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Failing to follow Trust guidelines led to another banned procedure

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Another case of failing to follow Trust guidelines resulted in a further banned procedure performed by Mr Arunkalaivanan (better known as simply Mr Arun) uro-gynaecologist.

Shoosmiths has assisted a former patient of Mr Arunkalaivanan who carried out a procedure using a banned mesh product during his employment with Sandwell & West Birmingham Hospitals NHS Trust.

Disho Virk suffered with urinary stress incontinence after the births of her three children.  She leaked urine whenever she was walking, getting out of bed and when she sneezed or coughed.  She felt embarrassed and self-conscious so went to her GP for advice. The GP referred her to Mr Arunkalaivanan at City Hospital in Birmingham.

Mr Arun told Disho that she had a vaginal prolapse and recommended an operation using trans-vaginal mesh (TVM).

Mr Arunkalaivanan performed operations without authority from the Trust

In accordance with guidelines from The National Institute for Health and Care Excellence (NICE), which cited major risks of long-term complications in using mesh for prolapse, Sandwell and West Birmingham Hospitals NHS Trust decided to stop this type of surgery in 2009. However this procedure remained Mr Arun’s preferred, and only suggested, option even after that date without any authority from the Trust.

Disho has since learned that she could and should have been offered a different procedure, but Mr Arun did not discuss any other treatment options with her and in so doing he also failed to discharge his responsibility to obtain her full informed consent to any proposed treatment.

Disho continued to have urinary problems after she’d had the operation under Mr Arun’s care. He then performed three more operations to try to cure her incontinence but none of these operations were successful.

She endured two further operations to try to remove the mesh and is likely to need another operation in the future. Not only have her urinary problems persisted, but she has also been left in pain from having had so many bouts of surgery. None of these operations would have been needed if Mr Arun had followed the Trust guidelines not to use this type of mesh and had offered Disho a choice of other treatments that may have been more suited to her when she first went to see him.

Seeking justice for Disho

Disho saw an article in a local newspaper which explained that Mr Arun had breached the policy of Sandwell and West Birmingham Hospitals NHS Trust by continuing to perform mesh surgery.  Disho knew that Mr Arun had been her surgeon and so she contacted Shoosmiths for help.

Lucy Adams, a specialist solicitor in the firm’s clinical negligence team, handled her case. Lucy advised Disho that a special scheme had been set up by Sandwell and West Birmingham Hospitals NHS Trust to process and settle cases of patients who were treated by Mr Arun as quickly and efficiently as possible. Disho’s case was accepted onto this scheme and Lucy has now agreed a settlement with the Trust on Disho’s behalf.

Lucy commented:

‘I am delighted we were able to help Disho, but I remain concerned that other women who have suffered complications from undergoing similar procedures without giving their full and informed consent may still be denied access to medical review.

It is also concerning that instructions given by the Trust to improve patient safety have been ignored by a clinician which clearly shows that there needs to be more effective clinical governance, whether that be by better communication at multi-disciplinary team meetings (MDTs) or other means.’

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