Welsh v Walsall Healthcare NHS Trust [2018] EWHC 1917 (QB) (25 July 2018)

This is a claim for clinical negligence relating to bariatric surgery undertaken at Walsall Manor Hospital on 3 January 2012. (paragraph 1)

C, who was aged 40 at the date of surgery, was very overweight… Sadly, she developed serious complications which left her extremely unwell. She required an ileostomy and reversal of the bypass. She had to spend seven months in hospital. The experience was traumatic and, at the end of it, she was left without any of the hoped-for benefits. It is her case that there has been a lasting impact on her physical and psychological health, for which she should be compensated. (paragraph 2)

Shortly after the surgery, an anastomotic leak occurred. This is a recognised complication of the procedure. It is agreed that its occurrence was not a result of negligence. There is, however, an allegation of surgical negligence which is said to have played a part in subsequent events. The remaining allegations concern the detection and treatment of the leak and the claimant’s post-operative care. The defendant admits a number of breaches of duty and accepts that the claimant has been caused some additional loss and damage. However, it is the defendant’s case that the majority of her problems were caused by the leak itself, for which there is no liability. (paragraph 4)

The parties having cooperated to narrow the issues, I am now essentially invited to choose between two alternative scenarios. C’s primary case is that the leak should have been successfully repaired rendering the bypass a success. She would have recovered much more quickly and gone on to experience substantial weight loss leading to a significant improvement in her physical and mental health. The secondary case or middle ground is that the bypass would still have needed to be reversed but C would not have required an ileostomy and there would have been fewer complications. The assertion then is that her condition would have been largely the same as pre-surgery. Within those two broad positions, there are some remaining issues to consider when looking at causation and quantum. (paragraph 5)

…C is to be compensated on the basis that she underwent three surgical procedures that would not have been required but for the defendant’s negligence. She was critically ill for 7 to 8 weeks and in hospital for about 7 months. Her recovery was very stormy and unpleasant as detailed above. She suffered significant pain and the psychiatric injury I have detailed. She is also to be compensated for the pressure sores she developed on her neck, chin and heel. These have left scarring. I note that C is conscious of her scars. That to her face was not readily visible to me when she gave evidence, but it is fair to observe that this does not represent normal conversational distance. C has regained her weight. She is morbidly obese. She is very unlikely to attempt bariatric surgery again. Her life expectancy is reduced. The claimant’s functional capacity is limited by shortness of breath and pain. She uses a stick to mobilise at home; requires a wheelchair to access the community and has been sleeping downstairs as she cannot properly negotiate stairs. She has pain throughout her body. There are significant digestive problems, including heartburn and diarrhoea. C requires assistance with normal daily living activities… (paragraph 100)

… an appropriate award for pain, suffering and loss of amenity is £100,000… (paragraph 104)