Penningtons Manches has settled a claim against Dartford and Gravesham NHS Trust for a delay in the diagnosis of a torted ovarian cyst.

In May 2011, the client began to feel unwell, experiencing stomach pain and vomiting. When her symptoms did not improve she attended her GP who advised her to attend the A&E department at Darent Valley Hospital to rule out ovarian torsion or a ruptured ovarian cyst.

Although a clinical examination, two X-rays and blood tests were performed, the client was discharged with a prescription for constipation. Her abdomen was noted to be tender but no ultrasound scan was performed and no assistance from the gynaecological on-call team was sought.

She continued taking the medication for a few days but still had pain in her abdomen and returned to the A&E department at Darent Valley Hospital. She was advised that she was suffering with a urine infection and was prescribed antibiotics.

Two days later, the client began to suffer severe pain and an ambulance was called. She was admitted to the Observation Ward at Darent Valley Hospital where she underwent an endoscopy and MRI scan the following day.

Although it was apparent that she was losing blood, the medical team was not sure where this was coming from and she had a blood transfusion later that afternoon. It was suggested that she had been suffering with an ovarian cyst which had ruptured. She was taken to theatre and underwent a laparotomy which revealed that a cyst on her left ovary had ruptured, causing 2.5 litres of blood to fill the abdominal cavity. The client had to undergo dissection of necrotic tissue and a partial resection of the ovary.

In a post-surgery follow-up, she underwent a repeat ultrasound scan which showed development of further cysts and possible endometriosis. A further laparoscopic surgery was scheduled to perform bilateral ovarian cystectomies. During the procedure it was noted that both tubes were significantly diseased with endometriosis which had caused adhesion to the sigmoid colon. A third surgery was scheduled with the assistance of a colorectal surgeon to free the sigmoid colon adhesions and remove the left fallopian tube and ovary.

The client has been severely traumatised by the experience and her fertility has been severely reduced. She continues to suffer with an adjustment disorder with prolonged depressive reactions. She has subsequently undergone four cycles of IVF treatment which sadly have all been unsuccessful and she is now unable to conceive naturally.

The Penningtons Manches clinical negligence team in Cambridge was instructed in February 2014 and obtained supportive independent expert evidence. This suggested that, had the defendant trust carried out appropriate and adequate examinations, the client would not have suffered a ruptured cyst and lost 2.5 litres of blood. If the torted ovarian cyst had been found earlier, this could have been untwisted and the ovary could have been preserved.

Emily Palmer, the solicitor at Penningtons Manches who dealt with the claim, said: “This was a very sad case and I am delighted with the outcome we have achieved for our client. It is hoped that the award will enable her to receive further therapy to give her and her husband a chance of conceiving their first child.”