§ GUIDE · ABDOMINAL SURGERY

Complications after
bowel or weight-loss surgery

Leaks, perforations and bile duct injuries are recognised risks of abdominal surgery, and courts start from that. Of the nine judgments here, four succeeded and five failed. The wins were about what happened after the operation, or about a step that should have been taken and was not.

Judgments read

9

Claimant succeeded

4 of 9

Largest sum stated

£1.2 million

Usual loss reason

Recognised risk

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§ BEFORE YOU GO FURTHER

For an abdominal surgery claim, these things usually need to be true

  • A leak, perforation, bile duct injury or infection followed the operation.
  • Either the injury itself was avoidable, or the warning signs afterwards were not acted on quickly enough.
  • Or a standard preventive step, like a preventive drug before the procedure, was skipped.
  • It happened within the last three years, or you only recently found out.

Five of nine claims here failed because the complication was a known risk competently handled. The successful ones pointed to a specific missed step or a slow response.

§ 01

Weight-loss surgery

Welsh v Walsall succeeded: a leak after gastric bypass was not diagnosed until a day after clear warning signs, and general damages were £100,000 plus care. Rai v Coventry failed: discharge two days after a sleeve gastrectomy was held reasonable. Tarrant v Monkhouse failed: a sleeve leak after balloon dilatation was a recognised complication with no breach in the care. Ward v Oxford failed: a stomach perforation during gastric band removal was not visible at the time.

The pattern is stark. Bariatric claims win on delayed recognition, not on the fact of a leak.

§ 02

Bowel and gallbladder surgery

Healey v McGrath: death after an unrecognised leak following bowel cancer surgery at a private hospital; £1.2 million settlement with the surgeon bearing 75%. Thomas v Curley: bile duct injured during keyhole gallbladder surgery and inadequate monitoring on readmission; £92,391 upheld on appeal. Clements v Royal Liverpool failed: the bowel join was properly formed and later obstruction came from adhesions. Deakin-Stephenson failed on consent for diverticulitis surgery.

§ 03

The preventive step that was skipped

Alexander v HCA International is different in kind. After a private ERCP to clear a bile duct stone, the standard preventive diclofenac was never prescribed, and the patient developed necrotising pancreatitis with months in hospital and permanent diabetes. Judgment for the agreed £550,000 against the doctor. Missing a routine protective step is much easier to prove than a technical error.

§ 04

What a solicitor will want

The operation note, the drug chart, and the observations and blood results for every day afterwards until the complication was found. The gap between the first warning sign and the response is what these cases turn on.

§ THE JUDGMENTS BEHIND THIS GUIDE

The nine judgments behind this guide.

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

Claimant succeeded

Welsh v Walsall Healthcare NHS Trust

[2018] EWHC 1917 (QB)·2018·Liability and damages decided at trial

A 40-year-old had gastric bypass surgery and developed a leak that was not diagnosed until a day after clear warning signs. Yip J found the trust liable for several failings and assessed general damages at £100,000 plus care and therapy costs.

After weight-loss surgery, signs of a leak need to be acted on promptly; delayed diagnosis can turn a treatable complication into life-changing injury. General damages reflect the whole picture of pain, disability and psychological harm.

Claim failed

Rai v University Hospitals Coventry and Warwickshire NHS Trust

[2019] EWHC 2488 (QB)·2019·Liability decided at trial

The claimant was discharged two days after a sleeve gastrectomy despite nausea, vomiting and pain, and weeks later developed severe sepsis from a leak. The judge found the discharge and follow-up were not negligent and that earlier action would not have changed the outcome.

Early discharge after bariatric surgery is not negligent if symptoms at the time were within the expected range. Claims fail if the leak would have developed and been treated the same way regardless.

Claim failed

Tarrant v Monkhouse

[2025] EWHC 2576 (KB)·2025·Liability decided at trial

After a sleeve gastrectomy the claimant had trouble swallowing; the surgeon performed a gastroscopy and balloon dilatation, after which the sleeve leaked. The judge found no breach of duty in the post-operative care or the dilatation and dismissed the claim despite the very serious consequences.

A bad outcome after a recognised complication is not enough; the claimant must show the treatment decision fell outside what a responsible body of surgeons would do. Sympathy for the patient does not change the legal test.

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.

Claimant succeeded£1.2M

Healey v McGrath & Anor

[2024] EWHC 1360 (KB)·2024·Liability decided at trial

Mr Healey died nine days after bowel cancer surgery at a private hospital when a leak at the surgical join was not recognised in time. The hospital settled the widow's claim for £1.2 million and the court ordered the surgeon to bear 75% of it, finding his failure to diagnose the leak the principal cause of death.

Post-operative deterioration after bowel surgery must prompt urgent consideration of a leak. Both the private hospital and the individual surgeon can be liable, with the court apportioning responsibility between them.

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.

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

Philippa Caroline Deakin-Stephenson v Nebil Behar and Chelsea and Westminster Hospital NHS Foundation Trust

[2024] EWHC 2338 (KB)·2024·Liability decided at trial

Admitted with perforated diverticulitis, the claimant had a laparoscopic washout and deteriorated about 36 hours later, needing an emergency Hartmann's procedure with a stoma and intensive care. She alleged she had asked for a colorectal referral, was improperly moved to private care and was not properly consented, but the judge found none of this proved and dismissed the claims against both the surgeon and the trust.

Consent disputes turn on evidence of what was actually discussed; where the records and the surgeon's account show the alternative procedure was explained, a claim based on inadequate consent is likely to fail.

Claimant succeeded£550,000

Alexander v HCA International Limited & Anor

[2026] EWHC 1284 (KB)·2026·Liability decided at trial

A patient developed life-threatening pancreatitis after a gallstone-removal ERCP. The judge found the consultant never prescribed or instructed the standard preventive diclofenac suppository, so it was not given, and entered judgment for £550,000 against him.

Failing to give a recognised prophylactic drug before a procedure can be negligent even in private care. The prescribing doctor, not the hospital, carried the liability here.

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

I had a leak after gastric sleeve or bypass surgery. Is that a claim?

A leak by itself is a recognised risk. The claim is about whether it was recognised and treated in time. Welsh succeeded on a one-day delay after clear signs; Rai and Tarrant failed where the care was held reasonable.

My bile duct was damaged during gallbladder removal.

A known risk, but Thomas v Curley shows a court can find negligence in how it happened and in the monitoring afterwards.

A relative died after bowel surgery at a private hospital.

Healey shows both the private hospital and the individual surgeon can be liable, and the court will apportion responsibility between them.

I was not given a preventive drug before my procedure.

That is Alexander. Omitting a standard protective step is a clear breach and the causation was proved using published trial data on how much the drug reduces risk.

How long do I have?

Three years from the complication, 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.