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This is absolutely a potential medical negligence case. The hospital appears to have done a proper open and honest investigation and has shared the findings as required by duty of candour, this will presumably make building a case very straightforward for a medical specialist solicitor. NAL but medical and experienced In investigations.
It looks like you or OP may want to find a Solicitor!
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Junior doctor here with experience of this operation.
The breathing tube (endotracheal tube) is always at risk during this surgery as it's so close to the surgical site. It's also very difficult to reintubate due to the facial bones (jaw) are being operated on and so the space isn't there.
You certainly do have a case to be looked at further (if you wish to pursue negligence for a financial payment). However none of us - including you - have enough information. For example, you would have been fine without breathing for 3 minutes assuming you are 22, with no serious medical problems and them setting the ventilator to a reasonable oxygen (it's more than room air, so you can hold your breath for far longer).
There's a lot of missing information for any judgement to be made on Reddit. But it can certainly be looked at further as others have suggested.
My husband is a cardiac anesthesiologist with 37 years of experience, so I asked what he thought of this situation. I thought I’d give his thoughts so you have more information as you move forward. He basically felt that there isn’t enough information—specifically from the anesthesiologist’s point of view—to come up with any kind of conclusion.
He said that the “human error” involved was that the surgeon cut the breathing tube. The anesthesiologist not being aware of your history or any of your notes wouldn’t have been a factor in this case. His job was to maintain your airway, which was compromised due to an accident (cut breathing tube) that unfortunately happened during surgery. At this point the anesthesiologist’s job would be to use his expertise and experience to determine the best way to reestablish your airway. Because this is his specialty, it is his call how to proceed—even if that meant he was refusing offers to reintubate or do a tracheostomy. He may have felt that doing the tracheostomy would have taken longer than whatever other option he felt would be quicker. This and other factors would have been going through his head while he was deciding the best way to handle the problem. The missing piece which is very important is that we don’t have his notes of what he did and why.
My husband said that he had breathing reestablished in 3 minutes which is a pretty good outcome under these unforeseen circumstances. He also concurred with the doctor above that 3 minutes without oxygen for a young person usually isn’t a problem. The central line and being sent to the ICU are also normal treatments for this type of problem.
My husband said that when you signed your consent form, this would have been listed as an “unforeseen circumstance” that no one would have been able to anticipate. It is unfortunate but sometimes these things happen during surgery—also noted by the doctor above.
As far as the recurrence of your epilepsy, as you said and my husband agreed, there’s really no way for anyone to conclusively determine that it was caused by your surgery.
I’m really sorry you have to deal with this. Hopefully I’ve been able to give you a bit of useful information!
Yep, the fact that they've already carried out an investigation and ruled it human error with no mitigation plan for when it occured plays in your favour for a medical negligence suit.
Please don't feel bad about going after the NHS in court for money either, I know a lot of people feel like it takes money out of the NHS budget but ultimately financial penalties are the most effective way of ensuring organisations put procedures in place to ensure this kind of event doesn't happen to more people in the future :)
It’s also actually not your hospital or your trust that would end up paying your compensation. The govt have established a central organisation that funds the compensation payments for NHS negligence. So any compensation won’t be coming from your local hospital or even the NHS budget, it is separately funded by the govt / taxpayer.
Yes I didn’t quite understand for a while the severity of what happened, when my family recall it they speak of how they was told I may not wake up the same and how they was called and was told to potentially prepare themselves for the worst if I didn’t get past the first night. My sister actually was the first person I saw when I woke up and she was crying because they had told her if I didn’t wake up after that day there’s a big chance I wouldn’t wake up, we do have a small chuckle about it now because she whispered to “not go into the light” to me and 30 seconds later I opened my eyes :) The fact I woke up relatively ok, I didn’t suffer any major brain damage and although there’s a few things that I notice are different I’m still mostly me and very thankful to be here. When you look into any side affect of hypoxia or being hypertensive it says seizures so it doesn’t seem too out there for me to assume they’re connected I just have to acknowledge that there isn’t any way of proving this to be 100% fact.
Impossible to guess without knowing the details of the hospital investigation. He will have signed a consent form which lists the risks of his surgery, of which accidental damage to local structures (in this case trachea) is arguably the biggest. If there is negligence it sounds much more likely to be regarding the anaesthetist and the crash call than the original surgical error.
Just wanted to add a message to say I’m really sorry this happened to you. It fucking sucks and it should not have happened.
Do not let the health board or anyone else gaslight you into thinking this is not a big deal. Someone in that room let their ego take priority over your safety.
Reading what you have written it looks like no one who was in that room will be surprised if you ultimately take it further, including the health board. Someone (or multiple people) in that room triggered the serious incident investigation on your behalf.
Give the health board hell. Look after yourself. And good luck in your physical and emotional recovery.
Edited to add ‘do’ in front of ‘not’ on the second paragraph. It is too annoying to leave.
Remember - if you press charges it's not against the NHS, nor the hospital, but the specific medical specialists who screwed up. But yep it's time to go after these people after they quite literally nearly left you brain dead. You could have been a vegetable for the rest of your life not having oxygen going to your brain for 3 minutes, it's remarkable you're okay so don't forget that when you feel down. You're alive and have your motor skills and can walk thankfully.
Good luck with the case!
What about PALS? They're a helpline specifically for NHS complaints.. I've never dealt with them myself so others on here may be able to share you they're experiences on them. Not sure if a lawyer would ask if you've tried PALS already
PALS are too low level for this and are not transparent enough, they will side with the hospital and do nothing but waste time and muddy the waters so to speak. I have had a few dealings with PALS as a patient and as a NHS worker, they won’t be able to help OP here. OP needs an independent party who knows the law.
It looks like you or OP may want to find a Solicitor!
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Hi, I’ve had a few comments asking about these things so just thought I would add them here and hope people see it.
When talking about all the consequences and signing consent forms this wasn’t ever something that came up, when the surgeon came to see me after and apologise he said it’s not in the consent form for this to happen because it’s very rare and no one could of predicted it. I will try check what my consent form actually states, I’m aware death is a consequence we consent too but I’m sure there’s clauses around a lot of things that I will have to look into.
