Case studies

Damages obtained for client who suffered retained swab during caesarean section


We have settled a claim against Epsom and St Helier University Hospitals NHS Trust for negligence relating to the treatment received by our client when giving birth to her baby in December 2012.

Our client was admitted to the antenatal ward at St Helier Hospital in labour with her second child. After a prolonged period during which the labour failed to progress and concerns were raised about the baby’s heartrate, the mother was transferred to theatre for a category 1 emergency caesarean section. Fortunately, the baby was born without injury but the delivery had been very difficult, with extensive post-partum haemorrhage and tears.

Post-operatively our client reported a lot of pain, with nausea and a tender abdomen. Her temperature was raised at times. An abdominal x-ray the day after the C section was not reported to show any abnormalities of concern. Our client’s symptoms persisted and her stomach was found to be distended. She suffered vomiting and was feverish.

Due to our client’s persisting symptoms, the x-ray was reviewed the following day by a consultant who determined that it showed distended loops of bowel and marked faecal loading. A CT scan was ordered and a retained swab was noted in the right iliac fossa.

An emergency exploratory laparotomy took place that evening which found pus-free fluid within the abdomen, a dilated small and large bowel, and omental adhesions. A large abdominal swab was removed from the right iliac fossa during the procedure.

The trust completed a serious incident investigation which criticised the retained swab. This is considered by the NHS to be a “never event”. This means that it is never acceptable for a swab to be left inside a patient following surgery, given the mandatory procedures which exist to prevent this from occurring. The consequences of a delayed swab can be serious and include infection, blockages, sepsis, adhesions and even death.

We obtained expert evidence from a consultant gynaecologist and obstetrician which was not only critical of the retained swab but also of the delays in proceeding to a C section as this exacerabated the rushed nature of the surgery and complication risk, and in identifying and removing the swab.

Following surgery to remove the swab, our client had a short stay in ITU before being transferred to a ward for several days. She was separated from her new-born baby due to her ill-health and she was unable to breastfeed due to the medication for the infection, the pain and discomfort, as well as the length of the separation. She was left with scarring from the surgical wound from the exploratory laparotomy. The events also had a significant psychological and emotional impact on our client in the form of Post-Traumatic Stress Disorder (PTSD), major depression and  a fear of childbirth causing her to curtail her plans to have more children.

The claim was submitted to the trust and partial admissions were received on liability and causation. The case subsequently concluded following negotiations between the parties and our client’s acceptance of an offer from the NHS Litigation Authority (NHSLA).


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