This claim arising out of an elective laparoscopic operation undertaken on 30 May 2017… In the course of the operation, the purpose of which was to remove a gastric band, C suffered a perforation of his stomach. [1]
There is agreement – that it was not negligent to cause the perforation. It is also agreed that if the perforation, at the time of surgery, was of sufficient size to be seen then it was Bolam negligent for the surgeons not to detect the lesion during the course of the operation, and to repair it. [2]
The issue… for the court… whether there was a culpable failure to identify and repair the perforation intra-operatively… whether the perforation was of a sufficient size such that there would have been visible signs. [3]
surgery started at 8.30am and, according to the anaesthetic chart, it concluded at approximately 10.30am [9]
no difficulties or complications in the course of this surgical procedure… straight forward and routine. [13]
at 12.20pm it was recorded that he was not in pain and he was fit to go home [17]
by 16.15, it was noted that C was complaining of severe pain [19]
[31 May 2017] 06.50, C was described as being distressed and in pain with tachycardia. The pain continued to worsen. At 07.15 Mr Jones noted that C was tender on examination ‘with guarding upper abdomen’. The impression was that there was a perforation. [26]
At or about 11.30 on 31 May… a re-look laparotomy. A perforation was found on the anterior of the stomach just above where the banding would have been located… the perforation as being 3 x 2 centimetres. There was evidence of peritonitis in all four quadrants. The perforation was resected. [27]
there was not a negligent failure to identify and repair this perforation intraoperatively on the basis that I am not satisfied that there was visible evidence of the damage. [71]
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