By the time of diagnosis, the condition had advanced to stage 4 (the most severe grade). She suffered severe pain, urgency to defecate, excessive vaginal bleeding, severe pain on intercourse, a mild to moderate depressive illness and would need a hysterectomy.
The claimant (C) was 18 when she saw her GP complaining of severe period pains and was prescribed contraceptive tablets. After numerous further GP visits and a trip to A & E she was referred to gynaecology the next year.
The gynaecologist examined her but did not do a scan or other investigations and did not think it was endometriosis, although C carried on in pain etc and did become worried that she had endometriosis. After multiple further GP visits, she was sent back to gynaecology. This was two years later. An assessment and an ultrasound were carried out which did not lead to a diagnosis. Following this, C assumed had irritable bowel syndrome (IBS).
Thirteen years later, her condition became very severe when she stopped taking birth control pills. The next year, exploratory surgery revealed Grade 4 endometriosis which had spread around her ovaries, colon and the wall of her abdomen. Surgery treated some of the endometriosis, but it was not possible to treat it all.
The claim alleged negligence in concluding that her symptoms were due to IBS alone; failing to properly consider a diagnosis of endometriosis alongside a diagnosis of IBS; failing to perform a laparoscopy (keyhole exploratory surgery) or arranging a laparoscopy after her symptoms were the same at the second review.
The Hospital admitted that a laparoscopy should have been performed after the second referral to gynaecology and that would have led to diagnosis and treatment. It was admitted this caused some injury but argued that most of C's problems were caused by the co-existent IBS.
C suffered with severe abdominal pain and urgency to defecate. She had suffered with chronic pelvic pain, excessive vaginal bleeding and severe pain in relation to intercourse (dyspareunia). She would need to undergo a hysterectomy and although this would improve her pain, it this would not entirely relieve it as she would continue to suffer with pain from adhesions. She would also need her colon to be resected (part removed). Her symptoms of urgency and impaired rectal emptying would continue. She had premature ovarian failure which was irreversible and resulted in a two-year reduction in her life expectancy. The endometriosis rendered her infertile and she required IVF to conceive. She had experienced bladder problems including discomfort while passing urine and urinary incontinency which were likely to remain.
She suffered mental health issues with mild to moderate depression, needed therapy with a psychological therapist and a consultant psychiatrist to try and improve her condition over a 12 month period.
C had to end her career as a full-time teacher due to her symptoms but was expected to resume in a supply role following surgery.
A breakdown of the Settlement was £120,000 for pain and injury (General Damages), and in rough figures, past financial losses of about £80,000 and future financial losses (including anticipated loss of earnings and pension) of about £300,000.