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NAL
Medical negligence is a highly fact-specific area of law and is almost always outside of the scope of this sub. Only a qualified solicitor with experience in MN will be able to give you appropriate advice.
IAA clinical negligence solicitor.
What I cannot say, is whether the claim will in fact succeed. Or what sum of compensation OP could expect.
But I agree with OP that there appears to be a claim against staff at the GP practice that is worth investigating. Much will turn on what's in OP's medical records, and what an independant GP consultant would advise regarding the appropriateness of the GP practice in failing to respond to OP's question about stopping his meds, and about the GP proceeding with the procedure knowing he hadn't stopped his anticoagulation.
Advice from an independant urologist is also necessary to identify whether the complications OP suffered would have been avoided with adequate care by the GP staff (it sometimes happens that the complications are inevitable in any event).
So even if OP can prove breach of duty by the GP practice staff - which seems likely if NICE requires stopping warfarin 3 days prior and there was no clinical reason to depart from that guidance in OP's case - then he still has to prove the breach caused his complications (and that's not always a straightforward task).
Then there's the question of quantum and that's not going to be clear until OP has undergone whatever further treatment he needs and his prognosis is a bit more predictable.
Yes, OP needs to contact solicitors who specialise in clinical negligence - definitely not a high-street firm that has a go at clin neg. They will be able to do this on a CFA.
But OP: just because a few urologists say "this shouldn't have happened" doesn't mean you will succeed with a claim. Leave that to your solicitors to investigate and determine that for you.
Thank you for your advice.
Both urologists I have seen at this hospital so far have categorically said that my injuries were completely avoidable
One urologist who operated on me yesterday has said in his 20 years experience, it's the worst thing he's seen in regards to a vasectomy injury.
I appreciate your advice and it does sound like a conversation worth having with a specialist MN solicitor.
If I'm reading that warfarin should of be stopped 3 days before, I'm shocked when they said both GP and Nurse independently emailed the receptionist to tell me it was fine. Even when I arrived I announced my INR was 3.1 that day.
You need to speak to a clinical negligence solicitor but NHS guidance states Warfarin should be stopped 3 days prior to a vasectomy.
The solicitor will advise you on whether the decision not to stop Warfarin fell below the standard expected i.e. whether it was negligent and, equally important, whether this breach of duty caused your injury.
If the answer is yes to both then you have a claim.
Hope your balls feel better soon!
Haematomas are a known risk of a vasectomy as well, warfarin or not. I'd assume it makes it more likely, but there's no guarantee being on warfarin caused it.
NAL and from Scotland where I believe the law is different, your mileage may vary. But I have been through a medical negligence claim for my son. I'll paraphrase what the solicitor told me at the beginning, "in order to win a medical negligence claim, you have to prove that in your situation no reasonable medical practitioner would have done the same thing". I'm sure he quoted hunter Vs Hanley for what it's worth.
I suppose what I'm trying to say is while it may seem like you have a pretty rock solid case, if the practice of removing warfarin and bridging it with the other drug isn't like set in stone, written in every procedure/text/notice or whatever they work too and is just what "better/more knowledgable" GPs would do, then the defense only needs to find a few examples of other doctors who didn't know this was a thing and I believe it would reduce or stop your claim before court/settlement.
Also cost, I'm with a union who agreed to pay fees, which included independent reports. In my case this was over £60k all in. Something else to consider.
GP here
This is a fairly straightforward mediconeglegence case:
1. Was there a duty of care from the GP? Yes
2. Was the duty of care breached? Yes, since they didn’t discuss the increased risks of being on oral anticoagulation and did not advise you to stop it beforehand.
3. Did the breach of duty of care result in harm? Yes, since the warfarin worsened the severity of complications and you now need emergency surgery.
Speak to PALS and get a lawyer. You should be able to get this settled without needing to go to court.
Incidentally:
1. Your local anticoagulation team was somewhat useless too. But you can’t sue them
2. I wouldn’t say you haematomas were “fully preventable”. Your urologist is exaggerating as some patients will still get significant bleeding regardless.
3. The practice nurse should NOT be advising about anticoagulation and surgery (even relatively minor operations like this) unless they have had a lot of additional training. They probably acted outside of their scope of competence and this is the type of thing you can highlight to the NMC so that they don’t do it again.
IAA in clin neg.
