Suing the NHS (*TW*)

[WhipperSnapperSteve]

TW - I was raped at 14, the bastard also raped me orally.

I'm male if not obvious from the username, have been on MN for years, my sex should make zero difference.

I had an oral laparoscopic procedure called an OGD&Endoscopic Ultrasound done four years ago and due to the previous trauma was given propofol sedation (it's the general anaesthetic component they use first to knock you out, milky white emulsion) and I woke up the procedure complete with no issues.

I needed an OGD (it's an endoscope threaded through the mouth into the stomach and first part of the duodenum) at the start of the year and called the department to be told that they'd give me midazolam/fentanyl sedation and that the dr would give me more than usual and just to mention it to them.

The dr could see I was super anxious, I explained my history (a triggering challenge in itself) and was told I'd be comfortable and "it wouldn't last long). It was a nightmare, I lay there completely frozen; and I have flashbacks both to the original assault and the procedure daily. He gave me the standard sedation.

I need a follow-up and this is agreed to be under propofol.

I really want to sue but I'm well aware what people think of suing the NHS, and that money wouldn't make me feel better. Thoughts?

You have no grounds to sue them. But you can put a complaint in.

@Overthebow

This isn’t really something to sue over, the doctor wasn’t negligent.

The above.

It isn't your fault that you had flashbacks, but nor is it the doctor's.

It is the fault of whicker horrible person forced you to admit to that awful ordeal.

How do you know you only received the standard sedation? It may be that the next-stage-up would have been a general anaesthetic. This can't be done lightly and requires a different team and aftercare to ensure that the patient is safe and doesn't react badly. There're possible complications with this (and indeed anything over the "standard" levels).

Sometimes the patient has to have a certain level of consciousness because the procedure involves them responding to different instructions (I don't know if this would have been so in your case).

People who have suffered trauma due to assault attend hospital every day. Hospital staff are as gentle and kind and accommodating as they can be - they really are. Occasionally procedures have to be undertaking which may be triggering - you were quite right to make them aware so that they could respond appropriately if you had a big meltdown, but it seems that awful as it was for you, you were ultimately OK.

I don't think your TW status is relevant in this situation - many people, both female and male have suffered sexual assaults. The staff will be used to this and do everything they can to minimise the effects of the procedure, but inevitably there will be some negative ones.

There is nothing to sue for, and as you say even if there was, money wouldn't help. Speak to PALS and get this off your chest- if you can think of a way to make it easier for victims of similar assault in future, please let them know this.

@EmbarrassingAdmissions

Is the nub of your complaint that they did not carry out the 'extra' midazolam/fentanyl sedation that had been agreed as part of your consent procedure?

Did they write that down rather than tell you verbally?

Do you feel that you should have been offered propofol rather than asked to try the midazolam/fentanyl option which didn't sedate you?

Yes / was verbal sadly / I do but as it was an urgent two-week pathway referral I was told I had no choice .

How do you know you only received the standard sedation?

Dosages noted on my patient letter.

Was it actually made clear that you were to get ADDITINAL sedation? He probably sees a lot of anxious patients and the standard meds probably do the job...
I’m really sorry you went through such a horrific rape and the trauma that having this procedure had on you.
I think unless it was made really clear in your notes /referral that you were to be effectively knocked out, then you would have a difficult time with getting anywhere suing tbh.
I don’t think it’s wrong to sue where malpractice and incompetence has caused avoidable trauma / damage with regards to medical procedures. But I think you would be hard pushed to win any such claim - I assure you they will bind together and protect each other. That doesn’t mean you should be put off , much the same as people are put off reporting rape as it is traumatic and heartbreaking going through it all especially when the desired outcome isn’t reached.
Maybe talk it through with an appropriate lawyer/ solicitor first and see how the land lies? I think you would have to prove they were in the wrong - is this something that realistically can be done?
Have you sought counseling for the assault and resulting issues you have had to deal with? I think this would be really meaningful for you if you haven’t already.

No negligence here as far as I can see. I had an endoscopy, and was very anxious as I have an awful gagging reflex. The consultant said he would give me sedation, and I would be ‘fine’. I had the sedation, but the procedure was very traumatic for me. I wouldn’t sue though, as the doctors can’t really tell how you will react to sedation. Some will be out of it enough for it not to bother them, but others for various reasons won’t.

@SchadenfreudePersonified - I am pretty sure the TW in the title is short for 'trigger warning' rather than indicating the OP is a trans woman!

Do talk to PALS and complain, complaints like this help the NHS to put protocols in place to avoid patients needs being ignored. A complaint about this is not silly, the doctor choose to ignore a trauma, which would equate to ignoring your medical history, exacerbate a previous more condition to treat another. That is medical negligence. Or it may be that you agreed to propofol being used and they forgot to note it, there is some room for improvement there.

It might not be enough to sue but you should complain. Whoever decided not to put propofol in your notes or do a procedure without it if it was noted, needs to be at least reminded to be more careful either writing the notes or reading them!

