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Missed Fourth Degree Tears

Fourth degree tears are a type of perineal tear sustained during a vaginal delivery. It is the most severe type of birth injury you can suffer, and it is absolutely vital the damage is diagnosed and repaired before a woman is discharged from hospital. If medical professionals fail to do so, there will be grounds for a medical negligence claim.

How can a fourth degree tear be missed?

A fourth degree tear can be missed in one of two ways:-

1. Medical professionals to do perform a post-delivery examination After a vaginal delivery, all women must undergo a thorough examination to ensure any injuries are detected. This should involve a genital and rectal examination, as this is the only way to check whether or not a fourth degree tear has occurred - an injury that extends to the anal sphincter. This is now a requirement under NICE guidelines, so if medical professionals fail to carry out such an assessment, the standard of care will have fallen to an unacceptable standard. If you subsequently develop complications and discover that you do in fact have a fourth degree tear, you will be entitled to pursue a compensation claim.

2. The tear is ‘under-diagnosed’ On other occasions, it may be that a medical professional (be it a doctor or a midwife) did perform this examination, but failed to accurately assess the level of injury, instead diagnosing a first, second or third degree tear. This will mean a patient is denied the correct type of treatment. Indeed, a fourth degree tear is an extensive injury and must be repaired in theatre by a colorectal surgeon. This is opposed to more minor tears - such as first and second degree tears - which simply require suturing in the delivery suite. An ‘under-diagnosed’ tear will therefore leave the sphincter defect unrepaired. This will be considered negligent, as a competent medical professional should be able to make a correct diagnosis. If this has happened to you, you will be entitled to pursue a compensation claim.

Was your fourth degree tear missed?

If your fourth degree tear was missed and you were discharged from hospital without receiving the right treatment, it is very likely that you have since developed problems that lead to a correct diagnosis being made.

However, secondary repairs often prove unsuccessful, so this delay in diagnosis may well mean that you are facing the possibility of long-term complications. If so, you must speak to a solicitor about the care you received while you were in hospital, as a missed fourth degree tear will, in all probability, amount to medical negligence. You will therefore be able to pursue legal action, allowing you to obtain the compensation you rightfully deserve.

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