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"Orthodontic/orthognathic treatment"

About: North West Anglia NHS Foundation Trust

(as the patient),

I had three lefort one osteotomy impactions (upper jaw surgery) to correct my dentofacial abnormality c/o Peterborough and Stamford NHS foundation Trust.

I began NHS Orthodontic treatment in 2008 in my early 30’s after suffering from years of being bullied. At the age of twelve I spent the night in hospital due to the severe effect of this bullying. The first operation took place in December 2009 and I was to believe that things had gone well. My confidence began to grow and as a student nurse at university I began to excel at presentations and assignments. I no longer lacked confidence in standing in front of my colleagues.

In July 2010 I attended a joint appointment at this hospital where the surgeon and orthodontist explained that I could have further surgery to improve the occlusion (I still had an overbite), I agreed even though my family and friends begged me not to. I had the operation in September 2010 and as an inpatient was sent to a clinic to have an assessment post surgery. It was advised I have an x-ray, so I was wheeled off for one and was then transferred back to the orthodontic clinic which was very busy. I was left alone in the dental chair in a room with the door closed for around half an hour and fell asleep. At one point the consultant orthodontist opened the door to offer to partially recline the dental chair but I refused due to the fact that i still felt very sick and sore. (I have spent most of the afternoon and evening vomiting stale blood and had not had much sleep).

The surgeon and sidekick came in around half an hour later to explain surgery had gone wrong and showed me a profile picture of my face saying that I had an open bite now and that I could have surgery one week later to correct it. I was wheeled up with a SHO to sign the consent form and to prepare the drug chart for the next week.

Later in the evening I was discharged home and told that I would receive a letter in the week to confirm the operation. I received nothing so left a message with the departments booking coordinator and a friend took me there the afternoon before surgery was due to take place again.

We asked a clerk to ask the surgeon if the operation was still going ahead, what would be done etc. The clerk went off to speak to the surgeon and came back saying the operation was still going ahead and that I should show up at 7.30 the next morning. We asked her to find out if it was okay for me to still take pain relief as I was still in a great deal of discomfort. Again she went off to speak to him and came back saying that this was fine and that the surgeon had said that they were looking forward to seeing me the next day. We left a little bit miffed off.

During the night I emailed PALS with frustration at the lack of information I had been given and explained that I was confused as to what would be happening to me.

I showed up for surgery again the next morning. The surgeon came and gave a very brief hello and made a joke about deja vu. The anaesthethic came and picked up on my anxiety, I wanted to cry when they asked why I was having the surgery. I just told them that as far as I knew it had been unsuccessful. When I was put to sleep they gave me some magic meds and the last thing I remember saying is "I feel so happy".

I came round in recovery to the worst pain I have experienced in my life. I used foul language and asked the nurse for more pain relief. I sat up in the bed holding my head. She explained that I had already had a disclosed amount of morphine and asked had I taken pain relief before admission. Yes I had.

It took some time for me to settle but I could hear the surgeon next to her in the recovery room discussing the fact that Tony Curtis had died and some other things that were in the paper that day. She came to hold my hand and said I was being transferred back to the ward now.

When I was transferred and they had done my obs, I grabbed my phone out of my bag which someone had left on the chair and phoned PALS to see if they had received my email. The person I spoke to kept asking me to repeat myself (not surprising considering the surgery I had just undergone). They confirmed they had not received it. I don't remember much else about the phone call, just that I definitely made it.

The morning after this surgery I was wheeled to an appointment with the surgeon and consultant orthodontist and was examined again after having another xray. The surgeon asked the orthodontist "What can we do to prevent this from happening again"? while I was in the dental chair and the orthodontist did not answer before saying goodbye to me.

I left after being discharged and told my family and friends all that had happened. I also told my university as I was shocked about it all.

I have since put in a complaint to this hospital. I have been very depressed since the incident and have been so upset that when I contacted this consultant orthodontist by email to say I was not happy to return for further treatment (other things happened after the surgery involving having seven mini screws placed in total which I have since discovered from NICE that I should have been given written information in regards to consent and understanding what these were doing. interventional procedures which did not follow nice guidelines around consent. As soon as I went private these were removed immediately by the new team.) I wrote to PALS which my GP advised to be transferred to another Trust as I could not return. This never materialised and I ended up having to borrow money to pay privately for my treatment elsewhere.

As it now stands the hospital are aware of what has happened. I received a letter from the chief executive stating that the surgeon states that if i had contacted the surgeon’s secretary before my third surgery they would have been very happy to discuss the procedure with me (we attended the surgeon’s department and they relayed information via their ward clerk to us, but did not come out or ask us to return).

The hospital now states that this surgeon gave me a clinical diagnosis of "Lax Ligament Syndrome". They surgeon never once mentioned this. They did ask me to bend my thumb back in July 2010 and asked me whether I could dance. I explained that I did dance sometimes (I should have explained only when I get very drunk). They now claim that as they do not have a policy on consent to operations and signing consent within 24 hours they do not use one. Yet the department of health and general dental council have one as do other trusts. Their protocol is for patients not to drink/drive, make important decisions/ sign legal documents within 24 hours of a general anaesthetic. My colleagues have advised me many times of this and it is on the original letter for my second surgery.

I am at my wits end with this Trust. We are all taught to give patients the right to make and to be involved in decisions about their healthcare. I was not allowed this right. I feel the Trust's response is laughable and contains lies. Is this really "High Quality Care for All"?

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