Bile Duct Injuries Explained
If the bile duct is injured during surgery and it is not repaired, the patient will go on to suffer serious complications. A second operation will also be needed to rectify the problem.
Failing to recognise a bile duct injury (BDI) will amount to medical negligence. If this has affected you or your loved one, please get in touch with us to discuss your options. You could be entitled to pursue a claim for compensation.
The bile duct
The bile duct connects the liver to the gallbladder, pancreas and the small intestine. Its function is to carry bile from the liver to the gallbladder and the small intestine.
Bile is produced in the liver and is made up of cholesterol, bile acids, body salts, bilirubin, water, copper and other metals. It aids the digestion of food.
The bile duct carries the bile from the liver and down to the gallbladder, which acts as a reservoir for bile. The bile duct then carries on from the gallbladder to the duodenum, which is part of the small intestine. Here the bile is used to help with the breakdown of food.
The bile duct and surgery
The bile duct can be vulnerable during abdominal surgery. The removal of the gallbladder – known medically as a cholecystectomy – is especially risky, as the bile duct is connected to the gallbladder.
When carrying out abdominal surgery, the surgeon must be particularly vigilant in protecting the bile duct from harm. For example, during a cholecystectomy, the gallbladder is clamped and tied-off, ensuring that bile does not escape from the bile duct. This must be done with great care or the bile duct will tear.
Even if the highest standard of surgical expertise is provided, there is the possibility that the bile duct will be injured during surgery. A patient must be informed of this risk before he/she signs the consent form, or there will be a failure on the part of medical practitioners to obtain proper consent.
Bile duct injuries during surgery
If the bile duct is harmed during an operation, it is absolutely essential that the injury is recognised and repaired there and then. As long as a competent repair is achieved, the surgeon will not be to blame.
This is because a bile duct injury is a recognised risk of surgery and cannot necessarily be prevented. Therefore a bile duct injury will not amount to medical negligence. The only exception to this is if the injury was caused by a substandard surgical technique.
Failing to recognise a bile duct injury
There will be grounds for a medical negligence claim, however, if the injury is not diagnosed and repaired.
Indeed, a bile duct injury may occur during surgery and this will not ordinarily amount to a substandard level of medical care. Yet what will be deemed unacceptable is if a surgeon and his/her team fail to spot the injury.
If this does happen, the operation will come to an end and a patient will be sent back to the recovery ward. Both the patient and the medical staff will be completely unaware that the bile duct has been injured and left unrepaired. This will quickly lead to a number of complications.
Complications of a bile duct injury
When a bile duct injury is not treated, bile will leak from the bile duct and into the abdominal cavity. This will infect the lining of the abdomen, which is called the peritoneum. The peritoneum will then become inflamed, a condition that is called peritonitis.
Peritonitis will make a patient extremely unwell and is commonly associated with symptoms such as: severe abdominal pain, nausea, fever and passing very little urine. Peritonitis must be treated immediately or the infection will spread very quickly. Within a short amount of time the infection will get into the bloodstream and spread to the organs, resulting in septic shock. This can cause the organs to shutdown, something which can be fatal.
Along with peritonitis, the bile duct injury will also reduce the intestine's ability to digest food, as bile will not be getting to the intestine. This will cause the build-up of food, waste products and faeces, blocking the small intestine. This is also very serious and can contribute towards the occurrence of septic shock and organ failure.
Repairing a bile duct injury
These symptoms should alert medical practitioners to the fact that something is wrong. Peritonitis is indicative of internal injuries, particularly a perforated bowel and a bile duct injury.
As soon as a patient shows signs of deterioration, medical practitioners should realise that there is a problem and take steps to determine the underlying cause. Tests such as an ultrasound scan can be used to diagnose the injury.
Once a bile duct injury is diagnosed, a patient should return to theatre for emergency surgery. The injury must be competently repaired, preventing any further leakage of bile. Subsequently the patient will need to be closely monitored, as more than one surgical repair may be required.
A patient's condition will become increasingly critical the longer treatment is withheld, so the sooner a bile duct injury is repaired the better. If it is not repaired in time, a patient may not survive. Therefore when it comes to recognising and repairing bile duct injuries, time really is of the essence. Any delay could be fatal.
Claiming for a bile duct injury
As mentioned above, the fact that a bile duct injury occurs during surgery will not normally amount to medical negligence. The exception to this is if a substandard surgical technique was used during the operation, which contributed towards the injury.
However, there are times when a bile duct injury will lead to litigation in the form of a medical negligence compensation claim. These are explored in more detail below.
