Summary
Miss C complained that a paediatric consultant carried out a manual labial separation (separation of the small inner lips around the entrance to the vagina which have become sealed together) on her young daughter at an out-patient clinic without the consent of her and the child's father (Mr B), and without anaesthetic. Miss C said the procedure had caused her daughter to suffer pain and bleeding, ongoing distress, and develop a fear of doctors.
Our investigation included taking independent advice from one of our medical advisers who was of the view that the consultant should have explained and discussed the treatment options with Miss C and Mr B, and had them sign a consent form prior to carrying out the procedure. However, there was no evidence the consultant did so. We were satisfied the consultant failed to obtain informed consent before he carried out the procedure. Our medical adviser also was of the view that undertaking the procedure without a topical anaesthetic (a local anaesthetic whereby a substance is applied directly to the skin to temporarily numb the skin) was unreasonable.
Recommendations
We recommended that the board: ensure that the consultant reviews his record-keeping and his practice in relation to the obtaining of informed consent; review their policy for the treatment of labial adhesions and consider providing parents with an information leaflet about the procedure and treatment options; ensure a consent document is signed by the child's parent or guardian prior to any clinical intervention being carried out; apologise to Miss C and Mr B for failing to obtain informed consent; ensure that the consultant is made aware of our adviser's comments and reflects on them; and apologise to Miss C and Mr B for the performing the procedure on the child without anaesthetic.
Related reading
View Decision Report 201401575 as a PDF (14.21 KB) Updated: March 13, 2018