Negligent Perineal Tear Repair
Compensation claims for 3rd and 4th degree tears during childbirth usually result from delayed diagnosis or misdiagnosis. Occasionally, even though the tear has been accurately identified, the repair itself is not up to standard.
The Royal College of Obstetricians and Gynaecologists (RCOG) has observed that more than 20% of repaired external sphincter injuries (3rd or 4th degree tears) retain a defect after repair. This is likely to lead to extremely unpleasant on-going symptoms such as wind and faecal incontinence, and the patient could be entitled to compensation.
Why might a repair be defective?
Inexperienced practitioner
RCOG guidelines state that surgical repair of an obstetric anal sphincter injury should only be carried out by a trained practitioner. Ideally, this type of surgery requires an experienced surgeon. There have been moves to improve training in this area, which will be particularly important as there seems to be an increase in the incidence of perineal tears in the UK. If surgery is carried out by an inexperienced or inadequately trained practitioner, the outcome is more likely to be poor.
Inappropriate location
The repair should take place in an operating theatre with good lighting and appropriate instruments except in exceptional circumstances under the guidance of a specialist. Where this does not occur, the chance of a successful repair is reduced. It may be that only part of the tear is repaired.
Inappropriate method
It is important that the best method of repair is used for the area of damage. Guidelines recommend the best suturing techniques as: interrupted stitches for an internal repair; overlapping or end-to-end stitching for a full thickness external sphincter injury; and end-to-end technique for partial thickness external injury. Research has suggested that these methods produce the best outcome for the patient and long-term reduction in symptoms. If an inappropriate method has been used, the woman may experience distressing symptoms, the repair may break down and she may require yet more surgery for a further repair.
Inappropriate Materials
There are specific recommendations as to the type of material to be used for the type and location of injury in order to reduce the chances of a breakdown of the repair. It is important that these guidelines are followed to avoid the woman experiencing discomfort after surgery.
Inadequate repair
If a repair has been misdiagnosed, it is possible that only part of the tear is repaired, leaving the possibility that internal anal sphincter or anal canal wounds continue to cause problems or deteriorate to produce a fistula.
Medical Negligence
If you received a severe perineal tear during childbirth which was poorly diagnosed or poorly treated, you may be entitled to make a claim for compensation for the effects of your on-going symptoms.
Contact Glynns Solicitors to discuss your circumstances. We are a team of medical negligence solicitors with considerable experience in pursuing compensation claims for poorly-treated perineal tears.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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