To make hospital complaint now?

[sleepycoffeemonster]

I'll probably get flamed for asking this due to the time passed but when DD was born by emergency c sec (she was stuck and not progressing) the surgeon accidentally cut the side of her cheek/chin when making the initial incision, not once but twice. After the birth they put steri strips on the wound and this was checked before we were discharged three days later. The doctor himself had to check it before we were allowed to go and he said these things happen and it will be healed up in no time and shouldn't leave a mark.

The health visitors came to visit post birth and nowhere in the notes had it said about this cut, I had to explain what had happened. At the time I was so preoccupied with having a new born, I didn't follow it up although I was upset about my babies face being cut.

DD is now 5, the cut healed fine but has formed a scar (two cuts next to each other) which has grown bigger as she has grown and is wider than when she was a baby. I feel really angry that it was played down and how visible it now, would I be U to follow it up with the hospital now?

I've got used to it on her face but sometimes I see how big it's getting and feel bad that it happened and nothing more was said. Surely if the surgeon knew she was facing up he should have acted with more care knowing her face was where he was cutting? I still remember the surgeon chatting away while he was doing it.

I think if it was that severe at the time OP you would have complained to your midwife about it. Has the scar not faded from 5 years ago?

I've got a gash under my eye from the metal part on the door hinge it's a lot better than it was years ago. In fact it's not that visable anymore.

Sutures would have left more of a scar, steristrips are much better for closing superficial wounds, as the wound lays flat and the steristrips hold the edges of the wound together.

I can understand your concern but think you may need to speak to your GP to see what can be done. Have you tried Bio-oil on the scars?

I'm sorry this has happened to you and dd. It sounds like the repair could have been better handled. I have a longer than average scar and thankfully temporary damage to my insides that the surgeon caused in his haste to get my youngest out as quickly as possible. It's easily done when they are trying to get the baby out quickly.

Sorry to be cynical about the health visitors- I imagine the surgeon did document on the operation note about the complication, but it probably wouldn’t make it onto the discharge paperwork that is sent to them. It is a known complication and not necessarily anything to do with the surgeons level of attention or competence.

That said, I don’t think you’re unreasonable to complain but depends on what outcome you want- if it’s for lessons to be learnt about post cut management then that’s fine. I think it would be good to see GP to work on scar reduction.

Rather than a complaint maybe speaking to the GP about treatments is a better option.

If they had their arm chopped off I would be saying complain but not over a scar. Sorry this IMO.

How big are the scars?

I did talk about the injury to the midwife/health visitors but apart from all the focus on why it wasn't in the notes, not much more was said about it apart from keep it clean until it had healed.
The skin healed after a few weeks but over the 5 years it has got longer and wider as her face has grown.
I was very upset at the time but as she was my first baby, had a tongue tie and a tough start to bf, I just tried to put it to the back of my mind thinking it couldn't be changed and would fade.
Now I wish I had done more for her sake as this may affect her in the future.
I will definitely try the gp for any topical treatment or anything else she may be able to be offered for the scar.

"Legally, you can make a claim for your child for any injury up until the age of 18. From their 18th birthday they have one year to do it themselves".

This is correct apart from limitation runs from the child's 18th birthday, so expires on their 21st not 19th birthday. If you did bring a claim your lawyer would apply for an interim payment to fund private cosmetic surgery so from that point of view, it would be worth seeking legal advice in the future if your child is bothered by the
scarring.

@Muchmorethan

How big are the scars?

Each one is about 2cm long but they overlap the end points so overall looks longer. Although the steri strips held the edges, the skin didn't heal together and the gap between the outside edges of the cuts has formed a sunken scar which has got wider.

@Nannewnannew yes, we've tried Bio oil but it's made no difference

Ask for a referral to a plastic or maxillo facial surgeon to see if there is anything that can be done to reduce it.

I think if it's something worth complaining about a healthcare professional would have advised you to do so.

You see so many professionals in the first 2 years of a child's life I'm very surprised nobody encouraged a complaint if it was one worth making.

I agree with speaking to the GP to see if there's anything that can be done but as it's aesthetic they might refuse to do anything until she's older.

I am a midwife and from what you have written I think that you could definitely ask to have her care looked at and it might be appropriate to complain. I would have asked for medical illustration and plastics input at the time and that would be routine care where I work. If your daughter would have benefited from this and it wasn’t done the mechanism to change practice really is complaining and if it was negligent she’s as entitled to compensation as anyone. The level of detail of risk that women are told about when consented for a C/S has changed in the last five years so I don’t know if you would definitely have been warned about it.

I mean I as the midwife not mother - obviously not suggesting you should have sorted this!

A referral to a plastic surgeon might help but I'm not sure that more surgery will be the answer. The only thing proven to help scarring is covering with silicone. You can get gels like kelocote or patches. I was told they work best when used as soon as the wound is healed and need to be used consistently for a year. The next best thing is massage, to stop scar tissue forming. I was told the reason bio oil can sometimes help is the massage element rather than the product itself.

This was all told to me by the surgeon who did my section as I have issues around scarring and was really concerned about it. Even though it ha been a while it might still be worth trying the silicone.

