Andalusian health service to compensate child's family for serious post-colonoscopy complications

A Malaga judge has fully upheld an appeal against the Andalusian health service (SAS) of a family of an eight-year-old child who suffered serious complications following a colonoscopy at the Materno Infantil hospital.

The judge has ordered the health administration to pay the family 183,086.73 euros in compensation. The Sas can still appeal the ruling to the same court and to the High Court of Justice of Andalucía's branch in Malaga.

The child suffered from Klippel-Trenaunay syndrome: a venous and lymphatic malformation. He underwent a colonoscopy on 13 July 2017. The doctor reported that, after several attempts and changes in position, "the child had suffered bleeding". For this reason, the doctor decided to "end the procedure and discharge the patient".

In the early hours of 14 July, "the child began vomiting and his fever rose to 38C, making breathing difficult". He continued experiencing general malaise.

The parents took him to the emergency department at Hospital Materno, where doctors confirmed that he had a colon perforation. The child required two emergency surgeries.

The plaintiffs "had attended an informed consent session just 15 minutes beforehand, without a clear and simple explanation of the procedure, its benefits and potential risks". The Andalusian health service denied the family's claim for financial compensation.

The SAS opposed the claim, arguing that there had been no improper conduct by the health staff and no failure to obtain informed consent. It based this on the child's medical history of Klippel-Trenaunay syndrome, which had already required seven previous operations to remove venous malformations in both legs, and another procedure to remove an abdominal lesion.

The judge considered that the doctor "provided inadequate information, since there was no prior documented explanation beyond a standard form and the discussion took place shortly before the procedure in the case of a minor with significant previous conditions and a history of multiple surgeries".

The doctor acknowledged that there was a colon perforation. "This did not stem solely from the Klippel-Trenaunay syndrome," the judge said. "Despite the prior risk factors and the detection of sufficient evidence to immediately halt the procedure, the test proceeded, causing bleeding and the subsequent colon perforation.

In fact, the documentation demonstrates that preparation for the test began before the coagulation test results were available and the test continued without those results.

"Although the doctor told the Sas lawyer that the tests had been done months earlier, he noted that the anaesthetist said a blood test beforehand would be advisable to check the platelets," the judge said. The procedure "began without prior confirmation of the test results".

The judge firmly stated "the child's prior condition required extreme caution". There was, therefore, "medical malpractice".

SUR has requested a statement from the Hospital Regional, without success so far.