Vasectomy and Sterilisation Negligence
If you have had a vasectomy or sterilisation and have subsequently conceived a child, have you been the victim of medical negligence?
In this article we explore vasectomies and sterilisations in more detail, explaining why the procedure might fail and whether this can amount to a substandard level of medical care.
Vasectomy
A vasectomy is when the tubes that carry sperm from the testicles to the penis are cut. This prevents the sperm from leaving the male body, ensuring that it will not reach the woman's egg and fertilise it. A male will still ejaculate semen at the point of orgasm, but there will not be any sperm in the fluid.
How is a vasectomy performed?
A vasectomy is normally carried out under local anaesthetic. During a conventional procedure, the scrotum will be numbed with local anaesthetic and two incisions made on each side. This will allow the surgeon to cut and remove a small section of the tubes which carry sperm from the testicles to the penis. These tubes are called the vas deferens. The severed ends will then be sealed and the incisions in the scrotum sutured with dissolvable stitches.
How do you know if a vasectomy has worked?
After the operation there will still be sperm in the semen. It is therefore vital to use contraception in the weeks following the vasectomy, as there is a risk that a partner will fall pregnant.
It normally takes around 20 to 30 ejaculations for the semen to be free of sperm. To make certain, a patient must attend follow-up appointments, during which a semen sample must be produced. These will be tested to check whether any sperm are present. Only after two clear semen tests are achieved can you feel confident that the vasectomy has been successful.
It is the duty of the healthcare organisation that carried out the vasectomy to arrange these follow-up tests. Until the semen is confirmed to be free of semen, other forms of contraception must be used.
How effective is a vasectomy?
The NHS estimates that vasectomies are effective 99% of the time. This means that if 2,000 men have a vasectomy, one will go on to conceive.
Can a vasectomy ever fail?
As the statistics above reveal, it is possible for a vasectomy to fail. Normally this will be for one of two reasons:
1. Recanalisation
Very rarely, the vas deferens will actually join back together. This is something the body does naturally and it cannot be predicted. If the tubes do heal of their own accord, the sperm will be able to travel from the testicles to the penis, meaning the patient will be fertile once again.
Recanalisation takes a long time to happen. So if you conceive and a significant amount of time has passed since the operation, it is likely that your tubes have reconnected.
This is a known risk of vasectomy. Although it is very unusual, all vasectomy patients should be warned of the risk of recanalisation before signing the consent form.
2. Surgical error
The other reason a vasectomy might fail is due to surgical error, whereby the vas deferens are not properly cut. This should be detected after the procedure when a patient fails to provide a semen sample that does not contain sperm. However, if these follow-up tests are not performed, or advice is not provided about the need to continue with contraception in the meantime, a patient may go on to conceive.
Vasectomy and medical negligence
If you conceive because the vas deferens have reconnected, it will not amount to medical negligence. However, you should be told about this risk before having the procedure. If medical practitioners fail to do so, there may be issues with the consent process.
If you conceive because of surgical error, you may have grounds for a medical negligence claim. This will be especially true if the healthcare organisation failed to organise follow-up tests, or failed to assess the results/inform a patient about the results.
Sterilisation
A female sterilisation is when metal clips are attached to the fallopian tubes, blocking them off. This prevents the egg traveling from the ovary, down the fallopian tube and into the uterus, where it would then be fertilised by the sperm.
How is a sterilisation performed?
A sterilisation is performed under general anaesthetic and can normally be done via keyhole surgery. In a laparoscopic procedure, the surgeon will insert a small tube through incisions made in the abdomen. The tube has a light and a camera attached to the end, relaying images back to a screen. The surgeon will insert metal clips through the incisions and attach them to each fallopian tube.
How do you know if a sterilisation has worked?
Before the surgeon sutures the incisions, he/she should take photographs of the fallopian tubes. This will verify whether or not the clips have been properly attached. After the procedure a patient must use contraception until she has her period. Subsequently a patient can assume that the sterilisation has been successful.
How effective is a sterilisation?
As with vasectomy procedures, the NHS estimates that 99% of female sterilisations are effective.
Can a sterilisation fail?
Therefore a sterilisation can fail. This might occur because:
1. Recanalisation
The fallopian tubes can re-join naturally, just as they can with a vasectomy. This is very rare and is thought to affect one in 200 sterilisation patients. Recanalisation cannot be predicted and a woman should be informed of the risk before consenting to the procedure.
Recanalisation will occur over a period of time, so if you fall pregnant a long time after the procedure, it is possible that your fallopian tubes have reconnected.
2. The patient was pregnant at the time of surgery
Before the operation is carried out, a pregnancy test must be done to confirm a patient is not pregnant at the time of the sterilisation. If medical practitioners fail to perform a pregnancy test and a patient is indeed pregnant, the standard of care will be considered negligent.
3. Surgical error
If the surgeon did not apply the clips correctly and did not take/assess photographs to confirm the occlusion, a woman will remain fertile. She may then fall pregnant at any point after the sterilisation. If a sterilisation fails due to surgical error, the care will be negligent.
Sterilisation and medical negligence
The recanalisation of the fallopian tubes is very unfortunate, but it is nonetheless a natural occurrence that cannot be prevented. It does not, therefore, amount to medical negligence.
However, failing to ensure a patient is not pregnant at the time of surgery, and failing to ensure the fallopian tubes have been properly occluded, will amount to medical negligence.
Contact us today
If your vasectomy or sterilisation has failed and you believe medical negligence is to blame, please get in touch with us today. If we suspect the care provided has been negligent and this has caused you harm, you may be in a position to pursue a claim for compensation.
Compensation will be awarded for the damages you have wrongfully incurred. This might include the:
- Pain and suffering of pregnancy/childbirth/having a termination
- Loss of the right to limit the size of your family
- The initial outlay of having a baby
- The cost of bringing up a child who has a disability
- Loss of earnings during maternity leave
To speak to a solicitor about a failed vasectomy or a failed sterilisation, please get in touch with us at Glynns Solicitors. Please call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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