This is a clinical negligence claim. The trial was to determine liability. In summary, in May-June 2018 C was diagnosed with bowel cancer and advised that she needed a right hemi-colectomy operation. This substantial and risky operation was performed successfully… on the 2nd of July 2018… C has recovered well from it. However, before the operation 10 attempts were made by consultant anaesthetists to site a Trocar into C’s back to provide post operative pain relief by way of epidural anaesthetic. None of these was successful. It is agreed that one of the attempts to push the Trocar into C’s back in fact travelled past the epidural space through the Dura, straight through the spinal cord and out of the other side. This caused damage to the spinal cord at the T11/T12 level and caused a bleed which travelled down the right anterolateral space (front – right) around the cord causing a haematoma (blood) from L1 to L3. [4]
By the end of the trial there were only two remaining issues on breach of duty:
did D obtain C’s informed consent to carry out the attempted unconscious epidural anaesthetic [UEPI], having already attempted and failed at 3 waking epidural anaesthetic [WEPI]?
Did carrying out the last few of the 10 attempted epidural anaesthetics with the Trocar (there were 3 attempted WEPIs and 7 attempted UEPIs) amount to negligent treatment? [7]
I find that informed consent was not obtained from C on 2 July 2018 in the morning or that afternoon for either the waking or the unconscious epidural attempts made by D. [[109]
The failure properly to consent C for the WEPIs did not lead to any injury because the C accepts in her pleadings that if she had been properly consented on the ward, or at any time before the WEPIs were performed, she would have accepted D’s advice to have a waking epidural. [111]
The failure to obtain C’s informed consent before putting her to sleep and starting 7 more epidural attempts was causative of the cord injury at T11/T12 and the haematoma running down the spine from there to around L3. On the medical evidence I have found that C’s neurological symptoms were caused by the attempts made after C was put to sleep. Hence 100% of the agreed damages were caused by the lack of consent. [112]
Judgment shall be entered for C. The agreed damages are £1.3 million. [113]
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