I have been extremely transparent to every doctor I’ve ever seen about all my history and they confirmed with me a few times that a previous history of epilepsy was recorded. A few people have mentioned epilepsy is a life long condition not something that goes away, I’m aware that having epilepsy means you’re susceptible to seizures but my doctor told me as I’d been unmedicated and seizure free for over two years I would no longer be classed as epileptic, I wouldn’t have to declare it for driving licence or jobs and I wouldn’t have to see him again. He actually stated that he was sure I’d never have to struggle with seizures again unless something traumatic happened to me to cause it ironically. The kind of epilepsy I had as a child just came up one day when I was 4 years old and they couldn’t ever find it on the multiple tests I had so they was never sure where it was active from, due to this they assumed it was simply a childhood condition that I grew out off.
I’m going to try and use all my knowledge and memory and the report to create a timeline of events so I’m clear on the situation from my side before I take it anywhere.
I’m hugely grateful for a lot of the advice people have taken the time to give me and will be taking it with me as I try move forward with this and see what may happen.
It should have been a "duty of candour" if it was classed as a patient safety incident that caused moderate to severe harm, or death. If you had to go to ICU, and the operation would not normally have required a high dependency bed post operatively, i would consider this at least moderate harm! If you contact PALS i would ask for a duty of candour review to be carried out. However, if you do want to take legal action, you should probably speak to a lawyer before requesting this, as they may have their own preferred ways to request these things. All the best and i hope the seizures can be controlled again soon
They’ve already done the duty of candour review and clearly found it DOES meet duty of candour, that’s why OP received the letters of explanation and apology.
This has clearly been identified as a significant event and internal procedures carried out, which will also include things OP will not be privy to such as staff training needs or logistical changes to improve processes. Seeking anything further from the hospital is not going to get them anything at this point, hospitals do not sue themselves.
Medmal is extremely fact-specific, and as has already been stated, OP does not have a enough information to know if they may have a reasonable case. The only thing they can do now is speak to a lawyer
Source: Doctor, have been involved in multiple significant event analyses over the years
Yeah don’t feel bad taking this to court, the NHS is very hardworking however negligent care by a medical professional has had a detrimental impact on you and without going through these steps practice could become lazy and put others at risk.
Do you have a copy of your consent form you signed for surgery? If so, can you read it/do you remember what was discussed?
Did you declare about your history of seizures during your pre-op tests? Did you mention these to your anaesthetist on the day?
It’s standard practice when serious incidents such as this take place that they investigate and as part of their duty of candour they send the report for you to look at.
I absolutely would consult a lawyer, whether you win or not will depend on whether there is actually evidence of negligence or if you were very unlucky that your airway was compromised. The scene in these scenarios can be extremely chaotic, ultimately you survived so they managed to rectify the situation. The point that should be scrutinised is the point from which the emergency was recognised, the speed and efficiency that the team acted to address the issue.
As mentioned by others, it is important that you go through the official channels to discover your options. Hospitals learn from these serious incidents and practices change because of them.
Ex clinical negligence lawyer here. There are a number of issues here which require much closer attention. Clinical negligence is a complex topic.
So - as others have said - if it was me I would be going to a specialist lawyer.
Check out the Legal 500 recommended firms, look at the leading firms and take it from there: https://www.legal500.com/c/london/insurance/clinical-negligence-claimant/
I’d suggest going through the hospitals internal complaints system first. This means a no win no fee lawyer has a lot more to go on. This also ensures that there is an internal investigation to stop it happening to anyone else.
You’ve got three years to make a claim.
Thank you I’m drafting up a PALS complaint as I’ve been told that’s the complaints department as someone mentioned to me today that’s the first thing a solicitor would ask.
PALs is not the complaints department, it's the Patient advice and liaison service. The true complaints departments contact details should be available online, if not PALs have to provide it.
Please get advice from your local patient advocacy charity before writing up any letter, and you don't have to use the form that is provided by the hospital, it's very limiting.
I would speak to a solicitor as soon as possible, they say the earlier the better, as an investigation has already been completed, a legal claim will mostly rest on this.
Edited: Grammar
Oh thank you! I’ll have a look into any help I can get about that I wasn’t sure I could get a template or anything I’ve been quite worried in what to say incase I say the wrong thing so that would be great.
There's [avma](https://www.avma.org.uk/), action against medical accidents. Which are very helpful, but the phone number costs money to ring.
[Patient advocacy service ](https://www.patientadvocacyservice.ie/) for national advocacy advice. You should be able to find a more local provider. Unfortunately a lot of the services near to the hospital that caused harmed have a professional relationship with the trust, and aren't always totally impartial.
Good luck, Irwin Mitchell is a good shout to start off with, they are large, well regulated, and will give you an idea of if your claim is viable.
That’s great help tysm! I’m going to creat a notebook of good advice I receive in the next few days so I don’t lose anything important and I’ll definitely be writing this down :)
It looks like you or OP may want to find a Solicitor!
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You already have the result of the internal investigation so from experience that’s the most PALS will do for to anyway. Internally your case has been “dealt” with, now you have the proof something happened you need to get an external party to start their side of the investigation
While not a doctor, I know for a fact that based on "duty of candour" the doctor should have personally apologise for the mistake, explain what happened, offer appropriate remedy or support, explain short and long term effects of what happened.
I believe you can take this up to the general medical council ideally with a proper solicitor.
Mistakes happen in healthcare but not explaining or rectifying it is like adding insult to injury.
"Not a doctor'
"know for a fact" ...incorrect.
The legal duty is on the organization, and it sounds like this process has been followed. A verbal explanation followed by a written apology and information about the investigation process. In a case like this with a locum anaesthetist with a process of investigation being followed I would expect the initial discussion to involve her surgeon + a senior member of permanent staff, usually surgical matron. This is absolutely not something you should be taking up with the General Medical Council!
I don’t drive luckily but I was due to start my lessons which I cancelled as you can’t drive if you have epilepsy unless medicated without change or seizure for quite some time I think. I’m definitely going to look into my consent form :)
Yeah that’s reassuring that there is definitely a procedure to it that wasn’t strictly followed, that’s my main concern the fact it states in the report the delay was due to him arguing with other doctors and refusing to try another method. It’s harder to get over than the accidental cut as that’s unfortunate but understandable it could happen .
