Fistula Problems Due to Undiagnosed 4th Degree Tear
As the delivery of Laura's first baby was not progressing well, it was decided to undertake an instrumental delivery. An episiotomy (a cut to the perineum to ease the process of the birth) was carried out and forceps introduced. The delivery then seemed to go smoothly and a healthy baby boy was born.
After the birth, Laura's perineum was inspected, no damage was identified and the episiotomy was repaired. Following this procedure a further examination including a rectal examination failed to identify any anal sphincter or anal canal damage.
Unfortunately, delaying the rectal examination until after the repair of the episiotomy reduced the chance of identifying a severe birth tear and Laura returned home with her baby, believing that all was well.
It was only as the days passed that she began to experience discharge from her vagina, an unexpected and highly distressing development.
Gradually, over the following months, Laura underwent a range of examinations and scans to try to ascertain what was causing her on-going symptoms. Finally, an anorectal fistula, an abnormal passage between the anal canal and the area immediately around the anus, was identified. This was followed by the discovery of a larger rectovaginal fistula between the rectum and the vagina, plus damage to both her internal and external anal sphincters. No aspect of this extensive and debilitating damage had been diagnosed at the time of the delivery.
Eventually, two years on from the birth of her baby, Laura underwent surgery to attempt to repair her injuries. Although this has succeeded to some degree and she no longer suffers discharge from the vagina, Laura continues to experience urgency when needing to go to the toilet and is in some discomfort.
The psychological impact caused by the nature of her symptoms and the difficulty in managing them continues to be a problem for her. Anxiety around leaving the home and having access to a toilet can be debilitating and has affected Laura's quality of life to a significant degree.
When Laura approached Glynns to investigate the quality of her maternity care, we instructed a medical expert to give us his view as to what had happened. Having reviewed Laura's medical records, he was strongly of the opinion that Laura had suffered a 4th degree tear as a result of her forceps delivery which should have been diagnosed at the time and would have been if a rectal examination had taken place before the episiotomy was repaired. A 4th degree tear is the most severe form of perineal childbirth tear. The injury extends from the vagina, across the perineum, through both external and internal anal sphincters and into the lining of the anal canal.
If the correct diagnosis had been made at the time of her baby's birth, Laura would, in the words of our expert, 'have retained her continence'. A competent and comprehensive repair of the anal damage would have meant that the later surgery would not have been necessary and Laura would not have struggled with such shocking symptoms which continue to affect her to this day.
In recognition of the unnecessary damage, debilitating symptoms and distress which Laura suffered, she was awarded in excess of £250,000.00 in compensation.
(Details which might identify our client have been changed.)
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