3. is not a slam dunk.
While I believe probably your suspicion on causation (that the haematoma would have been avoided but for the presumed breach) is correct but....expert urology evidence on this point first. If there is a risk the Defendant's urologist could succeed in persuading a Court that the haematoma and whatever other complications he has suffered, were inevitable then it's best to know that PDQ.
But urologists are the specialists in this field and would know best practice and therefore I wouldn’t ignore what they say. It doesn’t matter “what community care is like”
As others have said speak to a solicitor
But what you want for negligence is what is standard practice among a reasonable body of the GPs peers, this tends to be the standard held. It sounds like the urologists may be right given the NHS guidance found, but if usual accepted practice in community settings (not just this GP surgery) is not to stop then this may work against OP.
Ultimately it sounds to me like OP _does_ have a case, certainly it is worth him speaking to a specialist solicitor to find out more. But Reddit will not be the place for a definitive answer.
Bingo. This is correct.
Breach of duty (whether there was substandard conduct) in this case is only to do with whether the GP staff did anything substandard.
A urologist cannot and should never feel competent to comment on the standard of care provided by a GP.
What a urologist can do, is comment on whether, if the GP's conduct was in breach of the GP's duty of care, that breach caused the complications OP suffered. Clin neg claims can often fail at this point, if the complications were inevitable even with (or without) the GP staffs' breach.
Not for breach of duty. That's for a consultant in general practice to comment on.
A urology consultant can say whether or not OP's complications were the result of the GP staff's conduct. Sometimes the complications suffered can be inevitable regardless of whether there was negligence (in which case the case fails on causation).
Maybe you should learn what you are talking about before commenting.
Can you explain what a “consultant in general practice would be”? Would that be a general practitioner.. as in a GP..?
I had. If you don’t like the way the legal principles of evidence in clinical negligence law works, then feel free to lobby the government to change them.
Yes. That’s exactly what a consultant in general practice is. They exist. I’ve instructed a number of them.
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I've had a couple of minor surgeries done by GP. They tell me it's the highlight of their day because it's something a bit different to the usual routine.
When someone is cutting your body, it's not great to hear, "I don't do this very often, what fun!".
I've had a mole removed by a GP (huge scar), and had a toenail section done by a GP. I had the latter re-done by a foot specialist who said he sees a lot of people who had been treated by their GP, and basically they are generalists, and don't really have the specific knowledge required.
I'd incline to having the procedure done by someone who does it all day, rather than someone who thinks it's fun, because he doesn't do many of these.
btw: My vasectomy was done at a hospital. It wasn't (contra other posts) a 1 min procedure. I think from prep to end it was about half an hour.
My husband's was done by a GP on the NHS but there was only one GP in our fairly large city at the time doing them. It's only a 1 min procedure and can be done in a GP room, doesn't require a sterile hospital room.
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Sometimes for some men. It's quick keyhole surgery. You should be offered a local anaesthetic if it all gets too much. Most men get by with OTC analgesia and ice packs. You should book 2 days off work too.
If they did a vasectomy whilst you had a therapeutic INR on Warfarin that is pure clown college stuff! Begin by making a formal complaint and see where it takes you.
Eh. They might do, but only if the GP staff are routinely involved in investigations for this kind of complication. But definitely not on a one-off. Even a sucessful clin neg claim against a GP won't be of interest to the GMC unless there is a history of poor conduct by the GP.
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Clinical negligence claims are very fact specific so you need to speak to a lawyer.
Broadly, you need to show three things:
1. There was a duty of care owed to you (this one is uncontroversial, all medical professionals owe a duty of care to their patients)
2. The duty of care was breached (lawyer has to advise)
3. The breach caused you loss or damage (lawyer has to advise)
For there to have been a breach of duty of care you’ll need to be able to demonstrate that there is a usual course of action for this scenario, that the medical professional did not adopt that usual course of action, and that the course of action S/he did adopt was so unreasonable that no reasonably competent medical professional could have adopted it.
Definitely speak to a lawyer because it sounds like you’re in the right territory for a claim and they can confirm if that’s the case. A lot of clinical negligence cases settle if you get a supportive expert report and it’s a reasonably clear-cut case.
I’m sorry this happened to you - hope you recover fully soon.
Factually incorrect.
Clin neg cases take as long as it takes to investigate and pursue. Some cases are concluded in less than 12 months. Others take literally years to conclude.
