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Written on 10th March 2022 by Tara Pileggi-Byrne

Boyes Turner’s medical negligence claims specialists have secured a compensation settlement for a client after delayed treatment for a food blockage in his oesophagus (connecting throat and stomach) led to a perforated oesophagus  and pneumothorax (collapsed lung). Our client needed ITU care, including ventilation, for his life-threatening injury but eventually made a full recovery. 

Failure to provide emergency OGD treatment breached guidelines

Our client went to the defendant’s hospital late one night after experiencing a food mass blocking his oesophagus. His attempts to dislodge the mass by drinking water hadn’t worked and he was unable to swallow the water or his own saliva.

European Society of Gastrointestinal Endoscopy (ESGE) guidelines recommended that his condition (food bolus complete occlusion of the oesophagus) needed emergency treatment involving endoscopic examination of the upper part of the gastrointestinal (GI) tract. The guidance recommended that where the patient was unable to swallow liquids or saliva, indicating that the blockage was complete, an OGD  or ‘oesophagogastroduodenoscopy’ procedure to dislodge or remove the mass of food causing the blockage should be carried out within two hours. At the latest, according to the guidelines, this emergency treatment should take place within six hours. Where the blockage was incomplete, treatment should be carried out urgently, within 24 hours.

Our client was triaged on arrival and it was noted in his medical records that he couldn’t swallow, even his own saliva.  He was seen by an ENT (ear, nose and throat specialist) doctor in the early hours of the next morning who noted problems swallowing fluids and persistent retching. The doctor made a 24 hour urgent referral, instead of an emergency (two to six hour) referral for the OGD procedure recommended by the guidelines.

Mid-morning a respiratory doctor noted that he had persistent retching and continuous dribbling but could breathe. The doctor planned to arrange an OGD for the same day or the next morning. An ENT doctor then performed a nasendoscopy, using a camera on a tube to examine the back of his throat, but did not identify the food blockage. The doctor again noted that he was unable to swallow his own saliva but could breathe and move his neck.

On advice from another hospital, our client was transferred to the gastrointestinal team and an unsuccessful OGD was carried out mid-afternoon. Our client experienced intense chest pain during and after the procedure. An ECG was normal and his pain was treated with IV morphine and paracetamol. Later that night, another OGD was attempted and abandoned owing to our client’s pain. A consultant gastroenterologist then attempted a third OGD in the presence of an anaesthetist. During that procedure the doctor noticed that our client’s neck was swollen, suggesting an oesophageal perforation. He was transferred to ITU where he was ventilated. Further investigations confirmed the perforation and a pneumothorax (collapsed lung). The next day he was transferred from the defendant hospital to the ITU at the John Radcliffe Hospital. The food blockage was successfully removed and he was discharged after a further week in hospital.

At home, during his extended recovery period, he needed a soft diet. He was unable to exercise or help with household tasks or childcare. He returned to work after five months. He has a scar on his chest but made a full recovery.

Making a claim

We helped our client make a claim against the hospital which had negligently failed to provide emergency treatment for his blocked oesophagus within the timescale mandated by the guidelines. With correct treatment our client would have avoided further injury. The hospital denied responsibility for our client’s injuries. We issued court proceedings and after negotiations, our client accepted an offer of settlement.

If you have suffered a severe injury as a result of medical negligence and would like to find out more about making a claim, you can talk to one of our solicitors, free and confidentially, by contacting us here.