Perforated womb following fitting contraceptive coil

[mamamea]

I have had a coil fitted, and subsequently gone back to doctor after being unable to find it.

Was referred to hospital for ultrasound. Was told by hospital it would be 4 months+ waiting list, so we had to pay for it privately. They didn't find anything.

Went back to doctors today, had x-ray same day (why didn't they do it before), showed perforated womb.

Anyway, has anyone gone through procedure to remove it?

And secondly should we be speaking to solicitors, is this (the perforation) a de facto indication of negligence in the fitting of the coil? The doctor didn't seem that competent really.

[fannyanne]

I have a coil, and have no experience of the problem But I remember being told during the fitting that womb rupture was a known side effect although v v rare.
Did you sign a consent form before the fitting?

Hope all gets sorted with minimal of intervention

[milkymill]

Hello, I had exactly the same thing happen to me a few months ago; apparentll the chances are close to 1 in 1000! After it being located on the x-ray, I was booked in for a Laparoscopy around 3 mths later. Thankfully they were able to locate and remove with this keyhole surgery, if they haden't been able to it would have meant being cut open big style. I was quite angry really, as they were v.vague over how this happened etc, and as far as I'm aware it is pretty much always down to the person inserting it. I have since read that risk factors include; having had a c-section, and breastfeeding women. I was both of these yet was never even told about this sort of thing at all! Let me know if I can be of any more help.

[milkymill]

Just re read that they expected you to wait 4mths for a scan! That is disgusting!!

[macdoodle]

You shoulde be able to see a gynaecologist quicker than the scan and removed if necc as milky.....TBH it probably doesn't do much harma nd the perforation has probably already sealed itself ..
Unfortunately it is a recognised complication and your only complaint would be if you weren't warned of that risk beforhand - I think you would be hard pressed to prove negligence ....
Go and have a chat with the dr or the practice manager and let them explain/apologise perhaps the doc just needs an update course...or you may just be the unlucky 1%...sorry these things do happen am sure no harm was meant at all...good luck

[mamamea]

I had caesaerean for first baby, and second baby, born July was vaginal. Was breast-feeding when coil was fitted.

Did you speak to a solicitor at all milkymill? I don't want to end up having to pay for the laparoscopy as well :-(. 3 months is a long time.

[milkymill]

So you were at increased risk then like me. I didn't take up a complaint, although dh was pressing me to. I ca quite happily accept that there are always risks, I think it is the fact that I was always fobbed off with 'oh it's just migrated magically out of your womb' type explanations; and although I was given a leaflet about the coil weeks before having it fitted, and there may have been some mention of it on there (no idea), I was certainly never verbally warned about this. To be fair I was given a rather speedy app and booking, this should be the case because despite it being trivialised, itn is certainly not good to have this foreign body where it shouldn't be!

[mamamea]

3 months doesn't sound that quick to me, milkymil

[VoodooLULUmama]

i don;t thikn you will be able to sue, it is quite clearly stated in the leaflet you get with the coil..

you are the unlucky one in a thousand to whom it happens

4+ months wait is crapola though

[macdoodle]

Can understand how you feel...but can I ask a question....what is your aim/purpose in "suing" which is far more serious/sinister than an in house complaint or request for explanation/apology...what do you expect to gain from it or what outcome are you expecting/do you think you deserve...am genuinely curious as "suing" will have a major impact on the doctors life/confidence etc (am not sure you realise quite how much)especially when this is a recognised complication....am not being nasty really just curious as to what you expect the outcome to be...although honestly I do not think you will have a case....

[oops]

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[macdoodle]

Nope this part I get - as I said before if they weren't told or given a leaflet which explained it as a risk then that is certainly an error needing to be explained and dr made aware of...but suing is another kettle of fish with the expectation surely of a monetary payment??

[VoodooLULUmama]

i agree with macdoodle

the onus is also on the patient to READ the leaflet, and yes, the risk of a perforated uterus is rare, but it has to happen to someone..

if doc did something wrong, that caused the perforation, that is a different story, but if it was a side effect, albeit a rare one, of correct insertion, then what is the reason to sue?