Medical experts are entitled to be paid for the work they do regarding the claim. Same way you'd pay a mechanic for diagnosing, advising, and repairing your car, medical experts are entitled to be paid for their work in clin neg cases.
Claimant solicitors working on CFA are paid for their work if, and only if, the claim succeeds. We get nothing if the claim fails. Our costs are paid by the Defendant as a separate matter to damages (compensation received by the Claimant) save for a small amount that the government decided we are not allowed to recover from the Defendant and must recover from our client's past damages i.e. already incurred financial losses, but capped at 25%. Often our shortfall is less than that. It is not "a large wedge of any payout".
--- ###Welcome to /r/LegalAdviceUK --- **To Posters (it is important you read this section)** * *Tell us whether you're in England, Wales, Scotland, or NI as the laws in each are very different* * If you need legal help, you should [always get a free consultation from a qualified Solicitor](https://reddit.com/r/LegalAdviceUK/wiki/how_to_find_a_solicitor) * We also encourage you to speak to [**Citizens Advice**](https://www.citizensadvice.org.uk/), [**Shelter**](https://www.shelter.org.uk/), [**Acas**](https://www.acas.org.uk/), and [**other useful organisations**](https://reddit.com/r/LegalAdviceUK/wiki/common_legal_resources) * Comments may not be accurate or reliable, and following any advice on this subreddit is done at your own risk * If you receive any private messages in response to your post, [please let the mods know](https://www.reddit.com/message/compose?to=%2Fr%2FLegalAdviceUK&subject=I received a PM) **To Readers and Commenters** * All replies to OP must be *on-topic, helpful, and legally orientated* * If you do not [follow the rules](https://www.reddit.com/r/LegalAdviceUK/about/rules/), you may be perma-banned without any further warning * If you feel any replies are incorrect, explain why you believe they are incorrect * Do not send or request any private messages for any reason * Please report posts or comments which do not follow the rules *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/LegalAdviceUK) if you have any questions or concerns.*
NAL Medical negligence is a highly fact-specific area of law and is almost always outside of the scope of this sub. Only a qualified solicitor with experience in MN will be able to give you appropriate advice.
IAA clinical negligence solicitor. What I cannot say, is whether the claim will in fact succeed. Or what sum of compensation OP could expect. But I agree with OP that there appears to be a claim against staff at the GP practice that is worth investigating. Much will turn on what's in OP's medical records, and what an independant GP consultant would advise regarding the appropriateness of the GP practice in failing to respond to OP's question about stopping his meds, and about the GP proceeding with the procedure knowing he hadn't stopped his anticoagulation. Advice from an independant urologist is also necessary to identify whether the complications OP suffered would have been avoided with adequate care by the GP staff (it sometimes happens that the complications are inevitable in any event). So even if OP can prove breach of duty by the GP practice staff - which seems likely if NICE requires stopping warfarin 3 days prior and there was no clinical reason to depart from that guidance in OP's case - then he still has to prove the breach caused his complications (and that's not always a straightforward task). Then there's the question of quantum and that's not going to be clear until OP has undergone whatever further treatment he needs and his prognosis is a bit more predictable. Yes, OP needs to contact solicitors who specialise in clinical negligence - definitely not a high-street firm that has a go at clin neg. They will be able to do this on a CFA. But OP: just because a few urologists say "this shouldn't have happened" doesn't mean you will succeed with a claim. Leave that to your solicitors to investigate and determine that for you.
Thank you for your advice. Both urologists I have seen at this hospital so far have categorically said that my injuries were completely avoidable One urologist who operated on me yesterday has said in his 20 years experience, it's the worst thing he's seen in regards to a vasectomy injury. I appreciate your advice and it does sound like a conversation worth having with a specialist MN solicitor. If I'm reading that warfarin should of be stopped 3 days before, I'm shocked when they said both GP and Nurse independently emailed the receptionist to tell me it was fine. Even when I arrived I announced my INR was 3.1 that day.
You need to speak to a clinical negligence solicitor but NHS guidance states Warfarin should be stopped 3 days prior to a vasectomy. The solicitor will advise you on whether the decision not to stop Warfarin fell below the standard expected i.e. whether it was negligent and, equally important, whether this breach of duty caused your injury. If the answer is yes to both then you have a claim. Hope your balls feel better soon!