1. The bile duct injury is not repaired during the operation – if the bile duct is damaged, the surgical team should notice the injury and perform a repair before the close of the operation. If there is a failure to spot a bile duct injury, there may be grounds for a medical negligence claim.
2. There is a delay in diagnosis – if the bile duct is damaged and the injury is not repaired, a patient will soon become unwell. The healthcare practitioners caring for the patient should quickly realise that there is an underlying problem. If there is a failure to diagnose an unrepaired bile duct injury, resulting in further complications, the level of care will be deemed substandard. There may be grounds for a medical negligence compensation claim.
Can you claim for a bile duct injury?
If you or your loved one has suffered from a bile duct injury sustained during surgery, you may be wondering whether or not you are entitled to make a claim. To find out, you need to speak to a solicitor who specialises in medical negligence claims.
During an initial telephone consultation, a solicitor will ask you questions about the care you (or your loved one) received. This will include details about the bile duct injury and the complications it caused.
After all the information has been gathered, a solicitor will be able to advise you upon your options. If you are told there is a case to be investigated, you will be able to start a claim against the hospital responsible.
Successful bile duct injury claims
In order to make a successful bile duct injury claim, it is necessary to prove the following two things:-
1. There has been a breach of duty
All medical professionals owe their patients a duty of care, meaning they must exercise a level of skill and expertise deemed acceptable by a reasonable body of medical men.
For example, if the surgeon fails to spot the bile duct injury, it is necessary to consider whether a reasonable body of surgeons would also have missed the injury. If the answer is no, a reasonable surgeon would have diagnosed the bile duct injury, there will have been a breach of duty.
To verify whether or not there has been a breach of duty, your solicitor will instruct a medical expert to write a report. The expert will offer their professional opinion upon your case, stating if the care has fallen below a reasonable standard. If the report is favourable, it will add significant weight to your case.
2. The breach of duty has caused your injuries
Secondly, the breach of duty must have caused you to suffer injury. This is called causation. For example, if the bile duct injury was not diagnosed, this may have caused you to develop peritonitis, septic shock and organ failure. These injuries will have occurred as a direct consequence of the unrepaired bile duct injury, meaning there will be grounds for a claim.
The claims process
If you are eligible to pursue a medical negligence claim, your solicitor will act as your legal representative, handling the entire process for you. This can take a number of years to complete, so it is essential you are happy with your solicitor. It is also important that your solicitor is a specialist in this area of the law, as this will give your claim the best chance of success.
The claims process involves a number of steps, including:-
- Taking witness statements from you and, if necessary, your loved ones
- Getting copies of your medical records and reviewing them
- Asking a barrister for advice regarding the prospects of your case
- Asking medical experts to write a report on your case
- Sending a letter of claim to the other side
- Issuing court proceedings
- Calculating your compensation settlement
- Negotiating a sum of compensation with the other side
Your solicitor will take you through the claims process in more detail at the outset of your case.
Compensation for my bile duct injury
If your claim is successful, you will be awarded compensation. This is split into two separate elements. Your general damages reflect the physical/emotional pain and suffering you have endured. Your special damages reflect the financial losses you have incurred. This incorporates both past and future losses, so you can claim for things such as future loss of earnings.
Your solicitor will suggest an appropriate sum of general damages. To do so, he/she will assess the severity of your injuries against judicial guidelines for compensation. Your special damages will be calculated in a schedule of special damages, which sets out all of the money you have lost because of the negligence. This covers a wide range of losses, from pension loss to the money your relatives spent travelling to visit you in hospital.
Time limits for bile duct injury claims
As with all medical negligence claims, there are time limits in place for bile duct injury claims. In most cases there will be three years to bring a claim, starting from the date the negligence happened. So you will have three years starting from the date the bile duct was injured.
There are occasions when you can rely upon a later date of knowledge. However, a bile duct injury will cause symptoms almost immediately, so it is unlikely there will be much of a delay between the patient sustaining the injury and the patient becoming aware of a problem.
In cases where the Claimant lacks mental capacity, there will not be a time limit. In cases where the Claimant was under the age of 18 when the injury happened, he/she will have until their 21st birthday to make a claim.
Speak to a solicitor today
If you miss the three year timeframe, you are said to have exceeded the date of limitation. After this you will not be able to make a claim, even if you have a very strong case. To ensure you do not miss your chance to obtain financial redress, be sure to contact a solicitor as early as possible.
To speak to a solicitor about making a bile duct injury claim, please do not hesitate to get in touch with us today.
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