed, and this severe injury was not repaired.

A 4th degree tear damages the internal anal sphincter and the lining of the anal canal. If it is not repaired, it can lead to the development of a fistula, or hole, between the rectum and the vagina, which is precisely what happened in Sophia's case. One of our medical experts commented that a rectovaginal fistula is 'one of the most degrading conditions a woman can have'.

Within a couple of days of her baby's birth, Sophia found that she was leaking wind and faeces from her vagina, an extremely distressing situation. She sought medical help immediately but it has proved difficult to resolve her symptoms. Had her 4th degree tear been diagnosed correctly after her baby's birth, it is likely that a successful repair would have taken place at the time, a fistula would not have developed and Sophia would not still be suffering symptoms years later.

Over the past few years, Sophia has undergone a variety of surgical procedures in an attempt to resolve the symptoms caused by her fistula. These have met with limited success and she has suffered on-going leakage from the vagina as well as repeated infections. It is even possible that her symptoms will worsen over time.

Sophia may require yet more surgery although it is not certain that this will improve her condition. She may even need a stoma to be fitted to provide bowel function.

Not surprisingly, these symptoms have had a significant impact on Sophia's life. The embarrassing nature of her bowel symptoms has affected her confidence, self-esteem and anxiety levels, and the practical difficulties have affected the extent to which she can work and participate in social activities with her children.

Sophia asked Glynns to assist her in investigating the quality of her care. Our experts confirmed that the failure to diagnose Sophia's 4th degree tear was a breach of duty, leading to the development of a fistula and Sophia's subsequent symptoms.

Sophia's claim settled for over £450,000.

(Details which might identify our client have been changed).

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