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?

Just a followup on my thoughts above... If complaining (about any body, not just the NHS) it's always worth thinking about what resolution you want, because it effects the approach you take. It's also worth beign really explicit about it, because that makes it more likely that you will get a result you're happy with than if the person fielding the complaint has to guess!

There is no right answer here - only you can decide what your priorities are, but some examples to get you thinking:

1. "I am going to need therapy which will cost £x; I want the hospital to fund this because NHS waits are too long." Your route is to complain, being explicit about what you're asking for. If you get a no, it's to sue (subject to having a satisfactory case).

1. "I think this doctor is so unsafe they need retraining/shouldn't be allowed to work". Your route is to complain, saying exactly why you think this, followed up with reporting to the GMC if you get nowhere.

1. "I felt ignored. I want an apology, and them to listen next time." Your route is a 'more in sorrow than in anger' letter, saying how distressed you were, and that the team need additional training in how to deal with people with a trauma history (something I suspect most GI services are lacking in).

1. "I want to ensure that a Propofol service is available to everyone for 2WW care." Your route is to complain to the hospital and to NHSE, who commission those services.

I don't say any of these are the right route - only you can decide that! - but it's worth considering what you're trying to achieve before deciding on if and how you approach this. It's also worth considering how much energy you have for the fight, because certainly the first two will tie you up for the next 3 years and may involve you giving evidence in court.

I would contact PALS rather than sue, put in a complaint and give it to them til you are absolutely sure it's been put on your history and won't happen again, or to anyone else. Hope you're feeling better

Definitely needs a formal complaint.

@Motorina gives excellent advice. If you go into a complaint with the mindset of 'I want them sacked' - well that is v unlikely to happen.

What strikes me is that the doctor you saw worked in endoscopy but had little to no awareness of the impact having an OGD could have on a sexual assault survivor. His response to you was just 'It'll be very quick'

A meaningful thing the department could do, at low cost (always appealing in the NHS) is training on impact of sexual assault to those needing to have endoscopy, how they meet the needs of patients making those disclosures and support them through procedures - being aware procedure likely to be triggering, may want extra sedation or none, may find difficult to tolerate and withdraw consent during procedure etc .

This may well be something the GI department hasn't thought much about so bringing it to their attention would be making an important change for loads of patients. When I ran a service I actually liked these complaints (sometimes we had been wishing people would make them so we could show a project was needed) as they helped us improve.

Focussing your complaint on one doctor - he gets told off, complaint is forgotten about, no change happens.

@Motorina excellent posts and a real example of Mumsnet at its best.

OP -Steve- so sorry for what you have gone through and the ongoing suffering. I also hope that the results come back with the all-clear regarding the investigation if possible cancer .

I've name changed for this for obvious reasons.

I've been through the same thing, oral rape and gastroscopy with midazolam/fentanyl. It was a nightmare, especially since the nursing staff were holding me down as I was so distressed and I need these procedures twice a year. I really do understand your distress but I honestly wouldn't think of suing. It's not actionable.

I wouldn't consider having this procedure again without profopol, I honestly can't cope with it.
I wish you all the best

@SylvanianFrenemies

I'm further sorry for the responses you have had from people who are so keen to make their point that they leave all humanity and empathy behind. I hope they stand on lego.

What an odd response!

Everyone til then said they were sorry for the OP but also correctly stated that suing would be unlikely to be successful.

Of course it is relevant! The first post mentions rape

I didn't say it wasn't relevant merely clarifying what TW means.

@Porcupineintherough

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?

Excuse me? I quoted someone who obviously didn't know what the TW in the thread title stood for. I simply stated what it means.

I think it would be a very good idea to inform the hospital department, in writing, what happened (as described above). Your feedback experience is valuable, can help educate doctors, refine their procedures and improve the experience of other patients (including yourself if you ever need it again). You could also ask for someone to talk you through the drugs and doses used (and why). If indeed you had an unusual reaction to XYZ, you can ask to have that written into your notes for future use.

That  would perhaps help you come to terms with both a distressing experience and anxiety/ fears for the future,  It would also help the NHS,  and  any doctors treating you.  Those are positive outcomes for all concerned. It   lets your concerns be heard,  and  avoids all the   stress/frustration /expense and risk of a potential  failed legal action.

I'm so sorry for what you went through. I wouldn't sue but I would put in a formal complaint explaining you don't want anyone else to go through what you went through.

@Meowchickameowmeow

Of course it is relevant! The first post mentions rape

I didn't say it wasn't relevant merely clarifying what TW means.

But your post did say it wasn't relevant because there was no indication that the comment was a quote and not your words.

