Compensation of £50,000 recovered for misdiagnosis of ectopic pregnancy resulting in infertility
15 July 2024
The specialist clinical negligence team at Curtis Law Solicitors has recovered £50,000 in compensation for a client who lost her last remaining fallopian tube due to the negligence of the clinicians at Chelsea and Westminster Hospital NHS Foundation Trust rendering her infertile and in need of IVF treatment to conceive a baby.
Mrs H had a history of ectopic pregnancy and miscarriage which had caused the loss of her right fallopian tube. At approximately 7 weeks gestation, she developed light bleeding associated with stomach cramps and pain. Her GP referred her to West Middlesex Hospital where a scan revealed a mass attached to the left fallopian tube which sonographers identified as stool. She queried ectopic pregnancy, but this was discounted by the sonographers. She was sent home with instructions to return for a further scan in ten days’ time. Five days later, in the early hours, she developed severe abdominal pain and attended A&E. She was told that she had had a miscarriage and that her body was trying to pass the tissue. She again queried ectopic pregnancy, but this was discounted by the doctor. No scan was performed given the proximity of the previous scan. She was sent home once her pain had eased with advice to return for the repeat scan as previous advised. Two days later, she developed severe pain associated with heavy bleeding. She attended A&E where a scan was performed which confirmed that she had an ectopic pregnancy that had ruptured the fallopian tube. She underwent emergency surgery during which her fallopian tube was removed.
Chelsea and Westminster Hospital NHS Foundation Trust carried out an internal investigation into the events and confirmed that there had been a misdiagnosis of the ectopic pregnancy on the first scan.
Evidence was obtained from an independent Consultant Gynaecologist dealing with causation of avoidable harm. This confirmed that but for the breach of duty of care in relation to scan, the diagnosis of an ectopic pregnancy would have been made. Mrs H would have been suitable for medical management of the ectopic pregnancy with Methotrexate. This had a 95% possibility of successfully treating the ectopic pregnancy which would have avoided the need for surgery and would have preserved the fallopian tube. The alternative option was for laparoscopic salpingostomy to remove the pregnancy which would have preserved the fallopian tube. Both treatment options would have preserved Mrs H‘s fertility. The expert confirmed that a watch and wait approach, requiring Mrs H to return to hospital within 48 hours for additional blood test, also had a more than 50% chance of preserving the fallopian tube because it would have been found that the ectopic pregnancy was continuing and either treatment option could then have been provided.
As the negligence resulted in Mrs H losing her last fallopian tube, her only feasible option for fertility treatment was in vitro fertilisation. Evidence was obtained from an independent Professor of Reproductive Medicine and Consultant Gynaecologist on what in vitro fertilisation would involve and the associated costs. Based on Mrs H’s age, she would require two fresh cycles of IVF to have a 60% chance of conceiving and, because she already had a child, she was ineligible for NHS funding and would therefore require private treatment.
After presenting the claim to the Trust, the Trust asserted that Mrs H would always have lost her fallopian tube because she would still have chosen to have it removed if the ectopic pregnancy had been diagnosed at the time of the first scan. The Trust sought to equate a situation where Mrs H was in severe pain, but the fallopian tube had not ruptured with the emergency, life threatening situation that she went on to face because of the failures of care. Evidence was presented to contradict the Trust’s assertion which led to the commencement of settlement negotiations resulting in a settlement of £50,000.
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