[milkymill]

Speaking as someone who has gone through the same thing, I personally have no desire to sue but it doesn't seem right that this risk, particularly in circumstances such as the op's and my own, is not clesrly explained to a patient. As for the doctor doing something wrong, I would expect that given the known 'risk factors' involved they might take the insertion a little more gently. I recall out of curiosity, asking the nurse who attended my fitting, if my cervix was still open at all. Her answer was, that the doctor had to 'push a fair bit' to get it in. So yes, I do believe my doctor did something 'wrong' to cause this.

[macdoodle]

Oh dear it is very hard to get a coil in by pushing gently even after dilating the cervix..you do actually have to push quite hard...I speak from experience of both inserting coils and having one inserted into me...
It is this culture of blaming someone for something that may be unavoidable - when most doctors IME are trying to do their very very best for their patients - that upsets me ...I think I will bow outof this thread I am sorry for both your experiences but it distresses me that "someone must be blamed/pay for it"

[milkymill]

macdoodle believe me, I am not a vindictive person by nature, and I do not like to make a fuss. The point I am trying to make is that for me it felt as though I was deliberately being misled as to how this perforation physically occurs. I went through a lot of pain, worry and hassle, and I didn't get a single apology or honest answer. And yes, I do think that those 2 factors should be taken in to consideration and mentioned to the patient.

[mamamea]

Firstly, the leaflet does NOT mention any risk of perforation, here's a scan of it if you don't believe me img455.imageshack.us/img455/851/imagedd7.jpg

And secondly I am already out of pocket for the private ultrasound (which by the way I called up for and was told four+ months, and then said I would go private they said "we have 8:30am tomorrow [Tuesday], 9am tomorrow, 12:30 tomorrow, 5:30, or Wednesday"), and who knows how the operation will go, maybe I will have to pay for that as well, or there will be complications, I am not willing to wait for months, because there is no satisfactory alternative contraception for me (I previously had a gynefix coil which was very satisfactory, and I requested it again), it would be very disruptive to my sex life.

Whether or not the doctor was actively bad, I'm the one who is now in a bad situation, and while it might not be the doctor's fault, it's certainly not mine. And my understanding is that the doctor is not liable, it is the NHS that would be liable.

[mamamea]

sorry, just to add I specifically requested the Gynefix, which I was VERY happy with before, and is a frameless IUD, which has a near-zero risk of rupture, and was told by the doctor that the TT 380 device was exactly the same or better, and I had nothing to worry about with a different coil.

[expatinscotland]

another reason i'll never have a coil, despite the way they hard sell them here.

sorry you're going through this.

[mamamea]

and btw, the cost of a laparoscopy is £2,000

www.spirehealthcare.com/selfpay/Guide-prices/

I am quite small (150 cm tall), and when it has been taken out, I will be having the gynefix back, because it is designed for women with smaller uteruses.

[VoodooLULUmama]

i can see why you are so angry, the doctor surely would be liable, not the PCT or NHS as he/she was the one who actually carried out the procedure?

i am surprised there are no side effects mentioned in that leaflet. when i had a mirena coil fitted, the leaflet was more like a booklet and listed all possible side effects including perforation,perhaps something to take up with the manafacturers?

i hope everything works out, i really do, and i am sorry that this has happened to you

[mamamea]

www.bmj.com/cgi/content/full/326/7402/1333?etoc

"In any case, in the NHS, doctors are not sued but rather the NHS itself."

[macdoodle]

Not if it was a GP the dr will be liable ...they will be insured but not really the issue - only 2 reasons to sue that I can see (as oppose to complaining which IMo is more for an apology/explanation)...suing has two end points - financial gain or punishment !

[Lulumama]

that is what i thought macdoodle

i suppose you could seek legal advice, and see what you are advised, whether it is worth it, but i really do think if the manafacturers have not included any side effects or possible complications in the information they provide, you should think about taking action against them, rather than the GP

[Lulumama]

mamamea, why not post this in legal / money matters, there are some lawyers here, and i am sure you would get an indication of whether it is worth your while suing for this.