Are you dim or could you not understand that @Meowchickameowmeow was pointing out that TW stands for trigger warning as opposed to trans woman which seems to be a mistake made by previous poster who she was quoting

Thank you, I didn't bold the quote which led to some dim people not being able to understand.

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.

Here you go @SoupDragon, I quoted this post. Happy now?

Suing for what? The dr made a clinical decision on your clinical need at the time. Midazolam is an appropriate sedative because you can maintain your own airway, if you need propofol you will need an anaesthetist to make sure you don't go too deep and lose your ability to breathe. Also there is no antidote to propofol whereas if you had midazolam and had a reaction we can give a reversal agent.

Ultimately it's the doctors decision as to which agent they use and whether they need an anaesthetist or not.

Posted too soon. So basically if they can say why they made that clinical decision and back it up (you are safer in a clinical setting with no back up doctor without propofol) then you have no case

Here you go @SoupDragon, I quoted this post. Happy now?

What is your problem? There was literally no indication you were quoting anything. It looked like it was all your words. 🙄

Anyway, I'm not going to derail the thread further with someone else's formatting issues.

For context ( and in no way to mitigate the awful ordeal of the OP) at the beginning of this year very few anaesthetists were available in endoscopy units ( all deployed to ITUs) and so virtually all propofol lists (certainly in my trust) were cancelled. This presented a real challenge in scoping patients who needed urgent procedures with deeper sedation. That said if this was the case it should have been explained fully and other options discussed. There is a great deal of pressure on staff to get through large numbers/treat backlogs/not miss cancers without the necessary support required. I worry about the knock on effect of this on individuals like the OP who for very valid reasons can't go through a standard pathway.
I would go through PALS even if only to flag it, raise awareness and increase appropriate education.
I think suing will be protracted and extremely stressful particularly as showing that harm has been done is likely to involve reliving the initial trauma. In cases like this the 'quantum' is often small and may not feel like adequate recompense especially as the process is never straightforward.
On a pragmatic level you need to do whats best to protect your mental health.
So sorry you have had such a terrible experience.

I’m not against suing the NHS because they have a huge insurance policy in place for this

Who do you think pays this? It's not the same as a normal insurance policy with a huge private insurance company backing it and making profit; all the trusts and health boards pay into a central fund and make a claim on that. It's public money. Legal actions cost the NHS and government literally billions per year.

I am so so sorry that all that happened to you.

I can only try and imagine how hard it was for you to even explain why the procedure would trigger you, and it is very upsetting that you were not as protected as you wanted.

I understand your sense of grievance and wish for justice or reparation, but I worry that a legal process will be frustrating, drawn out, energy sucking, and may not have the outcome you hope for.

I would write a detailed letter explaining your complaint, dissatisfaction and Ayer effects, and send it via PALS as a PP suggested.

Heart out to you Steve: not easy facing the next procedure.

I also think some replies on this thread lack empathy.

NHS radiographer here. I think you should certainly raised this through pals/complaints as the team could probably use some enhanced training and hopefully you would feel like at least they listened to you. I would use this time to have it formally recorded that for future investigations you always have the drug that worked for you, as I suspect in this case the dr assumed you'd be fine on midazolam and didn't listen to what you said you had before.

I'm not telling you whether to sue or not but would money change your situation? I suspect you need some help to work through the trauma whether that be NHS or private counselling.

Wish you all the best for what you decide. The thought of you suffering on my xray table is heartbreaking, I dread having one for different triggering reasons, it's a horrible procedure anyway but given your experience it must have been truly horrific xx

I’m sorry for what happened to you. There are no grounds whatsoever to sue as you have not suffered any material harm, and were provided with adequate medical care. You can, however, complain to the hospital via PALs. Make sure to name the clinician(s) in question.

If anything is agreed outside the normal scope of a procedure, have them document it in the notes before starting.

I think with private companies you might sue because you want them to take you seriously. With the NHS it doesn't work like that. If you feel your complaint is not being listened to, there are ways of getting attention - mp, CQC, the local CCG. If you haven't made a complaint, please do - your experience is exactly the kind of thing people want to learn from. I've never once had a complaint forwarded to me for attention because someone was suing. It's a financial transaction.

If your mental health has taken a setback and you need compensation to fund treatment then consider it but it's not the right route to improve services.

PALS is fucking useless. I say this from recent experience. Fucking waste of time and it left us even more angry than we had previously been

I’m not against suing the NHS because they have a huge insurance policy in place for this

Wow. That is like saying 'I am not against driving without insurance or making fake or exaggerated accident claims because all the honest drivers pay a huge premium on their policy to allow for that.

The point is that ordinary people pay. It's not magic free money from the government's bottomless pit.