Nightmare Appendectomy

[mickkid]

I am currently in legal proceedings against the NHS regarding an appendectomy where I was taken to theatre much later than I should have been.

To keep the story relatively short, I was taken to hospital by my housemate on the Thursday morning after throwing up constantly since the Monday evening and I now had stabbing pains my left side. The hospital put me on anti-sickness drugs and a drip and said they would keep me in overnight for observation.

Overnight, the stabbing pains moved to my right side and I was in extreme pain. I was kept in a side room overnight where the Nurse Call button had been disabled - meaning that I had to phone the ward off my mobile on 2 occasions during the night.

On the Friday morning, two doctor's diagnosed me with Appendicitis and said I would be taken to theatre ASAP. Throughout the day, I was just given more and more drugs, moved to a different ward, made to feel like an inconvenience - and was taken to theatre once my appendix had "perforated", this was on the Saturday morning at about 4am.

I'm now left with a 4 and a half inch scar (as I am 5'3", it looks bigger ) and was off work for 3 and a half months.

Do you reckon this case will go anywhere? Has anyone else experienced a smiliar situation?

Any advice would be helpful.

Thanks

Michael

[colour-me-happy]

It sounds like a nightmare for you, hope you are feeling better now.

Hospitals have to prioritise urgent surgeries, unfortunately it sounds like there were people requiring attention before you.

It may still be worth getting someone to look into it for you, you may feel better knowing that the Dr saved someones life while you were waiting to be seen.

Notice you are in Liverpool, just out of curiosity was it the Royal?

Sorry for your pain, the NHS is in free fall at the moment.

Would you have had the op and this scar in any case? Like the last poster said perhaps it was because someone was in more urgent need than yourself, not trying to make excuses, but when I had my last daughter by C-section, I was delayed almost the hwole day, as women who were not booked in and due to have a natural birth, had complications and about 5 women has ememrgency op's before me. Just an example...without proof its a toughy

Good Luck

Louise xxx

[mickkid]

Hi,

Thanks for your replies - I am a lot better now by the way . No one mentioned why there was a delay, they just seemed to ignore me when I asked a few days later. I do have lawyers looking into the case. I would feel better knowing that someone's life was saved whilst I was waiting, if they have a reason as opposed to an excuse that would be ok. I suppose time will tell. I'm waiting to hear from my lawyers at the moment.

In response to the 2nd post, I would have had to have the op, but the scar would have been the small standard appendectomy scar, horizontal, barely noticeable and about 2 inches long - nothing compared to what they have left me with.

So in affect because you wrre delayed you had to have a larger operation, I would be complaining.

Maybe seek advise of an advocate too, they can be very useful if you get a good one!

Lou x

[mickkid]

Well with any luck the lawyers I've got on the case will be good enough to get something out of it. I was referred to them by the legal side of my house insurance. So it's free The lawyer in particular who is dealing with the case deals with Medical Negligence. I've sent her a detailed chronology of events along with photos of my scar and a Medical Report Access form. So I've got the ball rolling at least - let's see how it goes.

[pieterclassens]

Good luck with this case. Unfortunately as said before the NHS is in a downward spiral (no excuse of course but ....)

As to the delays ..... short of there having been a serious cardio or pulmonary emergency (in other words immediately life threatening) I cannot understand it.

Appendicitis in itself is potentially life threatening as once the appendix ruptures there is always the potential for peritonitis or inflammation of the peritoneum, which is the membrane around the internal organs. this condition can be treated with antibiotics which makes it less dangerous than it used to be but there is still a risk of abscess formation in the abdominal cavity which will require draining and if left untreated can cause major problems.

As to the size of the incision (and thus scar) ..... its usually a 3 to 6cm horizontal incision made in the lower part of the abdomen on the right side, through which the appendix is removed so 4 and 1/2 inches doesnt seem too long (depends on the size of the appendix on removal).

As always no-one here can advise without knowing the full story (including the case notes etc etc ) and you are wise to have it professionally investigated.

As I said above good luck with the case and please keep us informed of the outcome.

PM me if you like.

[Rich44]

you may feel better knowing that the Dr saved someones life while you were waiting to be seen

Im sure thats very comforting to someone who has nearly died from Pertonitis, appendicitis IS life threatening esp if left thats why as soon as they know thats what it is theyre supposed to operate as if left there are complications.

sorry but there is no excuse for the catalogue of cock ups above.

Just having the nurse call button disabled in potentially fatal on its own ffs let alone not being operated on in a timely fashion.

the NHs is such a gamble at the moment the missus is in being monitored since thursday for pre-eclampsia and being looked after beautifully (still rather be home though lol) whereas her mum cant even visit her or the baby when it arrives as the NHS have given her MRSA and refuse to operate on her massive hernia saying she has a heart condition she lives 80 miles away

amazing the difference a few miles can make

[pieterclassens]

Welcome to the NHS Postcode Lottery!!!