So sorry and big hugs for your trauma, it's a lot to live with.
Unfortunately I think you'll find there was no negligence on their part. You can of course complain but the dosage and drugs selected vary from Consultant to Consultant and maybe across the Trust's. The dose given of Fentanyl and Midazolam is enough for most people and can be given without the aid of an Anaesthetist and it's what a lot of Gastro consultants do. These 2 are very routine drugs for these procedures. They wouldn't have known it wasn't enough unless you were visibly in distress from your obs or looking at you but if you were immobilised with fear this would've been hard to gauge.
Thankfully they've agreed for you to have Propofol next time and your complaint will hopefully start a conversation around dealing with patients with underlying traumas.
That's not much reassurance I can give other than to say it is tricky road you're navigating with your issues and I hope you're receiving appropriate support.💐

I don't think your TW status is relevant in this situation

TW stands for trigger warning!

No, don't sue. It won't achieve anything other than to put pressure on an already pressured system.

What you must do is formally complain through PALS. Insist on a meeting.

This will ensure that the procedure will be looked at and training and other safety procedures will be put in place for others going forwards.

I'm so sorry this happened to you. Our NHS can and does make mistakes. It's not infallible but they do try hard to make amends and adapt procedure when necessary.

You won't be able to sue them over this. Three of my DC died because of the NHS messing up, even I didn't sue them for that.
What do you achieve by suing? Nothing. Get some therapy instead.

“No negligence here as far as I can see. I had an endoscopy, and was very anxious as I have an awful gagging reflex.”

Yes, because having an awful gagging reflex is as traumatic as being raped...

@Meowchickameowmeow

I don't think your TW status is relevant in this situation

TW stands for trigger warning!

Of course it is relevant! The first post mentions rape.

Even if you feel you were pressured into agreeing to the lower dose sedation from what you’ve written it sounds like you did agree to it. So I don’t think you’d have any success with suing. By all means complain.

The nhs aren’t very good with stuff like this ime. Dd needs a colonoscopy and she can’t tolerate it, they’ve tried. So they just said they can’t/won’t do it. No offer of better sedation, no offer of a camera pill colonoscopy. Just discharged as “refused investigation “.

I’m on your side OP I would sue. If the after affects are causing a significant impact to your life and the healthcare professionals involved a) had a history of the abuse and the previous way it was handled to minimise trauma - and ignored it b) were informed by yourself and knew your wishes .. it is in fact negligence on their part.
Shocking.

I do think you should complain, it sounds like they need more training for patients who have previously suffered trauma.

I am not sure about suing them though. I thought youd have to prove negligence and then show you've suggested material loss eg you've had to pay for extensive therapy caused by the issue, you've had time off work for this issue. Which I'm not sure if you have.

Hopefully if you complain then things will change for anyone in the future.

He gave me the standard sedation.

Unless the doctor actually agreed in advance and it was on your notes that you'd be given a higher dose than usual, I don't see that suing is appropriate or helpful. Even if it was agreed in writing I am not sure a relatively small mistake in the dose that didn't result in putting you in any medical danger would give you the result you are looking for. And and having to go through the case would just mean you re-living the trauma. You were sedated and that will probably be considered sufficient.

I am so sorry for what you have been through. You would be better off speaking to your GP about counselling or hypnosis for PTSD than about suing.

But please do complain.

@DeathStare

I'm not sure what you want to achieve by suing? I'd definitely put in a complaint though asking them to review their protocols for patients who have prior trauma.

That.

I'm sorry to read about your horrible experience.

Steve, Im terribly sorry to hear this. Ive had Endoscopy and it's not pleasant. My understanding of the procedure is, they cannot knock you out completely for it, as it relaxes all the muscles and it makes it difficult for the examiner to see with the camera.Now, having said this, I am in no way medically qualified. My advice would be to speak to your GP first, ask about the procedure, explain everything you have told us here and see what they say. Perhaps your GP could recommend some counselling for you, as it seems you still have flashbacks from your awful experience. Sadly, like others, I don't think you have grounds to sue. Please take care.

I think you should absolutely complain and if youd like to sue then consult a solicitor. They were negligent in their duty of care and you've been further traumatised as a result.

@Meowchickameowmeow are you dim or could you not be bothered to read even the first line of the OP?

karmanomore the point I was making is that you can’t hold the consultant accountable for you not being sedated enough. We will all react differently. They have to be careful they don’t overdose you. Obviously me having a bad gagging reflex is not comparable to being orally raped. 🙄

Oh god that sounds horrible, sending hugs!

No, I don’t think you should sue as you wouldn’t win and it wouldn’t make you feel any better.

Also, I do question the moral position on suing the NHS, an organisation that is set up to provide healthcare for everyone.

It’s clear that you’re still affected by your terrible assault and I hope you are able to access counselling for this. However, your post sounds like the consultant discussed the procedure with you at the appointment and I’m assuming you agreed to have it done under the sedation they suggested, but it turns out the sedation didn’t have the effect you were expecting. Hence the further triggering taking place.
As the consultant has agreed to give you the stronger sedation next time again I’m assuming this was discussed at the appointment? There may have been factors involved in them not being able to give you additional sedation during the procedure that you’re not aware of.
I suggest you make an appointment to speak to your GP in order to go through what happened during the procedure, this may go some way to reduce your anxiety. I’m not sure that you have any grounds to sue anyone though I’m afraid.