Failed DIEP Flap Reconstruction Following Mastectomy – Miss G

Background

Miss G was admitted to hospital in 2017 to undergo a delayed breast reconstruction following a right mastectomy for breast cancer performed in 2014. Miss G received both chemotherapy and radiotherapy following her mastectomy.

At a pre-operative consultation, her surgeon noted radiation damage and advised her that she was suitable for a free flap reconstruction using the deep inferior epigastric perforator (DIEP).

Surgery was performed, and the following day Miss G was informed that it had taken a long time to identify a blood supply for the graft. She was told her surgeon had already taken the DIEP flap and that it was therefore without blood supply during that period of time.

Sadly, the graft failed and had to be removed. This left a defect over Miss G’s chest which was filled using a full thickness skin graft from the inside of her upper left arm. She was then advised that there was no further form of reconstruction available, and was instead offered a series of fat transfers to provide a small mound to make her appearance in clothing more normal.

This medical negligence claim was pursued on the basis that during Miss G’s surgery the surgeon divided the donor flap vessels on the abdomen before suitable and adequate recipient vessels had been identified – this amounted to a basic and fundamental surgical error.

Recipient vessels should have been identified and tested prior to dividing the flap vessels on the abdomen. On the balance of probabilities, suitable and adequate recipient vessels would have been identified, meaning the procedure would likely have been successful.

Settlement

Initially the Defendant denied both breach of duty and causation, but eventually the claim settled for £55,000 prior to CCMC, of which £15,000 represented special damages.

This case was led by Tami Frankel.

NOTE: While our case studies are designed to give an indication of the outcomes that can be achieved in these circumstances, the compensation awarded in individual cases can vary significantly due to a range of factors, including effects on life expectancy, the severity of the medical negligence that took place, and the financial impact.