Just before we jetted off to Melbourne for the weekend, I received a reply from the Very Bad Hospital. These things always happen on those days when you least want them to, don’t they. It’s the Law of Very Bad Things, or somesuch equivalent. The day when we least wanted to deal with this crap, when we wanted to get away and escape for the weekend, we had that. To be fair, we did manage to have a good weekend anyway, but now we’re back, and before I leave the country, I have to deal with it. And I’m not really sure where to go from here.
For a quick recap: I had a missed miscarriage in my first pregnancy. I went to hospital, had a D&C, and spectacularly failed to have normal periods afterwards. After much to-ing and fro-ing, arguing, and protestations that no, I really wasn’t pregnant, I finally managed to see a sensible woman (Lovely Gynae Woman) who did a hysteroscopy and diagnosed me with Asherman’s Syndrome, which is a result of the D&C.
We weren’t particularly happy about this, for fairly obvious reasons. Not only did we not recall being consented for this, we knew that if they’d done the bloody surgery properly, it shouldn’t have been a problem. If they had told us at the time how real and how big the risk of Asherman’s was, we would perhaps have waited to see if a natural miscarriage would be forthcoming, and perhaps have avoided this situation. They didn’t. So we complained, in July.
They finally deigned to reply at the end of October. This was after a further disgruntled letter from myself regarding their lack of reply. They claim that I was consented for scarring. They claim to train all doctors in how to obtain informed consent. They claim that the registrar (Horrible And Rubbish Gynae Reg) is “a senior clinician with a considerable amount of clinical experience. In our experience she has excellent surgical skills and takes due care with all patients… there is no evidence that Asherman’s Syndrome was due to the surgical technique of the registrar.” Etc etc etc.
They basically waved away our concerns, refused to apologise, or acknowledge the fact that they have single-handedly irreparably damaged my uterus and my fertility. This is to say nothing of the emotional distress caused, or the likely medical costs from future fertility treatment, which may be futile. I am fuming.
Firstly, they didn’t consent me properly. We do not remember them mentioning scarring. We do not believe that they did, and we know that they did not therefore provide accurate information in regard to the extent of the risk. From their own literature, the person performing the operation has a legal responsibility to ensure the patient is adequately consented. I do not call “At least you can get pregnant” in the anaesthetic room ensuring adequate consent.
Secondly, they did cause Asherman’s Syndrome. That is in no doubt. We also know that Asherman’s Syndrome, and therefore scarring is caused when the basal layer of the endometrium is damaged. This should not be damaged during a D&C unless it is too aggressive, and was done in this procedure. I realise she didn’t do it intentionally, but she still did it, and some acknowledgement of that fact would go a long way.
They said that Asherman’s Syndrome is rare. The Asherman’s Guru in Sydney has published papers stating that the risk of Asherman’s from a D&C is at least 20%. That’s not what I call rare, and even if it was a rare condition, it is serious enough (if you’re a person who may even contemplate child-bearing) to warrant in-depth discussion.
The problem is, I know how the system works. If somebody has documented in the notes that they discussed the risk of scarring with us, despite the fact that they may not have done, that is what would be taken as the truth. In medicine, documentation is everything. If someone has written this somewhere, it also means that we have no legal case against the hospital. It would be our word against theirs.
But I can’t leave it like this. I’m a human being, and I believe that they should acknowledge what they have done to me and apologise for it. Every patient deserves respect, and when things go wrong they should be treated with compassion, which includes an apology when someone has done something wrong. My uterus deserves more than this. They cannot fob me off and expect me to simply accept this.