[callumsgran]

my daughter had an ectopic pregnancy and appendicitis op at the same time last year and only ended up with a scar 5cms long, also if your appendix was perforated you could have died from it so you should have been more closely monitored!! hope you get a result from all this!!!

[NHSworker]

Ok, firstly the call bell - no excuse for that being 'turned off' actually in all the places i've worked you cant turn them off (for obvious reasons) More likely is that i was broken - still not an excuse, they should not have been using a bed where the patient couldn't have summoned help. Sometimed what is percieved as a 'bell not working' is actually the fact that the nursing staff havent got time to help one patient before the next one rings and needs help. Not the nurses fault i hasten to add but thats not your fault either.

Delays getting to theatre - an all too common a problem. Most places run an emergency list which is kept seperate from the 'planned' operations list. You would have been on the emergency list.

Appendicitis - it can be a tricky one, not that easy to diagnose without an Ultrasound scan or a CT - did you get a scan?. Some patients with appendicitis dont ever get to theatre becasue it settles with analgesia and intravenous antibiotics.

Opperating theatres arent magical places where all your problems can be solved. Going to theatre has risks associated with it, no name a few...
- A general anesthetic
- Risks of post-op infection
- Cutting open an infected appendix and spilling pus all over your abdomen (slightly exagerated but you get the idea)
- peri-operative (during the operation) complications (heart attacks, blod clots, heamorrhage etc etc)

Given all the above sometimes it is somtimes in the patients best interest to 'sit and wait' to see if Theatre is necessary.

As for prioritisation there are many, many, many clinical conditions other than 'serious cardiac or pulmonary conditions' (whatever they are).. that may be perceived as more serious and life threatening and need urgent attention. By the way, a 'serious cardiac or pulmonary condition' would probably exclude you from going to theatre due to the increased risk - not mean you would be rushed there any quicker ..lol... some people need to get their facts straight

As for compensation - People who get the wrong drug injected and die, people who loose a limb because someone miss diagnosed something - all of these will probably get some form of compensation, becasue the outcome was terrible and unforgivable.

Now im not sticking up for anyone here, just giving a different point of view... young men who get a nasty appendicitis who do get to theatre to have it sorted and get safely discharged home without any post-op complications arent on the same scale as above. Just out of interest - why did you have 3 months off work?

Just a warning as not to get your hopes up, unless you can prove that someone did something wrong or was negligent, you probably wont get much. There again i've never been involved in a complaint that went that high up the hospital management ladder! If you want to complain about a negative exerience of being in hospital you should - each complaint goes towards pushing for a better healthcare system.

Most NHS workers are brilliant, caring people who work in a system that doesnt give the time to do things as well or as speedily as they would like to! please be gently on them!

Blimey that was a bloody long post.. no doubt some people have got something to say about what i've typed - would be happy to discuss more.

[pieterclassens]

I am assuming that the "get your facts straight" was aimed in my direction.

I assure you that I have all of my facts in order. Having consulted with both my uncle (a cardiothoracic surgeon) and my mother (a medical professor) as well as using my own experience as a former medic I can assure you that I know what I am talking about.

In certain cases of cardiac and pulmonary disfunction the OR is the immediate and usually only way of diagnosing and treating problems.

Perhaps with the lack of funds and poorly paid/trained staff things are done differently in this country. Thats the NHS for you!

I agree that all cases have to be treated on their merits and without any case notes nobody has the right to comment either way. However I was talking of extreme cases that DO require surgical intervention, in which case these would supercede any other operations planned for that day.

I am not going to go into details as to exactly what constitutes an extreme and viable case. I'll let you do your own medical research. Suffice to say that triage is a medical fact of life and although it may not be to everyones taste it ensures that the most urgent and life threatening cases are dealt with first.

By the way, may I please suggest using a dictionary. Incorrectly spelling words really paints medical staff as either lazy or incompetent (especially when attempting to use basic medical terminology).

Anyways, aside from all that I agree with everything else stated.

[frostie27]

same happened to me... was suposed to go to surgery 3 times. my appendics perforated. now i have 5 inch scar.

[ScarletPimpernel]

Originally Posted by NHSworker

Appendicitis - it can be a tricky one, not that easy to diagnose without an Ultrasound scan or a CT - did you get a scan?

Really? Whatever did we do before ultrasound and CT?

I've seen plenty of cases (my own included) where diagnosis was based upon history and examination alone. I'd suggest that a patient with an elevated temperature, raised WBC, tenderness and/or rebound in the RLQ and a coated tongue is a good candidate for appendicitis. There are a number of differential diagnoses but this may be affected by other factors e.g. age and sex and PMH of the patient.

Surgeons Net says of the use of ultrasound and CT in suspected appendicitis:

USS - Ultrasound itself has a low sensitivity and specificity for the diagnosis of appendicitis(6). It's use is for establishing other diagnosis.
CT has a much higher sensitivity and specificity(6) (94% and 95% respectivley) but carries the risk of a reasonably high radiation dose. It's use should be restricted to those patients where the diagnosis is uncertain and they would be a particular increased risk from an operation.

