£850,000 compensation to a 36-year-old man, after a delay in diagnosing a cancerous polyp in his rectum. He needed surgery, chemotherapy and was left with ongoing multiple symptoms.
When the Claimant (“C”) was aged 25 he first attended the hospital colorectal department complaining of rectal bleeding and painful defecation. He attended twelve more times over a nearly 4-year period. He also had piles and an anal fissure (this is a painful tear or open sore in the lining of the interesting near the anus). Most surprisingly, there was no record of any digital rectal examination (DRE) or rigid sigmoidoscopy having been performed and C alleged that these examinations had negligently never happened.
After 4 years a colonoscopy was performed, during which a biopsy was taken from a 25mm flat polyp in the rectum. This was suspected to be cancerous. Two months later, C had planned surgery (called an elective open low anterior resection and de-functioning loop ileostomy) which left him with a stoma bag on his abdomen.
Rectal cancer was confirmed after the histopathology department examined the tissue that had been surgically removed. C had 12 cycles of chemotherapy and suffered with episodes of neutropenia (low white blood cell count). After 8 months he was able to have the stoma reversed but an infection stopped him from recovering from the further surgery as quickly as could have been hoped.
The claim alleged negligence against the hospital for failure to investigate the cause of his problem, by either DRE (digital rectal examination) or sigmoidoscopy. Given the length of the delayed diagnosis and how much the polyp was likely to have grown C’s case was that had it been detected at the beginning of the 4-year period, then a simple procedure as a minor day case would have removed it and it should not have been malignant then. Otherwise, had the polyp been identified after about a year of his first presentation, then the simple surgical procedure (with access through the anus) would still have been available to him. Alternatively, if diagnosis had been made later he should still not have needed chemotherapy.
The Hospital denied breaches of duty initially but eventually admitted negligence for failure to perform a sigmoidoscopy investigation after some 2 years from first presentation. However, although it was accepted that chemotherapy should have been avoided, the Hospital maintained that the same, more extensive surgery would have been needed.
C was left with altered bowel frequency, episodic faecal incontinence and faecal urgency. He also had abdominal scarring and was at risk of complications from adhesions and incisional hernias in future that might also need further surgical treatment.
Another injury was erectile dysfunction caused by the surgery he had had. This interference with his sex life resulted in the breakdown of his relationship and he was unable to establish any new relationship which caused him great distress. The erectile dysfunction was considered likely to be a permanent problem.
As to employment, C was a successful digital marketing manager in the field of retail and fashion. His bowel problems and frequency caused him many occasions of embarrassment at work. He had to leave meetings suddenly and he lost confidence in his job security as he received complaints from his employers. He had moved jobs before risking being fired.
C had hoped his bowel condition might improve with therapy but after receiving advice that his condition was permanent, he became majorly depressed.
The case was settled on a global basis with no particular breakdown of damages. However, the following breakdown was estimated by the Claimant's counsel.
Out of the £850,000 compensation, £140,000 was allocated to pain and suffering (General Damages), with £60,000 for past financial losses and future loss of earnings: £530,000 and future care costs of £120,000.