Perforated Uterus - Negligence Claims

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Many OBGYN procedures require the insertion of a device, object or a doctor’s hand into the uterus. Each procedure brings with it the risk of complication. One of the more common complications that can arise is uterine perforation. Our specialist medical solicitors can provide you with advice as to whether you have a negligence claim if your uterus has been perforated. Contact our service for obligation-free assistance.

IUD and uterine perforation

One of the most common procedures that require entry to the uterus is for the insertion of an intrauterine device (IUD) such as Mirena. In the last two decades IUDs have seen a resurgence in popularity as drug eluting devices have become reliable and affordable. As a result, the insertion of these devices has become one of the most requested procedures amongst women. Typically taking just minutes to insert, the doctor places the device at the entrance to the uterus where it steadily emits medicine as well as providing a physical deterrent to embryo implantation.

Perforated uterus from surgery

Another common procedure is the hysteroscopy where the uterus is viewed through a device by the doctor. Other common procedures are dilation and curettage (D&C) and dilation and evacuation (D&E or STOP).

The risk of perforation is relatively low, however, there are some factors that will increase that risk. Anything that alters the strength of the myometrial wall can cause an elevated risk of perforation. A good example of this is pregnancy or menopause, thereby requiring more delicate care and monitoring to ensure the uterus does not tear during the procedure.

The most common way for a perforation to be noticed is self-reporting by the surgeon performing the work. When they are performing the procedure, they are the best to know if the uterus tears, and when it does, they immediately shift to treating the perforation. It is estimated that many tears go unnoticed and therefore the incidence is probably higher than that reported.

Complications from a perforation

The perforation of the uterus, when it is the sole complication is not a huge cause for concern. Left untreated it will most likely cure itself in a relatively short period of time. Frequently there are more perforations than just the uterus, and that is where it gets complicated. The most frequent ancillary perforation is in the bowel, which leads to a dangerous situation where microbe laden material enters the otherwise clean abdominal cavity. This brings with it a very high risk of infection which may be life threatening. Perforated organs may also result in haemorrhage where bleeding occurs within the body.

The risk of perforation is minimal with sound surgical technique, but if it is discovered that one occurs, it should be appropriately dealt with. Often the procedure is stopped, and a hysteroscopy is performed to see the severity. If it is required, the perforation can be repaired laparoscopically or through a laparotomy. How the perforation is dealt with, depends on the type of procedure, the location of the perforation and its severity. Often the perforation typically heals by itself, once it is ensured sepsis and excessive hemorrhaging is not a concern.

Uterine perforation compensation

Many would argue that a perforation of the uterus is an inherent risk of certain procedures and should not be compensible. This may be true in some cases, but not all. Each individual case needs to be assessed on its own merits. Attention should also be paid to how a perforation is dealt with to minimise further complications. At all times, including during the provision of treatment in dealing with complications, a doctor must exercise reasonable care. Failure to do so may result in compensation for negligence.

Should you have any concerns regarding gynaecological treatment provided by a specialist gynaecologist or a GP, contact our service.

 

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