General surgery clinical negligence reports
Independent reports from consultant general surgeons on abdominal surgery, its complications and delayed diagnosis, prepared to CPR Part 35 for courts in England and Wales.
General surgery negligence claims usually involve the abdomen: a bile duct injured during gallbladder removal, a bowel perforation during laparoscopic surgery that was not recognised afterwards, appendicitis or bowel obstruction diagnosed too late, a retained swab, and a delayed diagnosis of bowel cancer.
Expert Medical Examination arranges independent reports from GMC-registered consultant general surgeons, including colorectal and upper gastrointestinal surgeons where the claim needs that sub-specialty.
Complications after surgery
Many surgical claims are less about the operation than what followed it. The report looks at the observations, blood results and ward reviews after surgery, and whether signs of a leak, bleed or perforation were acted on as a reasonably competent surgical team would have acted at the time.
Condition and prognosis
The report sets out the effect of the complication, such as further operations, a stoma, a hernia at the wound or adhesions, and any lasting effect on eating, bowel function or work. It compares that with the course competent treatment would probably have followed.
Consent to abdominal surgery
Some gallstone and hernia problems can be managed without an operation. Where a claim says that option, or a particular risk, was never explained, the expert can say which alternatives were reasonable at the time and which risks were or should have been known. Whether a risk was material is for the court.
Surgical negligence evidence grounded in the records
The operation note, the ward observations and the timing of each decision usually tell the story, and the expert reads them against the standard of a reasonably competent surgeon at the time.
- Bile duct injury during gallbladder surgery
- Bowel perforation and anastomotic leak
- Missed or delayed appendicitis
- Delayed diagnosis of bowel cancer
- Retained swabs and instruments
- Hernia repair complications
- Post-operative sepsis and delayed return to theatre
General surgery clinical negligence reports: FAQs
Is a bile duct injury during gallbladder surgery negligent?
Not automatically, because bile duct injury can happen even when gallbladder removal is done with reasonable care. The expert looks at two things: whether the surgeon took the steps a reasonably competent general surgeon would take to identify the anatomy before dividing any structure, and whether the injury was recognised and repaired, or referred to a specialist unit, in good time. That opinion is for the court to weigh.
Who addresses a delayed diagnosis of appendicitis or bowel cancer?
That depends on where the delay happened. If a GP failed to refer, a GP expert addresses breach of duty; if an emergency department sent the patient home, an emergency medicine expert does; if the delay was on a surgical ward, a general surgeon does. A general or colorectal surgeon, and for cancer sometimes an oncologist, then addresses causation, such as whether earlier surgery would have prevented a perforation, or whether an earlier cancer diagnosis would have changed the outlook.
What does the report cover when a swab or instrument was left inside?
It sets out the consequences: the symptoms before the object was found, the further surgery needed to remove it, any infection or bowel injury it caused, and the long-term outlook. Breach of duty may be admitted in these claims. Where it is disputed, a surgeon considers whether the swab and instrument counts met a reasonable standard, with a theatre nursing expert where the count itself is in issue.
Which records does a general surgery expert need?
The operation note is central, along with the anaesthetic record, histology reports, imaging, observation and fluid charts, wound and drain records, the consent form, and the GP and hospital records from before and after the operation.
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