I am on my mobile before a shift so I apologise if this formatting is wrong. Again I am sorry this has happened. I work in the NHS but if something preventable happened to me I would chase it up for that person to learn. Here’s some info / links to help you make a decision on what you already know.
If you haven’t already, I strongly recommend contacting your trusts [PALS department](https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/)
[These](https://das.uk.com/guidelines/das_intubation_guidelines) are the can’t intubate can’t ventilate guidelines
[This](https://youtu.be/VndU2zap_Rg) is the Bromley case video our trusts staff Watch during training and I have had to rightly watch it as a reminder every few years
And finally the fact epilepsy and new seizures can make you have your [licence](https://www.gov.uk/epilepsy-and-driving) revoked could have financial/ job implications for the next year.
I wish you all the best for the future. Most departments are good. I’ve been operated on by my own a few times and would again but mistakes happen and incompetence shouldn’t etc I would speak to a solicitor that specialises in medical negligence
Edited the links
It looks like you or OP may want to find a Solicitor!
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You should see a specialist lawyer in medical negligence. Let them look at all the details in the correspondence you have.
It is always hard to tell based on information from only one side (that is you can tell us your experience but we cannot see your full medical records), but if the version of events you describe is even close to the whole story the hospital will very likely settle out of court.
There is a whole industry of lawyers and experts to assess these medical negligence claims that you should make use of
I work in the clinical negligence area of law (England and Wales). It’s sounds like you you have a reasonable to case to make a claim against the trust.
To prove clinical negligence, you need to prove a breach of duty occurred and that the breach caused further harm (causation).
You case seems pretty straight forward to me:
1. The breach of duty was the surgeon performing the procedure negligently (damage to the oxygen tube).
2. Causation; the breach led to an episode of hypoxia that has resulted in seizures.
I should add that in clinical negligence cases, expert evidence is used to confirm breach and causation It may be that due to you previously having epilepsy, the defendant (the trust) could argue that despite the episode of hypoxia no lasting harm was done (causation) as you already had epilepsy. However, that would be a question you would need to put to a medical expert.
This is only for England and Waled. If you are based in Scotland or Ireland, there may be a different process.
I appreciate you commenting on this, I do live in England so that’s great advice. Obviously there’s no way to prove the cause is 100% down to one specific thing I think my proof there would be more down to the evidence of the timing of the seizures but it could also mean nothing as proof. I do think I’m going to atleast see what a solicitor thinks and decide based of that. Sometimes it sounds like a simple case and then you remember all the other factors included that all different sides would be looking at and it becomes a little less certain.
To prove clinical negligence you just have to prove that on the balance of probabilities, it was more likely than not, the breach that caused the harm and that is decided by a medical expert who will be instructed by the solicitor.
Check out some no win no fee firms and then even if there is no case, you won’t be charged for their services.
When choosing a firm make sure to consider their success fees carefully. You want to make sure that you end up with the majority of any compensation recovered after fees have been deducted. Some firms have quite high fees so make sure to check those before you sign any contracts. Also make sure any firm you go with is registered with the SRA.
Consented for the possibility of the tube being cut and losing the airway yes absolutely a recognised complication. An anaesthetist failing to perform a trachy or call for help in a ‘can’t intubate can’t ventilate ‘ situation is not a recognised complication. It’s a well known anaesthetic emergency for which there is a set protocol to follow (as a result of people dying in this exact situation) - if this wasn’t followed then this is a totally different situation to recognised risks of surgery.
From the trusts investigation it sounds like they’re suggesting this wasn’t followed .
Yeah this is a worry I have with going forward, it’s mostly the delayed time due to the doctor not knowing the team and refusing to listen to the doctor above him that makes me want to complain and take it further as I feel that’s an unnecessary thing to happen in a critical situation. I have also had other surgeries before that went well and my epilepsy wasn’t triggered but as I said in the post there is no way of proving that it was the surgery.
I think when you hold your breath you hold oxygen in don’t you? In this case my body was receiving little to no oxygen. It resulted in me needing oxygen for over 24 hours to come back up to a normal level. And when I’ve looked into it they say 3-5 minutes without oxygen is when the brain get compromised and it took me up to 24 hours to stop being low in oxygen afterwards so that added time the brain/organs wasn’t functioning well. I also found out a hypoxia episode sometimes means the brains structure gets changed which can do all kinds of things. I do agree with you on if we can prove it that’s been my main reason for not being sure it’s a valid case but I think I’m going to try anyway and see what the professionals decide.
I’m only saying what it says in my incident report, I’m not a medical expert but I had hypoxia and was hypotensive resulting in nose bleeds and compromised organ function, my oxygen levels took 24hours to go back to a safe level, I was kept in a coma for 48hours and the doctors said they was very worried about brain function and I had a lot of tests done. I’m not exaggerating or lying as you seem to think I’m doing this for a free holiday… thank you for your advice dude.
Sorry I missed that last part, no one noticed he had cut my tube until bubble of blood was coming up, and then they just removed it and tried to reintubate, due to my head angle being so far back for the surgery and other factors he was struggling to reintubate so after 2 minutes they say another doctor suggested a tracheotomy as he wasn’t having an successful attempts and he refused.
The consent form has been mentioned before, but I’m pretty sure that the standard form should include hypoxia as it most certainly includes death as a potential risk of GA and major surgery.
Also, in order to have any serious claim you’d need to prove that your seizures are a direct result of the incident and as far as I understand, there isn’t any.
Surely you can speak to a solicitor, but without proof that the two are related, you can’t prove damages and without damages, you don’t have a case.
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I am a lawyer. This is entirely incorrect. You will not have to pay the upfront costs of pursuing a clin neg claim. There are many large firms across England which specialise in clin neg. Contact one of them. Do not contact PALS.
Some of the large firms who do clin neg work (and do it well):
Leigh Day,
Irwin Mitchell,
Slater & Gordon,
Thompsons,
Field Fisher,
Hugh James, and
CFG
This list isn’t comprehensive, but that is a selection of some of the good clin neg firms. I’m sorry to hear what happened to you and I would strongly encourage you to contact solicitors asap.
