Does an Apology Constitute an Admission of Negligence?

This case involves a lady admitted to hospital for removal of a cyst on her left ovary, which was carried out by laparoscopic (keyhole) surgery. One of the small incisions had to be extended laterally in order to deliver the cyst without rupturing it.

There was no evidence of bleeding during the surgery. However, within 10 minutes of being in the recovery unit, it was noted that blood was soaking into her dressing, her pulse was elevated, and her blood pressure had dropped. She was immediately taken back to the operating room, and the wound was explored. It was initially difficult to control the bleeding, which turned out to be from an artery in the muscles of the anterior abdominal wall. This was tied off, and the bleeding ceased. She was detained in the Intensive Care Unit for 24 hours and then released to the General Ward, being fit for discharge after a few days.

During the time she was in hospital, the Consultant explained to her what had happened and apologised to herself and her husband.

The lady took an action against the Consultant and stated: “The Consultant obviously admits mistakes in my surgery by way of the apology.”

Doctors are under a duty of candour to their patients and to explain the nature of the surgery and reasons behind any unintended outcome, such as a complication that may have arisen.

In this instance, there was no evidence of overt bleeding when the operation had finished. However, bleeding was noted within 10 minutes of her returning to the recovery ward, and appropriate action was taken. The vessel concerned was in the anterior abdominal wall and, therefore, the bleeding was not free into the abdomen and did not become obvious during the initial procedure. The condition was treated appropriately.

The blood loss would be regarded as a complication of the surgery, but was not evidence of any negligent act. The doctor’s apology was therefore not an admission of an error or mistake, and the action was subsequently discontinued.

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