Failure to diagnose and treat fourth degree perineal tear – £200,000

Emma Marsden suffered a fourth degree tear when her first child was delivered with the assistance of forceps and an episiotomy.  It went unnoticed and her episiotomy was stitched immediately.

Over the next few months she suffered perineal pain and discomfort as well as intermittent bleeding and problems with bowel control. She had developed an anovaginal fistula.

To find out more about this case please see below –


The Claim: Fran Pollard, specialist medical negligence solicitor, helped Emma make a successful claim that the fourth degree perineal tear should have been recognised at the time of her delivery and episiotomy repair. If this had happened and it had been competently repaired, she would not have developed an anovaginal fistula and would not have suffered from the consequences of the fistula, including the need for further surgery. She would also have regained reasonable bowel control.

Result: Proceedings were issued. Initially the Defendants denied both breach of duty and causation but eventually the claim settled six months before the date set for Trial. The Trust admitted liability and Emma accepted £200,000 in compensation.

Compensation awarded: £200,000 (General Damages £75,000 + Special Damages £125,000)


Case Summary:

During labour with her first child, Emma Marsden was given an episiotomy to aid forceps delivery of her son. After the birth, there was a failure to notice that Emma had sustained a fourth degree tear and the episiotomy was stitched immediately. She was discharged home four days later, despite expressing her concerns that all was not well and complaining of pain.


Emma continued to suffer over the next few months with perineal pain and discomfort as well as intermittent bleeding. She had also developed faecal urgency and had experienced some episodes of complete loss of bowel control. She was finally referred back to hospital where investigations revealed Emma had a loss of tone in her anal sphincter and an anovaginal fistula had developed which allowed faeces and gas to leak through her vagina. As well as causing physical discomfort, a fistula can be embarrassing and emotionally distressing.


Emma underwent surgical repair, although her prognosis is guarded. If Emma decides to have any further children, they will have to be delivered by Caesarean section.


Emma came to see Gadsby Wicks a year after the delivery to see if we could help her make a claim for compensation.


Posted in Birth injury to mothers,Perineal Tears – third and fourth degree