An Increase in Gynaecology Neurological Injury Claims

A Case Study Example

The Claimant, who had a history of irregular and heavy menstrual bleeding, underwent a subtotal abdominal hysterectomy and removal of ovaries. Before the surgery, the Claimant signed a consent form, which included the risk of surgery, but did not mention the risk of nerve injury or damage.

After the procedure, the Claimant was unable to feel her left leg. The Claimant was referred for a neurological assessment, where it was identified that she had suffered damage to her femoral nerve during the operation.

An Increase in Gynaecology Neurological Injury Claims

THEMIS’s Lead Clinical Partner, TMLEP, has identified a growing increase in the number of claims being brought against Consultant Gynecologists in relation to femoral nerve injuries sustained as a result of abdominal hysterectomies.

Neurological injuries commonly occur when the nerve is compressed against the pelvic sidewall as it emerges from the lateral border of the psoas muscle.

Currently in the UK, awareness of neurological injury is not widely recognised by gynaecologists, and it is not discussed in the standard consent form provided by the Royal College of Gynaecologists. Therefore, it is understandable why this risk is not commonly listed on a Patient’s consent forms.

A Recommendation to Prevent Claims and Improve Patient Safety

As more of these injuries are being reported, the knowledge of the risk is increasing and therefore, TMLEP suggest that, in the interests of improving healthcare standards and patient safety, risks surrounding neurological injury (especially that relating to the femoral nerve) should be discussed with all patients undergoing hysterectomy surgery and specifically consented to.

Important Note

This article is intended to raise awareness to clinical risk issues in an effort to reduce incidence recurrence and improve patient safety. This is not intended to be relied upon as advice. Facts have been altered to ensure this case is non-identifiable, albeit clinical learning points remain applicable.