'Surgery left me in excruciating pain'
BBCA Cumbrian woman has said she was not fully informed about an operation that left her in "excruciating pain" and with a large scar on her face.
Lis Dales, 66, from Kendal urged other patients to ask questions before undergoing surgery.
The procedure at Keswick Community Hospital in February 2024, involved removing a basal cell carcinoma, a type of skin cancer, from her face.
Cumbria Medical Services (CMS), the company commissioned by the NHS to perform the operation, said she had given fully informed consent.
Warning, this article contains a graphic image of post-operation facial surgery
Miss Dales said she previously had a basal cell carcinoma removed in 2007, after which she had "a few stitches" and was back at work the next day.
She was therefore expecting a "minor" operation when she was booked in for a 20-minute appointment.
But she said the procedure left her looking an "absolute mess" and in severe pain, which she had not been prepared for.
"My friend had to stop the car on the way home because I was in such excruciating pain, 20 minutes after I left the hospital, and then it got worse," she said.
CMS said the doctor who performed the surgery, Martin White, spent "around 30 minutes" discussing the procedure with her before it was carried out, and that she was given the opportunity to leave and seek alternative advice.
But Miss Dales said the discussion was actually around five minutes and that Dr White said "I need a yes" when she expressed doubt about the operation.
She said she asked how many stitches there would be and that Dr White answered "one".
But Miss Dales said she counted more than 30 stitches after the appointment, which lasted about an hour.
Lis DalesThe term "running stitch" can be used in medicine to mean a single thread pulled through the skin multiple times.
But Miss Dales said she believed "stitch" meant a thread pulled through the skin once and that would be how a "reasonable person" would understand it.
When asked, CMS did not comment directly on whether Dr White had said the patient would have one stitch.
Miss Dales said Dr White, a GP with a special interest in surgery and part owner of CMS, should have ensured she was properly informed about what would happen to her.
'Still painful'
Guidance from the General Medical Council (GMC) and British Medical Association on consent and decision-making places an onus on doctors to provide information in a way patients can understand.
The GMC looked into Miss Dales' complaint and found no issues that would call into question the doctor's fitness to practice.
However, the Parliamentary and Health Services Ombudsman (PHSO) said it had recommended improvements to the consenting process.
A spokesperson for PHSO said: "We understand that, as a result of the medical treatment Miss Dales underwent, she experienced levels of pain and scarring for which she was not prepared.
"We are really sorry to hear this."
The spokesperson added that a more detailed investigation was not carried out because the GMC had looked into the matter and found "no clinical failings".
However, concerns about the consenting process were being addressed by CMS.
Lis DalesMiss Dales said her discharge letter had advised her to manage pain with paracetamol but that the NHS later prescribed her stronger pain medication.
She added that she had been given trauma counselling last year.
Her scar remains painful and prevents her from taking part in activities she used to enjoy, including fell walking and swimming, she said.
CMS said it "would like to express its sympathy to Miss Dales, who has experienced a serious medical problem".
A spokesperson said: "Miss Dales was in a position to offer fully informed and considered consent, which she did on the day of the operation.
"Moreover, all appropriate and proper advice was provided both before and after the procedure."
The company said "it is always possible to improve processes" and that in future patients would be offered an optional extra appointment to explain a procedure ahead of it taking place.