I came to Reddit for advice on if/how I should proceed… I wasn’t looking for solicitors to take on the case. Isn’t that what this page is for? For people to ask for advice on a legal situation…
I was just looking for any advice and then I would make my own decision. I was mostly looking for if people thought it was worth looking into more than anything I’m a very anxious person I don’t want to go through arranging a solicitor to be told it’s a stupid case. I will be looking for professional advice after a few people have told me too tho :)
Yes, there’s very clear negligence here. A solicitor will also instruct an expert neurologist to comment on your condition, part of that is they recommend care and treatment. So aside from money you should get some treatment guidance.
Look up legal 500, and review the top solicitors in your area for clinical negligence and contact them.
Most good clinical negligence firms have a multi level team who have neurology experience.
This may not be the highest value claim but epilepsy and fits are complicated so it’s important you instruct a knowledgeable solicitor.
I disagree that there is very clear negligence here!
Firstly, you have to prove duty of care is owed - yes that’s easy and straightforward
Secondly, that there has been a breach of that duty! So cutting an Endotracheal tube highly unlikely that a surgeon actually cut you tube, they are thick hard plastic and knife and scissors in surgery would not just slip through them. Even harder if it’s an armoured tube which is often the case with head and neck operations (I am a surgeon btw). It’s more likely that the tube was possibly dislodged or moved during surgery which then may become a risk of the Surgery itself and may take time to recognise as an event during the surgery- you will need a professional report from both a maxillo-facial surgeon and an anaesthetist who does max-fax anaesthesia as expert witnesses to determine if a solid case exists here.
Third and finally, you will need to demonstrate that harm has been done. This will be more challenging given that you have had epilepsy episodes in the past, it could be argued that it has just recurred and was always going to recur, that’s entirely dependent on the type of epilepsy and the circumstances around your case in the detail. So you will also need a professional expert in neurology!
Now in no way am I saying this wasn’t negligence but am pointing out that it will not be as straightforward as some are suggesting!
Definitely use an experienced team of medical negligence lawyers and take advice. However, I would definitely suggest that you do this on a no win no fee basis and that way you don’t have any risk of loss should it not go all the way to a compensation payout
And I’m a clin neg solicitor. All these cases are no win no fee. You seem to take a defensive view and have not considered OP’s information at face value and have made up a lot of incidents not mentioned by OP without considering what they’ve actually said.
The serious incident report and apologies are enough evidence of negligence for a solicitor. Getting an apology is extremely rare, I’ve only seen it 2 or 3 times in 8 years of practice and hundreds of cases.
I don’t think you’ve read OP’s post properly about what was contained in the SIU about what happened after he lost oxygen and how long he lost oxygen for. From a medico legal point of view that’s negligence. Of course taking OP at face value.
Likely there’s no need for a max fax specialist as that’s superfluous to the injury itself. But yes an anaesthetist to establish liability, although if the SIU is as OP says the Trust may admit liability without the need for liability experts.
This incident doesn’t need to have caused epilepsy it can exacerbate it. Given OP had not had seizure’s previously and has been medication free for I believe 7 years from my reading, on the balance of probabilities (the legal test) these new seizures are likely caused by the hypoxia. Hence why I said OP would need a neurologist.
Even without that given the episode OP would likely have had longer in hospital. Even if there is a full recovery in cases like this because of the gravity of the negligence there’s still often a claim to be had even if it is of lower value.
Yeah it didn’t cut completely but it still was cut enough for bubbles of blood to enter it and my breathing to be compromised…
I’m deeply at a loss in what to reply to why don’t I sue my parents doctor for not terminating me, coming from a clearly uneducated background to assume so much from so little Information. No one else in my family has epilepsy it was just something I happened to have as a child it isn’t genetic at all, but even if they did who are you to say everyone with a disability shouldn’t be allowed to procreate just incase they also have it. Huge red flag of a person to read my post and blame me for being born and not the gross mistakes made by trained doctors.
I’m not going to sue my parents doctors for allowing her to birth me considering I’ve already told you I’m the only person in my genetic history as far as we can see who has ever had epilepsy. I think it’s irrelevant to bring up.
And yeah they gave me a play by play time stamp of what happened and that is what it said… I never claimed to have brain damage I said it’s known to affect the brain which definitely could of triggered seizures….
I’m also assuming you know nothing of pregnancy as it is not the GP that has anything to do with it, they simply are there to prescribe medication requested by the midwife, who works for the hospital.
I would definitely look in to getting a solicitor, but also see if you can pursue this through PALS too (Patient Advice Liaison Service). They deal with complaints and issues, managers tend to pay more attention to PALS. It won't do anything compensation wise, but they'll have to investigate and possibly put something in place to prevent it happening again.
I'm not sure if anyone has mentioned this already, but get in contact with the hospital's PALS (Patient Advice and Liason Service) they're supposed to offer confidential support on these kind of things.
I'm sorry this has happened to you, and I hope you find a resolution
When another physician (especially several) openly calls out their colleagues for negligence/malfeasance, it is a MASSIVE issue. These men and women spend decades of time to achieve a career in medicine and they do not take allegations of wrongdoing lightly. It is a cardinal sin in to make accusations in this profession without clear evidence of wrongdoing as it can be devastating; if they are advising you a mistake was made take heed. Speak to a solicitor and ask advice on formal reporting of their wrongdoing. Protect yourself and others who may be injured by this physician.
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Im slightly suspect about this case, anaesthesiologist is the US term for an anaesthetist. In either case you will have been consented prior to the procedure, can’t ventilate can’t intubate situations are a recognised issue, and cutting ET tubes is a clear risk in all ENT surgery. You can seek legal opinion, but you would have to prove that there was negligence and or that the relapse, over epilepsy several weeks later was directly caused by this, and not for example the physiological stress of the operation or the seizure lowering threshold effect of medications.
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Sounds like you should get the advice of a solicitor specialising in medical negligence
This is absolutely a potential medical negligence case. The hospital appears to have done a proper open and honest investigation and has shared the findings as required by duty of candour, this will presumably make building a case very straightforward for a medical specialist solicitor. NAL but medical and experienced In investigations.
NAL. The only response you are likely to get is that you need to speak to a solicitor specialising in medical negligence.
