§ PUBLISHED JUDGMENT · 2022

Dalchow v St George's University NHS Foundation Trust

[2022] EWHC 100 (QB)·High Court (Queen's Bench Division)·20 January 2022

After routine day-case removal of a scrotal cyst, the claimant returned in the early hours in severe pain; intravenous antibiotics were not started when they should have been and an ultrasound request was delayed, and he was later diagnosed with Fournier gangrene, needing repeated surgery and losing both testicles. The judge found breach of duty but held the claimant could not prove the delays changed the outcome.

Outcome

Claim failed

Sum stated in judgment

Not stated

Claim type

Urology & Catheter Injury

Decided

Liability decided at trial

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§ WHAT HAPPENED

The facts, in brief.

Defendant: St George's University NHS Foundation Trust · this trust’s claims data

Injury: Fournier gangrene (necrotising fasciitis of the scrotum and perineum) requiring multiple debridements and removal of both testicles

Specialty: Urology · England

§ WHAT THE COURT SAID

In the judgment’s own words.

“Although it appears to me that breach of duty has been established (including breach of duty not admitted), it cannot be proved that the breach of duty caused loss.”
[2022] EWHC 100 (QB) at [132] · read the full judgment

The money

Claim dismissed on causation; no damages assessed.

§ WHY IT MATTERS

What this case shows.

Proving that care fell below standard is only half the case: the claimant must also show the negligence made a difference. Where surgery would have happened at the same time anyway, delayed antibiotics or scans may not be shown to have caused the injury.

About urology & catheter injury claims →

§ MORE UROLOGY & CATHETER INJURY JUDGMENTS

Claimant succeeded£195,888

Biggadike v El Farra & Anor

[2024] EWHC 1688 (KB)·2024·Liability and damages decided at trial

The patient had a hysterectomy, pelvic floor repair and incontinence tape fitted by one consultant, then mesh removal and a colposuspension by a second consultant. The court cleared the first surgeon but found the second performed the colposuspension without clinical justification, leaving the patient with severe bladder symptoms.

Performing an operation that is not clinically justified is a breach of duty even if it is technically done well. Damages are limited to the harm caused by the negligent procedure, not the patient's pre-existing symptoms.

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Devonport v Gateshead Health NHS Foundation Trust

[2016] EWHC 1729 (QB)·2016·Liability decided at trial

After a radical hysterectomy for cervical cancer the patient developed an abscess and a narrowed ureter, and later lost a kidney; she alleged the bowel was perforated at surgery and that urologists should have been involved in a second operation. The judge preferred the hospital's explanation for the infection and found no negligence in either operation.

Ureteric and kidney damage after pelvic surgery is not automatically negligent; the court will examine the most likely mechanism. Expert evidence on the cause of infection is often decisive.

Claimant succeeded£459,758

O'Connor v The Pennine Acute Hospitals NHS Trust

[2015] EWCA Civ 1244·2015·Appeal decision

During surgery to repair a bladder-vagina fistula caused by an earlier hysterectomy, the surgeon damaged the femoral nerve while dissecting the sigmoid colon. The trial judge awarded £459,758 and the Court of Appeal upheld the finding that the injury was caused by negligent direct injury rather than retractor pressure.

Where a nerve is damaged in an area the surgeon was working on, a court may infer negligence from the mechanism of injury and the expert evidence. Appeal courts rarely overturn a trial judge's factual findings on how an injury occurred.

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Contains information licensed under the Open Justice - Licence v2.0. Judgments from Find Case Law, The National Archives. Summaries are ours; amounts only where printed in the judgment.

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