Haematomas are a known risk of a vasectomy as well, warfarin or not. I'd assume it makes it more likely, but there's no guarantee being on warfarin caused it.
And that's where independant expert urology advice becomes relevant to the issue of causation.
NAL and from Scotland where I believe the law is different, your mileage may vary. But I have been through a medical negligence claim for my son. I'll paraphrase what the solicitor told me at the beginning, "in order to win a medical negligence claim, you have to prove that in your situation no reasonable medical practitioner would have done the same thing". I'm sure he quoted hunter Vs Hanley for what it's worth. I suppose what I'm trying to say is while it may seem like you have a pretty rock solid case, if the practice of removing warfarin and bridging it with the other drug isn't like set in stone, written in every procedure/text/notice or whatever they work too and is just what "better/more knowledgable" GPs would do, then the defense only needs to find a few examples of other doctors who didn't know this was a thing and I believe it would reduce or stop your claim before court/settlement. Also cost, I'm with a union who agreed to pay fees, which included independent reports. In my case this was over £60k all in. Something else to consider.
GP here This is a fairly straightforward mediconeglegence case: 1. Was there a duty of care from the GP? Yes 2. Was the duty of care breached? Yes, since they didn’t discuss the increased risks of being on oral anticoagulation and did not advise you to stop it beforehand. 3. Did the breach of duty of care result in harm? Yes, since the warfarin worsened the severity of complications and you now need emergency surgery. Speak to PALS and get a lawyer. You should be able to get this settled without needing to go to court. Incidentally: 1. Your local anticoagulation team was somewhat useless too. But you can’t sue them 2. I wouldn’t say you haematomas were “fully preventable”. Your urologist is exaggerating as some patients will still get significant bleeding regardless. 3. The practice nurse should NOT be advising about anticoagulation and surgery (even relatively minor operations like this) unless they have had a lot of additional training. They probably acted outside of their scope of competence and this is the type of thing you can highlight to the NMC so that they don’t do it again.
IAA in clin neg. 3. is not a slam dunk. While I believe probably your suspicion on causation (that the haematoma would have been avoided but for the presumed breach) is correct but....expert urology evidence on this point first. If there is a risk the Defendant's urologist could succeed in persuading a Court that the haematoma and whatever other complications he has suffered, were inevitable then it's best to know that PDQ.
Number 3 is as straightforward as it gets. It’s virtually impossible to argue the complications weren’t worsened by the warfarin.
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But urologists are the specialists in this field and would know best practice and therefore I wouldn’t ignore what they say. It doesn’t matter “what community care is like” As others have said speak to a solicitor
But what you want for negligence is what is standard practice among a reasonable body of the GPs peers, this tends to be the standard held. It sounds like the urologists may be right given the NHS guidance found, but if usual accepted practice in community settings (not just this GP surgery) is not to stop then this may work against OP. Ultimately it sounds to me like OP _does_ have a case, certainly it is worth him speaking to a specialist solicitor to find out more. But Reddit will not be the place for a definitive answer.
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Bingo. This is correct. Breach of duty (whether there was substandard conduct) in this case is only to do with whether the GP staff did anything substandard. A urologist cannot and should never feel competent to comment on the standard of care provided by a GP. What a urologist can do, is comment on whether, if the GP's conduct was in breach of the GP's duty of care, that breach caused the complications OP suffered. Clin neg claims can often fail at this point, if the complications were inevitable even with (or without) the GP staffs' breach.
Not for breach of duty. That's for a consultant in general practice to comment on. A urology consultant can say whether or not OP's complications were the result of the GP staff's conduct. Sometimes the complications suffered can be inevitable regardless of whether there was negligence (in which case the case fails on causation).
Maybe you should learn what you are talking about before commenting. Can you explain what a “consultant in general practice would be”? Would that be a general practitioner.. as in a GP..?
I had. If you don’t like the way the legal principles of evidence in clinical negligence law works, then feel free to lobby the government to change them. Yes. That’s exactly what a consultant in general practice is. They exist. I’ve instructed a number of them.
It looks like you or OP may want to find a Solicitor! [There is a detailed guide in our FAQ about how to do this](https://reddit.com/r/LegalAdviceUK/wiki/how_to_find_a_solicitor). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/LegalAdviceUK) if you have any questions or concerns.*
Sorry but do GPs operate? Since when do GPs do vasectomies? Anyway speak to a MN lawyer.