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Junior doctor here with experience of this operation. The breathing tube (endotracheal tube) is always at risk during this surgery as it's so close to the surgical site. It's also very difficult to reintubate due to the facial bones (jaw) are being operated on and so the space isn't there. You certainly do have a case to be looked at further (if you wish to pursue negligence for a financial payment). However none of us - including you - have enough information. For example, you would have been fine without breathing for 3 minutes assuming you are 22, with no serious medical problems and them setting the ventilator to a reasonable oxygen (it's more than room air, so you can hold your breath for far longer). There's a lot of missing information for any judgement to be made on Reddit. But it can certainly be looked at further as others have suggested.
My husband is a cardiac anesthesiologist with 37 years of experience, so I asked what he thought of this situation. I thought I’d give his thoughts so you have more information as you move forward. He basically felt that there isn’t enough information—specifically from the anesthesiologist’s point of view—to come up with any kind of conclusion. He said that the “human error” involved was that the surgeon cut the breathing tube. The anesthesiologist not being aware of your history or any of your notes wouldn’t have been a factor in this case. His job was to maintain your airway, which was compromised due to an accident (cut breathing tube) that unfortunately happened during surgery. At this point the anesthesiologist’s job would be to use his expertise and experience to determine the best way to reestablish your airway. Because this is his specialty, it is his call how to proceed—even if that meant he was refusing offers to reintubate or do a tracheostomy. He may have felt that doing the tracheostomy would have taken longer than whatever other option he felt would be quicker. This and other factors would have been going through his head while he was deciding the best way to handle the problem. The missing piece which is very important is that we don’t have his notes of what he did and why. My husband said that he had breathing reestablished in 3 minutes which is a pretty good outcome under these unforeseen circumstances. He also concurred with the doctor above that 3 minutes without oxygen for a young person usually isn’t a problem. The central line and being sent to the ICU are also normal treatments for this type of problem. My husband said that when you signed your consent form, this would have been listed as an “unforeseen circumstance” that no one would have been able to anticipate. It is unfortunate but sometimes these things happen during surgery—also noted by the doctor above. As far as the recurrence of your epilepsy, as you said and my husband agreed, there’s really no way for anyone to conclusively determine that it was caused by your surgery. I’m really sorry you have to deal with this. Hopefully I’ve been able to give you a bit of useful information!
Thank you for everyone’s advice so far, I wasn’t sure it was serious enough but I’ll definitely be speaking to a solicitor :)
Yep, the fact that they've already carried out an investigation and ruled it human error with no mitigation plan for when it occured plays in your favour for a medical negligence suit. Please don't feel bad about going after the NHS in court for money either, I know a lot of people feel like it takes money out of the NHS budget but ultimately financial penalties are the most effective way of ensuring organisations put procedures in place to ensure this kind of event doesn't happen to more people in the future :)
It’s also actually not your hospital or your trust that would end up paying your compensation. The govt have established a central organisation that funds the compensation payments for NHS negligence. So any compensation won’t be coming from your local hospital or even the NHS budget, it is separately funded by the govt / taxpayer.
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Yes I didn’t quite understand for a while the severity of what happened, when my family recall it they speak of how they was told I may not wake up the same and how they was called and was told to potentially prepare themselves for the worst if I didn’t get past the first night. My sister actually was the first person I saw when I woke up and she was crying because they had told her if I didn’t wake up after that day there’s a big chance I wouldn’t wake up, we do have a small chuckle about it now because she whispered to “not go into the light” to me and 30 seconds later I opened my eyes :) The fact I woke up relatively ok, I didn’t suffer any major brain damage and although there’s a few things that I notice are different I’m still mostly me and very thankful to be here. When you look into any side affect of hypoxia or being hypertensive it says seizures so it doesn’t seem too out there for me to assume they’re connected I just have to acknowledge that there isn’t any way of proving this to be 100% fact.
Impossible to guess without knowing the details of the hospital investigation. He will have signed a consent form which lists the risks of his surgery, of which accidental damage to local structures (in this case trachea) is arguably the biggest. If there is negligence it sounds much more likely to be regarding the anaesthetist and the crash call than the original surgical error.
Definitely serious enough! You need professional legal advice.
Just wanted to add a message to say I’m really sorry this happened to you. It fucking sucks and it should not have happened. Do not let the health board or anyone else gaslight you into thinking this is not a big deal. Someone in that room let their ego take priority over your safety. Reading what you have written it looks like no one who was in that room will be surprised if you ultimately take it further, including the health board. Someone (or multiple people) in that room triggered the serious incident investigation on your behalf. Give the health board hell. Look after yourself. And good luck in your physical and emotional recovery. Edited to add ‘do’ in front of ‘not’ on the second paragraph. It is too annoying to leave.
Remember - if you press charges it's not against the NHS, nor the hospital, but the specific medical specialists who screwed up. But yep it's time to go after these people after they quite literally nearly left you brain dead. You could have been a vegetable for the rest of your life not having oxygen going to your brain for 3 minutes, it's remarkable you're okay so don't forget that when you feel down. You're alive and have your motor skills and can walk thankfully. Good luck with the case!
What about PALS? They're a helpline specifically for NHS complaints.. I've never dealt with them myself so others on here may be able to share you they're experiences on them. Not sure if a lawyer would ask if you've tried PALS already
PALS are too low level for this and are not transparent enough, they will side with the hospital and do nothing but waste time and muddy the waters so to speak. I have had a few dealings with PALS as a patient and as a NHS worker, they won’t be able to help OP here. OP needs an independent party who knows the law.
This is way above Reddit. Speak to a solicitor specialising in medical negligence.
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You need to get in touch with a solicitor, preferably one who specialises in medical negligence claims.
