Fourth Degree Tear Mistaken for Third Degree Tear

If you were diagnosed with a third degree tear –  when in actual fact you had a fourth degree tear – you could be entitled to pursue a claim for compensation. Contact a solicitor to find out more.

The different between 3^rd degree and 4^th degree tears

The 2001 Royal College of Obstetricians and Gynaecologists guidelines classify perineal tears as follows:-

• First degree: laceration of the vaginal epithelium or perineal skin only
• Second degree: involvement of the perineal muscles but not the anal sphincter
• Third degree: disruption of the anal sphincter muscles, which is further subdivided into:
  • Grade 3a: less than 50% thickness of external sphincter torn
  • Grade 3b: more than 50% thickness of external sphincter torn
  • Grade 3c: internal sphincter torn also
• Fourth degree: a third degree tear with disruption of the anal epithelium (a layer of the anal canal)

Therefore a fourth degree tears extends deeper into the anal sphincter than a third degree tear. A third degree tear might just involve the external anal sphincter (unless it is a 3c tear), while a fourth degree tear will involve the external anal sphincter, internal anal sphincter and the anal epithelium.

Diagnosing a 4^th degree tear

All perineal tears should be diagnosed shortly after a woman has given birth. A midwife or doctor should examine the genitalia and rectum, checking to see whether an injury has been sustained, and if so the extent of that injury. Both midwives and doctors should have the skill and expertise to recognise a perineal tear, and to make an accurate diagnosis. If there is any doubt as to the classification of the tear, a more senior opinion should be sought.

Wrong diagnosis of a 4^th degree tear

Despite this, there are times when a fourth degree tear is wrongly diagnosed for a more minor tear. This will be problematic as the injury will not be properly repaired. Consequently a woman will leave hospital unaware that she has a defect in her anal sphincter. This is associated with symptoms such as faecal soiling and flatus incontinence. A secondary sphincter repair can be undertaken, but normally this is not as effective as a primary repair.

Claiming for a wrongly diagnosed 4^th degree tear

If your fourth degree tear was not accurately diagnosed, causing you to suffer unnecessary symptoms, you could be entitled to pursue a claim for compensation. Contact us today to find out more.

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