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Daily Record
Daily Record
National
Ellie Forbes & Fionnuala Boyle

Trainee doctor damaged woman's bowel during hysterectomy at Scots hospital

A woman whose bowel was damaged while undergoing a hysterectomy at a Paisley hospital was operated on by a trainee too junior to handle the intricate procedure, a watchdog has found.

The woman, in her 40s, had a hysterectomy at the Royal Alexandra Hospital in Paisley, Renfrewshire, on January 14, 2020, to treat heavy periods.

The procedure was deemed more risky than usual because she had previously had four caesarean sections.

After the woman woke up from the operation, she was in significant discomfort which continued to increase in the following days.

Her bowel injury was discovered three days later when doctors, qualified for less than two years, responded to her deteriorating condition.

An investigation by the Scottish Public Services Ombudsman found the op was carried out by a doctor at least three years away from completing their specialist training.

The watchdog expressed 'considerable concern' about why the procedure was considered appropriate for a trainee.

A report also found NHS Greater Glasgow and Clyde failed to be transparent about the junior level of the operating trainee when a complaint was made.

The SPSO has ordered the healthboard to apologise to the patient, referred to in documents as C.

A report said: "The Adviser did not consider the operation was suitable for a trainee doctor to undertake, given the particular risks associated with the case and the point they were at in their training.

"Therefore, it was unreasonable to have expected a trainee to perform this procedure.

"The records from the operation did not indicate a complication occurred, however, the adviser's view was that it should have been recognised during the operation given the nature of the damage and consequently dealt with at that time.

"It was unreasonable that the complication during the surgery wasn't recognised.

"According to the operation note the procedure was performed by a trainee (operating trainee) assisted by the operating consultant.

"Hysterectomy is no longer a procedure that all trainees in obstetrics and gynaecology are trained to do.

"Hysterectomy is now part of the Advanced Training and Skills Module (ATSM) in benign gynaecological surgery which is not done by all trainees.

"If taken, it is done at the end of training.

"For all the reasons above this was a procedure with a higher than usual degree of difficulty.

"This was not a suitable case for a trainee except for one very close to becoming a consultant and already trained in hysterectomy and doing it under supervision and certainly not for a trainee unless doing the ATSM.

"Neither the operating trainee or the operating consultant sufficiently monitored C.

"If they had done it should have been very obvious that there was a significant intra-abdominal abnormality."

A spokesman for NHSGGC said: "We would like to extend our apologies to the patient and we are truly sorry for any failings in the care they have experienced.

"At all times, patient centred care is our absolute priority and our teams work hard to provide the highest possible standards of care.

"We recognise the learnings from this case and are implementing an action plan, following these findings."

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