§ GUIDE · SURGICAL INJURY

Something went wrong
on the operating table

A serious injury during an operation is not, by itself, negligence. Six of the ten judgments here were lost on exactly that point: the injury was a recognised complication, competently managed. The four wins show when a court will say the surgeon fell below the standard.

Judgments read

10

Claimant succeeded

4 of 10

Largest sum stated

£2.5 million

Typical loss reason

Recognised risk

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§ BEFORE YOU GO FURTHER

For an injury during surgery to be a claim, these things usually need to be true

  • The injury was to something the surgeon was not operating on: a nerve, the bile duct, a blood vessel, another organ.
  • There is a reason to think the technique fell below the standard, not just that a known complication happened.
  • Or the complication was recognised late: warning signs after the operation were not acted on.
  • It happened within the last three years, or you only recently found out.

Courts start from the position that every operation carries risks. The claim has to explain why this injury was avoidable, and that usually needs an independent surgeon's opinion.

§ 01

When a court will find the surgeon at fault

O'Connor v Pennine Acute is the clearest win: during repair of a bladder fistula, the surgeon damaged the femoral nerve while dissecting the sigmoid colon. The trial judge inferred negligence from the mechanism of injury and awarded £459,758; the Court of Appeal upheld it. Thomas v Curley involved a bile duct injured during keyhole gallbladder surgery plus inadequate monitoring on readmission; judgment for £92,391 was upheld on appeal.

MJF v University Hospitals Birmingham succeeded because the physical evidence contradicted the doctor's account of how a feeding tube had been fixed. CTQ v King's College Hospital, an anaesthetic case, settled with court approval for £2.5 million.

§ 02

When a court will not

Clements v Royal Liverpool alleged the bowel was twisted at the join during cancer surgery; the judge found the join was properly formed and later obstruction came from adhesions. Ward v Oxford involved a stomach perforation missed during gastric band removal; the court found it was not visible at the time. Shally v Imperial was a spinal operation where the surgeon changed approach mid-operation; that was held to be a recognised, logical choice.

Devonport, Saunders and Guest all failed on similar grounds: the complication was real and serious, but the evidence did not show the technique fell below what a responsible body of surgeons would do.

§ 03

The second chance: what happened afterwards

Several of these judgments treat the post-operative period as a separate question. In Thomas v Curley the failure to arrange fluid and kidney monitoring on readmission was a distinct negligent act. Even where the operation itself is defensible, a slow response to bleeding, leaking or infection can found a claim.

§ 04

What a solicitor will look for

The operation note, the consent form, the anaesthetic chart and the observations for the days afterwards. An independent surgeon then advises whether the injury was avoidable. Without that opinion, a claim about an intra-operative injury will not be taken forward.

§ THE JUDGMENTS BEHIND THIS GUIDE

The ten judgments behind this guide.

Every one a published decision of the courts of England and Wales, linked to its source. Six losses and four wins.

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.

Claimant succeeded£92,391

Thomas v Curley

[2013] EWCA Civ 117·2013·Appeal decision

Mrs Thomas's bile duct was injured during keyhole gallbladder removal and the surgeon also failed to arrange fluid and kidney monitoring when she was readmitted unwell. The trial judge found both failures negligent and awarded £92,391; the Court of Appeal dismissed the surgeon's appeal.

Bile duct injury during gallbladder surgery is not automatically negligent, but a court can find negligence where the anatomy was recognised and the injury still occurred, and separately for inadequate monitoring afterwards.

Claimant succeeded

MJF v University Hospitals Birmingham NHS Foundation Trust

[2024] EWHC 3156 (KB)·2024·Liability decided at trial

A young woman with cerebral palsy had a PEG feeding tube inserted and was found unresponsive two days later with peritonitis and sepsis. The judge rejected the doctor's account of how the tube was fixed, found it was placed under too much tension, and entered judgment for the claimant.

Where a clinician's recollection is unreliable and contradicted by the physical evidence, the court can find a procedure was done negligently. Causation may still be limited where a pre-existing condition would have deteriorated anyway.

Settlement approved£2.5M

CTQ v King's College Hospital NHS Foundation Trust

[2023] EWHC 2975 (KB)·2023·Settlement approved by the court

A 37-year-old mother suffered a cardiac arrest because intravenous fluids were not given during spinal anaesthesia just after her daughter's birth, leaving her with a brain injury; the hospital admitted liability. The court used its inherent jurisdiction to approve a settlement worth roughly £5.56m including periodical payments.