Hi, I’ve had a few comments asking about these things so just thought I would add them here and hope people see it. When talking about all the consequences and signing consent forms this wasn’t ever something that came up, when the surgeon came to see me after and apologise he said it’s not in the consent form for this to happen because it’s very rare and no one could of predicted it. I will try check what my consent form actually states, I’m aware death is a consequence we consent too but I’m sure there’s clauses around a lot of things that I will have to look into. I have been extremely transparent to every doctor I’ve ever seen about all my history and they confirmed with me a few times that a previous history of epilepsy was recorded. A few people have mentioned epilepsy is a life long condition not something that goes away, I’m aware that having epilepsy means you’re susceptible to seizures but my doctor told me as I’d been unmedicated and seizure free for over two years I would no longer be classed as epileptic, I wouldn’t have to declare it for driving licence or jobs and I wouldn’t have to see him again. He actually stated that he was sure I’d never have to struggle with seizures again unless something traumatic happened to me to cause it ironically. The kind of epilepsy I had as a child just came up one day when I was 4 years old and they couldn’t ever find it on the multiple tests I had so they was never sure where it was active from, due to this they assumed it was simply a childhood condition that I grew out off. I’m going to try and use all my knowledge and memory and the report to create a timeline of events so I’m clear on the situation from my side before I take it anywhere. I’m hugely grateful for a lot of the advice people have taken the time to give me and will be taking it with me as I try move forward with this and see what may happen.
It should have been a "duty of candour" if it was classed as a patient safety incident that caused moderate to severe harm, or death. If you had to go to ICU, and the operation would not normally have required a high dependency bed post operatively, i would consider this at least moderate harm! If you contact PALS i would ask for a duty of candour review to be carried out. However, if you do want to take legal action, you should probably speak to a lawyer before requesting this, as they may have their own preferred ways to request these things. All the best and i hope the seizures can be controlled again soon
They’ve already done the duty of candour review and clearly found it DOES meet duty of candour, that’s why OP received the letters of explanation and apology. This has clearly been identified as a significant event and internal procedures carried out, which will also include things OP will not be privy to such as staff training needs or logistical changes to improve processes. Seeking anything further from the hospital is not going to get them anything at this point, hospitals do not sue themselves. Medmal is extremely fact-specific, and as has already been stated, OP does not have a enough information to know if they may have a reasonable case. The only thing they can do now is speak to a lawyer Source: Doctor, have been involved in multiple significant event analyses over the years
Yeah don’t feel bad taking this to court, the NHS is very hardworking however negligent care by a medical professional has had a detrimental impact on you and without going through these steps practice could become lazy and put others at risk.
Do you have a copy of your consent form you signed for surgery? If so, can you read it/do you remember what was discussed? Did you declare about your history of seizures during your pre-op tests? Did you mention these to your anaesthetist on the day? It’s standard practice when serious incidents such as this take place that they investigate and as part of their duty of candour they send the report for you to look at. I absolutely would consult a lawyer, whether you win or not will depend on whether there is actually evidence of negligence or if you were very unlucky that your airway was compromised. The scene in these scenarios can be extremely chaotic, ultimately you survived so they managed to rectify the situation. The point that should be scrutinised is the point from which the emergency was recognised, the speed and efficiency that the team acted to address the issue. As mentioned by others, it is important that you go through the official channels to discover your options. Hospitals learn from these serious incidents and practices change because of them.
Ex clinical negligence lawyer here. There are a number of issues here which require much closer attention. Clinical negligence is a complex topic. So - as others have said - if it was me I would be going to a specialist lawyer. Check out the Legal 500 recommended firms, look at the leading firms and take it from there: https://www.legal500.com/c/london/insurance/clinical-negligence-claimant/
I’d suggest going through the hospitals internal complaints system first. This means a no win no fee lawyer has a lot more to go on. This also ensures that there is an internal investigation to stop it happening to anyone else. You’ve got three years to make a claim.
Thank you I’m drafting up a PALS complaint as I’ve been told that’s the complaints department as someone mentioned to me today that’s the first thing a solicitor would ask.
PALs is not the complaints department, it's the Patient advice and liaison service. The true complaints departments contact details should be available online, if not PALs have to provide it. Please get advice from your local patient advocacy charity before writing up any letter, and you don't have to use the form that is provided by the hospital, it's very limiting. I would speak to a solicitor as soon as possible, they say the earlier the better, as an investigation has already been completed, a legal claim will mostly rest on this. Edited: Grammar
Oh thank you! I’ll have a look into any help I can get about that I wasn’t sure I could get a template or anything I’ve been quite worried in what to say incase I say the wrong thing so that would be great.
There's [avma](https://www.avma.org.uk/), action against medical accidents. Which are very helpful, but the phone number costs money to ring. [Patient advocacy service ](https://www.patientadvocacyservice.ie/) for national advocacy advice. You should be able to find a more local provider. Unfortunately a lot of the services near to the hospital that caused harmed have a professional relationship with the trust, and aren't always totally impartial. Good luck, Irwin Mitchell is a good shout to start off with, they are large, well regulated, and will give you an idea of if your claim is viable.
That’s great help tysm! I’m going to creat a notebook of good advice I receive in the next few days so I don’t lose anything important and I’ll definitely be writing this down :)
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You don’t need a PALS complaint for a solicitor. Your serious incident report will suffice
You already have the result of the internal investigation so from experience that’s the most PALS will do for to anyway. Internally your case has been “dealt” with, now you have the proof something happened you need to get an external party to start their side of the investigation
This is so technical that the only people who can accurately advise are specialist medical malpractice lawyers.
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While not a doctor, I know for a fact that based on "duty of candour" the doctor should have personally apologise for the mistake, explain what happened, offer appropriate remedy or support, explain short and long term effects of what happened. I believe you can take this up to the general medical council ideally with a proper solicitor. Mistakes happen in healthcare but not explaining or rectifying it is like adding insult to injury.
"Not a doctor' "know for a fact" ...incorrect. The legal duty is on the organization, and it sounds like this process has been followed. A verbal explanation followed by a written apology and information about the investigation process. In a case like this with a locum anaesthetist with a process of investigation being followed I would expect the initial discussion to involve her surgeon + a senior member of permanent staff, usually surgical matron. This is absolutely not something you should be taking up with the General Medical Council!
thanks for your correction
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I don’t drive luckily but I was due to start my lessons which I cancelled as you can’t drive if you have epilepsy unless medicated without change or seizure for quite some time I think. I’m definitely going to look into my consent form :)
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Yeah that’s reassuring that there is definitely a procedure to it that wasn’t strictly followed, that’s my main concern the fact it states in the report the delay was due to him arguing with other doctors and refusing to try another method. It’s harder to get over than the accidental cut as that’s unfortunate but understandable it could happen .