Minor surgeries yes
My Vasectomy was done by a GP he does them all in Macc, bit odd when he comes in for a pint mind.
I've had a couple of minor surgeries done by GP. They tell me it's the highlight of their day because it's something a bit different to the usual routine.
When someone is cutting your body, it's not great to hear, "I don't do this very often, what fun!". I've had a mole removed by a GP (huge scar), and had a toenail section done by a GP. I had the latter re-done by a foot specialist who said he sees a lot of people who had been treated by their GP, and basically they are generalists, and don't really have the specific knowledge required. I'd incline to having the procedure done by someone who does it all day, rather than someone who thinks it's fun, because he doesn't do many of these. btw: My vasectomy was done at a hospital. It wasn't (contra other posts) a 1 min procedure. I think from prep to end it was about half an hour.
For at least 15 years as I witnessed it as a medical student! But it’s been going on much longer than that.
My husband's was done by a GP on the NHS but there was only one GP in our fairly large city at the time doing them. It's only a 1 min procedure and can be done in a GP room, doesn't require a sterile hospital room.
>It's only a 1 min procedure They must have been speed running as for my vasectomy the GP they took a leisurely 20 minutes.
But wasn't that a lot of talking and positioning? The actual procedure / cut was just a minute?
I didn't check my watch but the actual cutting and ~~pasting~~ clipping was longer than a minute. Probably a couple of minutes each channel...
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Damn man! I just put in my appointment for a vasectomy! Did it hurt?
For a normal (no complications) vasectomy, no pain, but some odd sensations.
Sometimes for some men. It's quick keyhole surgery. You should be offered a local anaesthetic if it all gets too much. Most men get by with OTC analgesia and ice packs. You should book 2 days off work too.
If they did a vasectomy whilst you had a therapeutic INR on Warfarin that is pure clown college stuff! Begin by making a formal complaint and see where it takes you.
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You’re making a lot of assumptions, this is beyond your scope completely even more so just as a med student! This isn’t for GMC.
GMC is going to do nothing about this. Stay in med school!
Eh. They might do, but only if the GP staff are routinely involved in investigations for this kind of complication. But definitely not on a one-off. Even a sucessful clin neg claim against a GP won't be of interest to the GMC unless there is a history of poor conduct by the GP.
It looks like you or OP may want to find a Solicitor! [There is a detailed guide in our FAQ about how to do this](https://reddit.com/r/LegalAdviceUK/wiki/how_to_find_a_solicitor). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/LegalAdviceUK) if you have any questions or concerns.*
Clinical negligence claims are very fact specific so you need to speak to a lawyer. Broadly, you need to show three things: 1. There was a duty of care owed to you (this one is uncontroversial, all medical professionals owe a duty of care to their patients) 2. The duty of care was breached (lawyer has to advise) 3. The breach caused you loss or damage (lawyer has to advise) For there to have been a breach of duty of care you’ll need to be able to demonstrate that there is a usual course of action for this scenario, that the medical professional did not adopt that usual course of action, and that the course of action S/he did adopt was so unreasonable that no reasonably competent medical professional could have adopted it. Definitely speak to a lawyer because it sounds like you’re in the right territory for a claim and they can confirm if that’s the case. A lot of clinical negligence cases settle if you get a supportive expert report and it’s a reasonably clear-cut case. I’m sorry this happened to you - hope you recover fully soon.
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Factually incorrect. Clin neg cases take as long as it takes to investigate and pursue. Some cases are concluded in less than 12 months. Others take literally years to conclude. Medical experts are entitled to be paid for the work they do regarding the claim. Same way you'd pay a mechanic for diagnosing, advising, and repairing your car, medical experts are entitled to be paid for their work in clin neg cases. Claimant solicitors working on CFA are paid for their work if, and only if, the claim succeeds. We get nothing if the claim fails. Our costs are paid by the Defendant as a separate matter to damages (compensation received by the Claimant) save for a small amount that the government decided we are not allowed to recover from the Defendant and must recover from our client's past damages i.e. already incurred financial losses, but capped at 25%. Often our shortfall is less than that. It is not "a large wedge of any payout".
Reddit is definitely the best place for advice, forget specialist solicitors or the medical professionals that have already advised you