It seems to me that the issues in OP's case, as so often, revolve around communication.

Firstly, the call bell. As has been suggested, there can be no excuse for this. If it's u/s, the side-room shouldn't be used. If that's the Trust's excuse, ask to see the record of when it was reported and what action was subsequently taken. A patient having to phone ward staff on a mobile is wholly unacceptable.

Secondly, the reason for an open appendicectomy being performed rather than laparoscopic, resulting in a larger surgical wound and thus scar. This will almost certainly come down to the clinical judgment of the surgeon, and whether any delay that occurred played a part in his decision to use one procedure rather than another is something that he will be able to explain - indeed, it may even be in the operation notes. In an ideal world, the surgeon would explain all this post-operatively and when the patient is sufficiently recovered to understand.

Again as has been suggested, it's sometimes necessary to prioritise patients for emergency surgery, and this is done on the basis of clinical need. However, patients should be kept informed by ward staff.

The first step in finding out what happened probably doesn't need a lawyer - just get in touch with the Trust's Patient Advice and Liaison Service (PALS) and put your concerns to them.

[Alipeeps]

Originally Posted by ScarletPimpernel

However, patients should be kept informed by ward staff.

This simple concept is, I fear, at the heart of many of the complaints about/problems with the NHS. My experiences of NHS hospitals (just for reference, I do have a fairly good understanding of how the NHS works internally, having previously worked in admin at a DGH) during the 4+ years of my sister's treatment for cancer, is that lack of communication is one of the biggest issues leading to patient dissatisfaction/distress. My sister had numerous similar experiences of waiting around (often in some discomfort) on a hospital ward having been told she would have a certain test/certain treatment etc and then be left waiting and waiting and have it postponed or rescheduled or cancelled etc *without explanation*. And I can state with conviction that she would not have been so stressed or upset, and would have happily accepted the reasoning that e.g. other priorty cases may have come in and require treatment more urgently etc, if she had simply been kept informed and told what was happening and that there would be a delay and why.

In her - and my - experience, it would seem that wards are often woerfully understaffed and the nurses (most of whom are doing their very best under difficult circumstances) simply don't have the time to devote to each patient that they should. The hospital where my sister had most of her treatment recently opened a brand-new dedicated cancer wing and the wards are lovely and new and shiny... but the nurses themselves admit they don't have enough staff to properly man the shiny new wards and on occasions where my sister was in the bay furthest from the desk (and, at the time, was too sick to get up and go to the desk to ask for an update) she would be left for hours at a time without seeing a member of staff and would feel completely isolated and abandoned. Even when the call button was used (e.g. when a patient in a neighbouring bed started vomiting) it could often be 20 minutes before anyone came to investigate (again, this is no slur on the nurses - they were lovely, just not enough of them!! What if that call button alarm had been because someone was having a stroke or a heart attack or worse? )

Sadly, my sister's experience with the NHS was that the only way to get things done or, more to the point, to get TOLD what was happening, was to make a fuss and be demanding.

[miziwizzi]

Originally Posted by mickkid

I am currently in legal proceedings against the NHS regarding an appendectomy where I was taken to theatre much later than I should have been.

To keep the story relatively short, I was taken to hospital by my housemate on the Thursday morning after throwing up constantly since the Monday evening and I now had stabbing pains my left side. The hospital put me on anti-sickness drugs and a drip and said they would keep me in overnight for observation.

Overnight, the stabbing pains moved to my right side and I was in extreme pain. I was kept in a side room overnight where the Nurse Call button had been disabled - meaning that I had to phone the ward off my mobile on 2 occasions during the night.





On the Friday morning, two doctor's diagnosed me with Appendicitis and said I would be taken to theatre ASAP. Throughout the day, I was just given more and more drugs, moved to a different ward, made to feel like an inconvenience - and was taken to theatre once my appendix had "perforated", this was on the Saturday morning at about 4am.

I'm now left with a 4 and a half inch scar (as I am 5'3", it looks bigger ) and was off work for 3 and a half months.

Do you reckon this case will go anywhere? Has anyone else experienced a smiliar situation?

Any advice would be helpful.

Thanks


Michael

Where do you want this case to go/what are you expecting to achieve?


The case would need to focus on either negligence or battery, I am uncertain to if you would have a strong case as I feel confident the NHS trust would be able to demonstrate that surgery was prioritised and that you sadly were not number one on the list.

Were there other complications not mentioned? I know of several people whos appendix have ruptured non of which required 3 months off work so I wonder if you may have other issues. Is it loss of earnings you want to recoup or extra on top, if so please consider the fact that taking monies from the NHS makes the service even worse.



The call bell thing is not right, and should have been rectified immediatly.

My husbands scar is around 4.5 inches.

[Bookworm]

Original post is 2 yrs old, mizi.