Surgery Left Me in Agonizing Pain

A Woman’s Struggle with a Painful Surgery and Concerns Over Informed Consent

A 66-year-old woman from Cumbria has shared her distressing experience following a facial surgery that left her in severe pain and with a noticeable scar. Lis Dales, from Kendal, emphasized the importance of patients asking questions before undergoing any medical procedure. Her story highlights the critical role of clear communication between doctors and patients, especially when it comes to understanding what to expect during and after surgery.

The operation took place at Keswick Community Hospital in February 2024, where Dales had a basal cell carcinoma—a type of skin cancer—removed from her face. While the procedure was intended to be minor, Dales described the outcome as far more invasive than she anticipated. She reported experiencing “excruciating pain” and a large scar that significantly impacted her quality of life.

Dales had previously undergone a similar procedure in 2007, which involved only “a few stitches” and allowed her to return to work the next day. Based on this experience, she expected a short, straightforward appointment. However, the 2024 surgery lasted about an hour and left her in severe discomfort. She recalled that her friend had to pull over on the way home because she was in so much pain just 20 minutes after leaving the hospital. The pain continued to worsen over time.

According to Cumbria Medical Services (CMS), the company responsible for the operation, Dales gave “fully informed consent.” They claimed that the doctor who performed the surgery, Martin White, spent around 30 minutes discussing the procedure with her and provided her with the opportunity to seek alternative advice if needed. However, Dales disputed this account, stating that the conversation lasted only about five minutes. She also said that Dr. White pressured her for a “yes” when she expressed hesitation about the surgery.

One of the key points of contention was the number of stitches Dales would receive. She said Dr. White told her there would be “one stitch,” but upon returning home, she counted more than 30. This discrepancy raised concerns about how medical terms were explained to her. In medicine, a “running stitch” refers to a single thread pulled through the skin multiple times, but Dales believed the term meant a single pass. She argued that a “reasonable person” would interpret it that way.

CMS did not directly address whether Dr. White had indeed said there would be one stitch. However, the company maintained that Dales had given informed consent and that all necessary advice was provided before and after the procedure.

Legal and Ethical Considerations

Guidelines from the General Medical Council (GMC) and the British Medical Association emphasize that doctors must provide information in a way that patients can understand. The GMC investigated Dales’ complaint and found no issues that would affect Dr. White’s fitness to practice. However, the Parliamentary and Health Services Ombudsman (PHSO) recommended improvements to the consenting process.

A PHSO spokesperson acknowledged that Dales experienced unexpected pain and scarring and expressed sympathy for her situation. They noted that a more detailed investigation was not conducted because the GMC had already reviewed the case and found no clinical failings. Nevertheless, CMS is taking steps to improve its processes, including offering an optional extra appointment to explain procedures to patients before they undergo surgery.

Long-Term Impact on Dales

Despite receiving stronger pain medication from the NHS and trauma counseling, Dales continues to experience pain from the scar. It has limited her ability to engage in activities she once enjoyed, such as fell walking and swimming. She has also criticized the discharge letter, which advised her to manage her pain with paracetamol.

CMS expressed sympathy for Dales, stating that she had given fully informed consent and that appropriate advice was provided. The company also acknowledged that there is always room for improvement and plans to implement additional support for future patients.

Dales’ story underscores the need for transparency and clarity in medical communications. Her experience serves as a reminder for patients to ask questions and ensure they fully understand what to expect from any surgical procedure.