A group of 100 women are considering legal action against Britain’s most influential pelvic surgeon, claiming that operations he conducted left them with traumatic, life-altering complications.
They claim that Anthony Dixon, a consultant colorectal surgeon at Southmead hospital in Bristol and the private Spire Bristol hospital, was too quick to recommend invasive surgical procedures to deal with pelvic problems.
There are also complaints by several of the women that he made lewd or inappropriate comments about their appearance or sex lives.
Dixon is recognised as a pioneer of surgery aimed at repairing bowel problems, often linked to childbirth. He was founding chair of the Pelvic Floor Society and his reputation is such that patients travelled from across the country and from abroad to seek his help.
But after numerous complaints, the surgeon has been placed under investigation by his local health trust. He has been suspended from work, and the General Medical Council is carrying out a separate “fitness to practise” inquiry.
The Guardian has spoken to eight former patients of Dixon’s. Complaints include:
- Suffering unmanageable pain or incontinence after elective surgical procedures – risks they say they were not adequately informed about.
- Needing to undergo further major surgery to help resolve complications they say followed from Dixon’s treatment.
- Inappropriate remarks made during consultations. One woman, who was in her twenties when she sought treatment, says she was told: “You have the ass of an 80-year-old. I wouldn’t want you dancing in my strip club.”
- Another woman said that after her operation Dixon threw some polaroids on to her bed, saying: “There you go, would you like to see your insides?”
Dixon said he was unable to comment on specific allegations due to patient confidentiality. He added: “As with any surgical procedure, there may be complications but I would like to reassure patients that the overwhelming majority of operations I have completed have been successful.”
Jean-Jacques de Gorter, group medical director at Spire Healthcare, the private group where Dixon carried out some of his work, said an internal review of the “complications relating to Mr Dixon’s practice” found they were “within normal parameters”.
Several former patients told the Guardian they felt they had been inadequately informed about risks of operations they had signed up for and they ought to have been offered alternative treatments before surgery.
Many of the complaints relate to an operation carried out by Dixon known as a rectopexy, in which a plastic mesh is used to repair weakened pelvic floor tissue.
Sam van der Heijden, 57, from Hastings in East Sussex, asked to be referred to Dixon by her local trust. A difficult childbirth had left her with a damaged rectum, which was causing bowel problems. Dixon recommended surgery and Van der Heijden recalled that the main risk she was alerted to was the general anaesthetic.
The operation, in 2011, initially seemed to have worked, but she later underwent a series of revision surgeries, including having her colon removed. She claimed that after one surgery, when she suffered complications, he told her: “I don’t do aftercare,” and: “You’re costing me money. You’re supposed to be out of here in five days.”
Van der Heijden was left with debilitating bowel problems and this month underwent major surgery elsewhere to have her mesh implant removed, spending three days in intensive care to recover.
Rebecca Curzon, 36, had been dealing with unexplained pelvic pain for years before she was referred to see Dixon privately at Spire Bristol in December 2013. She was also given a rectopexy, but after the surgery, Curzon said, she was surprised to read in the operation letter that he had also performed a vaginal repair, which she said had not been discussed.
After the operation, her pain became worse, she said. “I couldn’t go to the toilet at all. I didn’t go for six weeks,” she said. “I was so ill. I still had the chronic pelvic pain, but now I had rectal pain too.”
Some patients recalled inappropriate remarks during consultation. One woman said he told her she could be sexually promiscuous after he had operated on her.
Several said he had suggested they see a psychiatrist or take antidepressants when they had ongoing pain. One of those was Curzon; in her case she said Dixon had suggested seeing a psychiatrist. “If he thought it was in my head why did he perform such massive surgery on me?” she said.
A woman who was under Dixon’s care for nine years said that after she had had her colon removed, Dixon had asked her if she would like to see a picture of the organ and then texted her a photo showing it, held by a hand in a surgical glove, “like a trophy”.
Some of Dixon’s former patients also underwent a second procedure, called a Starr, which involves using surgical staples in a rectal procedure. The Guardian understands that the GMC investigation was triggered by a complaint from a woman who suffered serious complications after being given the operation as an NHS patient.
Sohier Elneil, a consultant urogynaecologist at University College hospital in London, has, along with colleagues, treated nine of Dixon’s former patients with mesh-related complications. She said some had stated they were not sure why they had had the two procedures, rectopexy and Starr, in the first place. “We’re in a bit of a quandary as to how much information these patients had, based on what they recounted to us,” she said. “Currently you would not be doing that kind of surgery without full discussion.”
Andrew Williams, current chair of the Pelvic Floor Society, said Dixon had a reputation for taking on patients with complex problems and was one of the most experienced surgeons in the country at carrying out the rectopexy procedure. He also pointed out that the more operations a surgeon carried out, the more patients with complications they were likely to have. “However fantastic a surgeon you are, surgery is not without complications,” he said. “When and if complications occur they can be really horrible for both the patient and the surgeon.”
Williams added that the best available evidence suggested 60-70% of patients with internal prolapse benefited from the rectopexy procedure, a fraction would see no change or get worse and about 2% would have complications linked to their implant.
The women considering legal action are primarily represented by Thompsons Solicitors and Irwin Mitchell. Madeleine Pinschof, from Thompsons, said most of the women had said they were “in worse pain now than before the surgery and were not adequately warned of the complications that could arise”.
Luke Trevorrow, from Irwin Mitchell, added: “Concerns raised include not having been told of risks and complications prior to surgery, and whether the surgery was appropriate.”
Monica Baird, deputy medical director at North Bristol NHS trust, said it was investigating concerns raised by several patients “regarding certain pelvic floor repair procedures”.
“We would like to reassure patients affected by this that we are doing all we can to investigate their concerns fully,” she said. “We will continue to update patients as more information is available.”
Spire Healthcare added: “Our top priority is always the welfare and safety of our patients.”
- Additional reporting by Alexandra Topping