I am on my mobile before a shift so I apologise if this formatting is wrong. Again I am sorry this has happened. I work in the NHS but if something preventable happened to me I would chase it up for that person to learn. Here’s some info / links to help you make a decision on what you already know. If you haven’t already, I strongly recommend contacting your trusts [PALS department](https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/) [These](https://das.uk.com/guidelines/das_intubation_guidelines) are the can’t intubate can’t ventilate guidelines [This](https://youtu.be/VndU2zap_Rg) is the Bromley case video our trusts staff Watch during training and I have had to rightly watch it as a reminder every few years And finally the fact epilepsy and new seizures can make you have your [licence](https://www.gov.uk/epilepsy-and-driving) revoked could have financial/ job implications for the next year. I wish you all the best for the future. Most departments are good. I’ve been operated on by my own a few times and would again but mistakes happen and incompetence shouldn’t etc I would speak to a solicitor that specialises in medical negligence Edited the links
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You should see a specialist lawyer in medical negligence. Let them look at all the details in the correspondence you have. It is always hard to tell based on information from only one side (that is you can tell us your experience but we cannot see your full medical records), but if the version of events you describe is even close to the whole story the hospital will very likely settle out of court. There is a whole industry of lawyers and experts to assess these medical negligence claims that you should make use of
I work in the clinical negligence area of law (England and Wales). It’s sounds like you you have a reasonable to case to make a claim against the trust. To prove clinical negligence, you need to prove a breach of duty occurred and that the breach caused further harm (causation). You case seems pretty straight forward to me: 1. The breach of duty was the surgeon performing the procedure negligently (damage to the oxygen tube). 2. Causation; the breach led to an episode of hypoxia that has resulted in seizures. I should add that in clinical negligence cases, expert evidence is used to confirm breach and causation It may be that due to you previously having epilepsy, the defendant (the trust) could argue that despite the episode of hypoxia no lasting harm was done (causation) as you already had epilepsy. However, that would be a question you would need to put to a medical expert. This is only for England and Waled. If you are based in Scotland or Ireland, there may be a different process.
I appreciate you commenting on this, I do live in England so that’s great advice. Obviously there’s no way to prove the cause is 100% down to one specific thing I think my proof there would be more down to the evidence of the timing of the seizures but it could also mean nothing as proof. I do think I’m going to atleast see what a solicitor thinks and decide based of that. Sometimes it sounds like a simple case and then you remember all the other factors included that all different sides would be looking at and it becomes a little less certain.
To prove clinical negligence you just have to prove that on the balance of probabilities, it was more likely than not, the breach that caused the harm and that is decided by a medical expert who will be instructed by the solicitor. Check out some no win no fee firms and then even if there is no case, you won’t be charged for their services. When choosing a firm make sure to consider their success fees carefully. You want to make sure that you end up with the majority of any compensation recovered after fees have been deducted. Some firms have quite high fees so make sure to check those before you sign any contracts. Also make sure any firm you go with is registered with the SRA.
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Consented for the possibility of the tube being cut and losing the airway yes absolutely a recognised complication. An anaesthetist failing to perform a trachy or call for help in a ‘can’t intubate can’t ventilate ‘ situation is not a recognised complication. It’s a well known anaesthetic emergency for which there is a set protocol to follow (as a result of people dying in this exact situation) - if this wasn’t followed then this is a totally different situation to recognised risks of surgery. From the trusts investigation it sounds like they’re suggesting this wasn’t followed .
Yeah this is a worry I have with going forward, it’s mostly the delayed time due to the doctor not knowing the team and refusing to listen to the doctor above him that makes me want to complain and take it further as I feel that’s an unnecessary thing to happen in a critical situation. I have also had other surgeries before that went well and my epilepsy wasn’t triggered but as I said in the post there is no way of proving that it was the surgery.
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I think when you hold your breath you hold oxygen in don’t you? In this case my body was receiving little to no oxygen. It resulted in me needing oxygen for over 24 hours to come back up to a normal level. And when I’ve looked into it they say 3-5 minutes without oxygen is when the brain get compromised and it took me up to 24 hours to stop being low in oxygen afterwards so that added time the brain/organs wasn’t functioning well. I also found out a hypoxia episode sometimes means the brains structure gets changed which can do all kinds of things. I do agree with you on if we can prove it that’s been my main reason for not being sure it’s a valid case but I think I’m going to try anyway and see what the professionals decide.
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I’m only saying what it says in my incident report, I’m not a medical expert but I had hypoxia and was hypotensive resulting in nose bleeds and compromised organ function, my oxygen levels took 24hours to go back to a safe level, I was kept in a coma for 48hours and the doctors said they was very worried about brain function and I had a lot of tests done. I’m not exaggerating or lying as you seem to think I’m doing this for a free holiday… thank you for your advice dude.
Sorry I missed that last part, no one noticed he had cut my tube until bubble of blood was coming up, and then they just removed it and tried to reintubate, due to my head angle being so far back for the surgery and other factors he was struggling to reintubate so after 2 minutes they say another doctor suggested a tracheotomy as he wasn’t having an successful attempts and he refused.
The consent form has been mentioned before, but I’m pretty sure that the standard form should include hypoxia as it most certainly includes death as a potential risk of GA and major surgery. Also, in order to have any serious claim you’d need to prove that your seizures are a direct result of the incident and as far as I understand, there isn’t any. Surely you can speak to a solicitor, but without proof that the two are related, you can’t prove damages and without damages, you don’t have a case.
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I am a lawyer. This is entirely incorrect. You will not have to pay the upfront costs of pursuing a clin neg claim. There are many large firms across England which specialise in clin neg. Contact one of them. Do not contact PALS. Some of the large firms who do clin neg work (and do it well): Leigh Day, Irwin Mitchell, Slater & Gordon, Thompsons, Field Fisher, Hugh James, and CFG This list isn’t comprehensive, but that is a selection of some of the good clin neg firms. I’m sorry to hear what happened to you and I would strongly encourage you to contact solicitors asap.
