Negligent removal of the appendix

Ms F was admitted to hospital after having suffered with abdominal pain for a few days, which had localised to the lower left abdomen.

She was diagnosed with appendicitis and underwent a laparoscopic appendectomy (removal of the appendix) the same day.

She continued to deteriorate and her symptoms worsened so Ms F was readmitted to hospital.

The clinical impression was that she had developed peritonitis (an infection of the inner lining of the abdomen) and a CT scan reported free fluid seen in her pelvis which confirmed probable abdominal peritonitis and she was consented for laparoscopic washout.

The findings of surgery noted there was a remaining necrotic stump of appendix – which was adherent with the ileum (part of the small intestine) and fallopian tube and mixed with pus and slough. Free fluid was also noticed to the left of the liver under the diaphragm.

The stump was removed, a drain was placed and antibiotics prescribed.

Ms F was later diagnosed with a faecal fistula and required total parenteral nutrition (TPN) via a central line. She was discharged with a stoma bag and gastroenterology follow-up. She now suffers from adhesions.

It was Ms F’s case that it was negligent to leave an appendix stump in situ at the time of the index surgery and had the appendix been properly removed she would have made an uneventful and comparatively swift recovery. She would have avoided the subsequent deterioration and further surgery and the complications she suffered thereafter including: continuing sepsis, a faecal fistula (which resulted from the pus, slough, necrosis and septic complications caused by the stump), the need for TPN feeding and the development of intra-abdominal adhesions.

Settlement negotiations took place in which Ms F was awarded a financial settlement.