Delayed diagnosis of appendicitis

Mrs H attended A and E due to suffering with significant abdominal pain and vomiting. This was following intermittent abdominal pain over the course of a month.

On examination, she had abdominal tenderness and rebound (pain felt on removal of pressure). Her white cell count was raised and she was referred for surgical review with suspected appendicitis.

Following this review, the initial opinion was that she had gastroenteritis. The plan was to stop antibiotics and after checking her C – reactive protein (CRP) levels, (which would have indicated an infection or inflammation) and if she was feeling well, she could be discharged. Mrs H was however discharged home the following day without her CRP being checked.

Over the following months, Mrs H visited her GP on a number of occasions with ongoing abdominal pain. She returned to the hospital, complaining of left sided abdominal pain and vomiting. She underwent laparoscopic appendicectomy to remove the appendix.

It was Mrs H’s case that had her symptoms been reasonably and adequately investigated on her first presentation at the hospital, a diagnosis of appendicitis would have been made promptly following her presentation at hospital.  Laparoscopic appendicectomy would have been undertaken and she would, on the balance of probabilities, have enjoyed an uneventful and full recovery. She would have avoided the subsequent complications that she suffered after the operation and subsequent laparotomy, sepsis and the loop colostomy and its consequence.

The Defendant denied that Mrs H had appendicitis and as such there was no negligent failure to diagnose and provide treatment.

The case was complicated when Mrs H was diagnosed with Crohn’s disease after pleadings had been served. The Defendant suggested that she had in fact suffered with Crohn’s at the time of the alleged negligence and there wasn’t a failure at all to diagnose appendicitis.

Testing/review of biopsy slides from the surgery were not indicative of Crohn’s and were in keeping with appendicitis. Mrs H’s case therefore did not change.

Mrs H received payment of damages following negotiations for settlement.