OP, just to say your DD may well not be worried by the scar. My 20 year old daughter has a scar stretching from her eyebrow to her hairline… we call it her Harry Potter scar. It’s quite pronounced when she gets very hot/very cold. She’s actually quite fond of it in an odd kind of way, and was rather disgruntled when it was airbrushed out of her Year 10 school photos.

Personally I’ve always understood cuts (small nothing crazy) are a risk of having a section. Comes up if you google it, same as maybe a tear is with a vaginal delivery. I’m not sure a complaint would take you far tbh, you might just find it wasted energy.

@Justcallmebebes

"Legally, you can make a claim for your child for any injury up until the age of 18. From their 18th birthday they have one year to do it themselves".

This is correct apart from limitation runs from the child's 18th birthday, so expires on their 21st not 19th birthday. If you did bring a claim your lawyer would apply for an interim payment to fund private cosmetic surgery so from that point of view, it would be worth seeking legal advice in the future if your child is bothered by the
scarring.

Civil claim prospects would be extremely poor. The surgeon was acting in an emergency situation minor scarring is better than the infant passing. No wonder so many HCPs are leaving the NHS,

Sometimes in life bad things happen. It doesn’t mean that you’re due money or that someone is at “fault”.

Civil claim prospects would be extremely poor. The surgeon was acting in an emergency situation minor scarring is better than the infant passing. No wonder so many HCPs are leaving the NHS

But a HCP in the field has explained above that this infant didn't get the standard care in this situation

I've got a scar on my cheekbone from forceps delivery and it has got worse as I've aged. From what you've described I would complain.

Former midwife. The time lapsed is not an issue, but I really don’t think you have grounds to complain when this is very clearly explained as a risk prior and a consent form signed. It’s not a common event, but a relatively known risk and the overwhelming majority heal without any issues. My own daughter had a forceps laceration to her face, but it healed without any lasting scar. So referring to plastics at such an early stage is not really necessary. There would have been a paediatrician/neonatologist at the birth, who would have assessed whether immediate repair was necessary.

Ideally a “body map” would have been put in your child’s “red book” following their initial examination - this would have avoided the Health Visitors questioning how the marks occurred. But that’s only a point of good practice, not something legally required, so again very little grounds for complaint. The act of the Health Visitors asking about a mark hasn’t done your child any enduring harm/treatment costs etc.

@MagicWorkout

Civil claim prospects would be extremely poor. The surgeon was acting in an emergency situation minor scarring is better than the infant passing. No wonder so many HCPs are leaving the NHS

But a HCP in the field has explained above that this infant didn't get the standard care in this situation

I’ve worked in several hospitals, it was not standard care in any of them.

@sleepycoffeemonster

Thanks for the replies, I think it's like PP mentioned it's more the associated feelings that have become more as I've come to realise it not only left a mark but is getting bigger and will be so visible as she get older. Of course I understand it was an emergency and the surgery needed to be done, it's the feeling it was brushed off. Also why the health visitors thought it was so strange that it wasn't noted anywhere? They also kept questioning almost implying it had happened since the birth, I had to show them pictures from the hospital before they would let it go!

To be honest, if I were going to complain about anything it would be the lack of it in your notes. I’m sure it would be on the hospital’s notes as they don’t always match but this can cause difficulties. My DS was born last year with two head marks/bumps. One was from the ventouse cup and one was cause by lying so long in the cervix for a long time. The one cause by my cervix could have been mistakes for a bang to the skull if you hadn’t known. In my notes, the diagram of the baby just had a circle around its head. I now know that this needed to be two separate circles or notes for clarification needed to be added. They weren’t. One midwife visited ten days after birth (a couple of others had been before) and asked about his “bump”. I said “oh it’s gone down quite a bit from birth”. She replied that there was no note of it being there from birth so I checked my notes and Lo and behold it wasn’t. She said would have to go down to the child’s department for assessment and a cross reference to be made to the hospital notes unless I had a photo of it from straight after birth. He had a hat on all of them except oNe but luckily we had that one picture. I work in safeguarding and was mortified that I was going to be referred! When we have another baby I will put reading notes above getting sleep in the hospital now that I know what the implications can be!

I’m not sure if a complaint about the scars would be upheld with it being so long ago but perhaps there is a lesson to be learnt or even something they can do for her.

Something similar happened to me & my DD - we had a emcs after a failed forceps attempt and it's the forceps which have left a permanent scar on my DD's face (at the time she also had severe bruising from
the forceps which was partly behind her failure to latch). I complained to the hospital trust and they did eventually refer us to a hospital plastic surgeon who reviewed the scarring. Treatments are possible and I felt a lot better for putting my concerns in writing - might also encourage the hospital to review their procedures & prevent it happening to other children.

It’s standard in my hospital for a paediatrician to look at the cut and apply steri strips if it’s superficial.

A deeper cut would be referred to plastics.

Sometimes paeds discuss with plastics, send photos and ask for opinions. Very few babies ever actually need surgery.

There will be unlikely any ‘lessons learnt’ from complaining. As others have said, it’s a known risk and is more likely to happen in an emergency CS.

Maybe arrange to obtain a copy of yours and your child’s medical records from the hospital and you can read about what happened and what paeds thought of the cut at the time?