Anaesthetic errors around delivery can found a maternal negligence claim even when the baby is unharmed. Courts can approve settlements for adults with cognitive impairment even where they have not formally been found to lack capacity.

Claim failed

Clements v The Royal Liverpool and Broadgreen University Hospitals NHS Trust

[2012] EWHC 2335 (QB)·2012·Liability decided at trial

Mrs Clements alleged that during bowel cancer surgery the surgeons twisted the bowel's mesentery before rejoining it and failed to check, causing obstruction, a second operation and catastrophic complications. The judge found the join was properly formed and the later obstruction was caused by adhesions, so there was no negligence.

Serious complications after surgery do not by themselves prove the operation was done negligently. The court will weigh the operating surgeons' evidence against what was found at the second operation.

Claim failed

Ward v Oxford University Hospitals NHS Foundation Trust

[2023] EWHC 2803 (KB)·2023·Liability decided at trial

Mr Ward's stomach was perforated during keyhole removal of a gastric band; the hole was not seen during the operation and was repaired the following morning after he deteriorated. The judge found the perforation was not visible at the time and so there was no negligent failure to identify and repair it.

A perforation missed during surgery is only negligent if there was visible evidence the surgeon should have seen. Post-operative pain that leads to timely re-operation may not give rise to a claim.

Claim failed

Shally v Imperial College Healthcare NHS Trust

[2023] EWHC 1304 (KB)·2023·Liability decided at trial

During surgery for a giant calcified thoracic disc the surgeon changed from the planned approach to opening the dura, and the patient was left partially paralysed. The judge found the change of approach and the surgical technique were supported by a responsible body of neurosurgical opinion and dismissed the claim.

Changing surgical plan mid-operation is not negligent where the alternative is a recognised, logical approach. Catastrophic outcomes from high-risk spinal surgery do not by themselves establish a breach of duty.

Claim failed

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.

Claim failed

David John Saunders v Central Manchester University Hospitals NHS Foundation Trust

[2018] EWHC 343 (QB)·2018·Liability decided at trial

Five days after surgery to reverse his ileostomy the 60-year-old claimant developed sepsis and his whole colon had to be removed because its blood supply had failed. He alleged the surgeon had damaged the marginal artery, but Yip J was not satisfied that the injury was caused by negligence rather than a naturally occurring clot.

A serious complication after bowel surgery is not itself proof of negligence; the claimant must show on the balance of probabilities that a surgical error, rather than an unavoidable event, caused the harm.

Claim failed

Callum Joe Guest v Nottingham University Hospitals NHS Trust

[2026] EWHC 704 (KB)·2026·Liability decided at trial

During long spinal surgery for scoliosis and chest wall deformity the claimant deteriorated, arrested while being turned over, and was left with severe sight loss. He alleged the anaesthetist negligently failed to treat a raised potassium reading, but the judge found that reading was spurious and the arrest was caused by a pulmonary embolism, so the claim failed.

Even after a devastating complication a claim fails if the court finds the true cause was a non-negligent event, so proving the mechanism of injury is often the decisive issue.

Browse the whole case library →

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.

§ QUESTIONS

Common questions

A nerve was damaged during my operation. Is that negligence?

Not automatically. In O'Connor the court inferred negligence because the nerve was directly injured in the area being dissected. Where a nerve injury is a recognised risk that was explained beforehand, the claim is harder.

My bile duct was cut during gallbladder surgery.

Bile duct injury is a known risk of keyhole gallbladder removal, but Thomas v Curley shows a court can still find negligence where the anatomy was recognised and the injury still occurred, and separately for poor monitoring afterwards.

The hospital says it was a known complication.

That is the usual defence, and it succeeded in six of these ten cases. The answer is an independent surgeon's view on whether the technique fell below the standard.

The problem was only found at a second operation days later.

Then the question shifts to whether the warning signs after surgery were acted on quickly enough. That can be a claim even where the original injury was not negligent.

How long do I have?

Three years from the operation, or from when you first realised the care may have fallen short.

This guide is general information about the law in England and Wales, not legal advice about your case. ClaimGavel is run by Costart Projects Ltd on behalf of Tomlin & Partners, a specialist medical negligence firm regulated by the SRA. The free assessment on this page is an AI overview to show you roughly where you stand; a solicitor confirms the position in a free, no-obligation conversation.