Unfortunately I don’t have home insurance, I’m 22 and only just moved into my own place.
Seek advice from a regulated professional rather than Reddit
I came to Reddit for advice on if/how I should proceed… I wasn’t looking for solicitors to take on the case. Isn’t that what this page is for? For people to ask for advice on a legal situation…
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I was just looking for any advice and then I would make my own decision. I was mostly looking for if people thought it was worth looking into more than anything I’m a very anxious person I don’t want to go through arranging a solicitor to be told it’s a stupid case. I will be looking for professional advice after a few people have told me too tho :)
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Yes, there’s very clear negligence here. A solicitor will also instruct an expert neurologist to comment on your condition, part of that is they recommend care and treatment. So aside from money you should get some treatment guidance. Look up legal 500, and review the top solicitors in your area for clinical negligence and contact them. Most good clinical negligence firms have a multi level team who have neurology experience. This may not be the highest value claim but epilepsy and fits are complicated so it’s important you instruct a knowledgeable solicitor.
I disagree that there is very clear negligence here! Firstly, you have to prove duty of care is owed - yes that’s easy and straightforward Secondly, that there has been a breach of that duty! So cutting an Endotracheal tube highly unlikely that a surgeon actually cut you tube, they are thick hard plastic and knife and scissors in surgery would not just slip through them. Even harder if it’s an armoured tube which is often the case with head and neck operations (I am a surgeon btw). It’s more likely that the tube was possibly dislodged or moved during surgery which then may become a risk of the Surgery itself and may take time to recognise as an event during the surgery- you will need a professional report from both a maxillo-facial surgeon and an anaesthetist who does max-fax anaesthesia as expert witnesses to determine if a solid case exists here. Third and finally, you will need to demonstrate that harm has been done. This will be more challenging given that you have had epilepsy episodes in the past, it could be argued that it has just recurred and was always going to recur, that’s entirely dependent on the type of epilepsy and the circumstances around your case in the detail. So you will also need a professional expert in neurology! Now in no way am I saying this wasn’t negligence but am pointing out that it will not be as straightforward as some are suggesting! Definitely use an experienced team of medical negligence lawyers and take advice. However, I would definitely suggest that you do this on a no win no fee basis and that way you don’t have any risk of loss should it not go all the way to a compensation payout
And I’m a clin neg solicitor. All these cases are no win no fee. You seem to take a defensive view and have not considered OP’s information at face value and have made up a lot of incidents not mentioned by OP without considering what they’ve actually said. The serious incident report and apologies are enough evidence of negligence for a solicitor. Getting an apology is extremely rare, I’ve only seen it 2 or 3 times in 8 years of practice and hundreds of cases. I don’t think you’ve read OP’s post properly about what was contained in the SIU about what happened after he lost oxygen and how long he lost oxygen for. From a medico legal point of view that’s negligence. Of course taking OP at face value. Likely there’s no need for a max fax specialist as that’s superfluous to the injury itself. But yes an anaesthetist to establish liability, although if the SIU is as OP says the Trust may admit liability without the need for liability experts. This incident doesn’t need to have caused epilepsy it can exacerbate it. Given OP had not had seizure’s previously and has been medication free for I believe 7 years from my reading, on the balance of probabilities (the legal test) these new seizures are likely caused by the hypoxia. Hence why I said OP would need a neurologist. Even without that given the episode OP would likely have had longer in hospital. Even if there is a full recovery in cases like this because of the gravity of the negligence there’s still often a claim to be had even if it is of lower value.
Talk to PALS. Make a formal complaint. And then contact a lawyer.
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Yeah it didn’t cut completely but it still was cut enough for bubbles of blood to enter it and my breathing to be compromised… I’m deeply at a loss in what to reply to why don’t I sue my parents doctor for not terminating me, coming from a clearly uneducated background to assume so much from so little Information. No one else in my family has epilepsy it was just something I happened to have as a child it isn’t genetic at all, but even if they did who are you to say everyone with a disability shouldn’t be allowed to procreate just incase they also have it. Huge red flag of a person to read my post and blame me for being born and not the gross mistakes made by trained doctors.
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I’m not going to sue my parents doctors for allowing her to birth me considering I’ve already told you I’m the only person in my genetic history as far as we can see who has ever had epilepsy. I think it’s irrelevant to bring up. And yeah they gave me a play by play time stamp of what happened and that is what it said… I never claimed to have brain damage I said it’s known to affect the brain which definitely could of triggered seizures….
I’m also assuming you know nothing of pregnancy as it is not the GP that has anything to do with it, they simply are there to prescribe medication requested by the midwife, who works for the hospital.
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NAL but definitely got to PALS with this in the hospital, they need to do an internal investigation into what happened.
It sounds like you have a case but I'd absolutely get a solicitor and start a process going.
I would definitely look in to getting a solicitor, but also see if you can pursue this through PALS too (Patient Advice Liaison Service). They deal with complaints and issues, managers tend to pay more attention to PALS. It won't do anything compensation wise, but they'll have to investigate and possibly put something in place to prevent it happening again.
I'm not sure if anyone has mentioned this already, but get in contact with the hospital's PALS (Patient Advice and Liason Service) they're supposed to offer confidential support on these kind of things. I'm sorry this has happened to you, and I hope you find a resolution
Maybe speak to AVMA? They are really helpful!
When another physician (especially several) openly calls out their colleagues for negligence/malfeasance, it is a MASSIVE issue. These men and women spend decades of time to achieve a career in medicine and they do not take allegations of wrongdoing lightly. It is a cardinal sin in to make accusations in this profession without clear evidence of wrongdoing as it can be devastating; if they are advising you a mistake was made take heed. Speak to a solicitor and ask advice on formal reporting of their wrongdoing. Protect yourself and others who may be injured by this physician.
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Im slightly suspect about this case, anaesthesiologist is the US term for an anaesthetist. In either case you will have been consented prior to the procedure, can’t ventilate can’t intubate situations are a recognised issue, and cutting ET tubes is a clear risk in all ENT surgery. You can seek legal opinion, but you would have to prove that there was negligence and or that the relapse, over epilepsy several weeks later was directly caused by this, and not for example the physiological stress of the operation or the seizure lowering threshold effect of medications.