Boyes Turner’s medical negligence lawyers have secured £375,000 in compensation for a 32 year old woman who suffered a tear from her vagina through her anal sphincters at the time of delivery. The woman was left, after a number of years without treatment, with no separation between her vagina and rectum.The medical issues were complex as it was not obvious to the woman whether the full thickness (4th degree) tear was suffered when her first or second child was delivered. The claimant gave birth to her first child at the age of 22. During the delivery she suffered a vaginal tear which was noted to be 2nd degree. This was repaired without obvious complication and the claimant went on to have a second child nearly two years later.After the second delivery, the midwife recorded in the medical notes that the claimant’s perineum was intact, however, shortly after discharge from hospital the claimant experienced incontinence of faeces and flatus and found that she had been left with only one opening for her vagina and anus with no perineal wall in between.The claimant was reassured by her GP that this was not unusual following delivery and it was not until five years after her delivery that she was properly investigated.When she was finally referred to a gynaecologist for examination and underwent anal-rectal physiological study and endo-anal ultrasound scans her condition was noted to be so severe that she was referred to a specialist consultant colorectal surgeon for secondary anal sphincter repair. She suffered a post-operative recto-vaginal fistula after the operation.The claimant was left incontinent of flatus and faeces. She suffers recurrent thrush infections and is unable to have sexual intercourse. She suffered a psychological injury and finds it difficult to leave the house or engage in social or leisure activities. She needs adaptations to her home to provide private toilet facilities, and further medical treatment including sacral nerve stimulation, sphincter reconstruction and future permanent colostomy.The case was complex and the defendant contested liability throughout the court proceedings and it appeared that the case might go to trial. The contemporaneous medical records did not reflect the severity of the claimant’s condition after one or both of the deliveries. The defendant hospital relied on the midwife’s records as proof that correct post-natal examinations had taken place. The defendant argued that even with proper examination such injures could be missed and while it was regrettable the injury had been missed it was not negligent of the midwife to miss the tear. The defendant relied on large scale scientific studies demonstrating it was common place and certainly not negligent for such injuries to be missed at that time (as without obvious vaginal / perineal tearing it was not, at that time, mandatory, in these circumstances, for the midwife to check for anal sphincter damage, which can only properly be done with a rectal examination).The defendant served expert obstetric and midwifery evidence which supported its defence and sought to aggressively defend the case towards trial.Boyes Turner’s lawyers and medical experts undertook a detailed analysis of the factual evidence from the claimant’s recollection of her symptoms and the reality of her current condition to reconstruct how and when the injury could have occurred. The case was carefully prepared with the legal team being confident the court would find for the claimant if the case did go to trial Despite the defendant’s strong denial of liability negotiations took place and at a round table meeting shortly before trial Boyes Turner secured a full valuation settlement for the claimant of £375,000.