A woman who says Canberra Hospital botched her breast reconstruction has been granted permission to broaden her lawsuit against the ACT.
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Suzanne Smith required further surgery after complications led to the death of some of the flesh involved in an October 2008 breast reconstruction.
An ACT Medical Board investigation got an explanation from the surgeon, who said post-operative care had been botched by ward staff not following instructions.
The surgeon said a blanket, used to maintain a patient's temperature and improve healing, had been removed, causing part of the flap of skin to die.
In October 2011, Ms Smith launched legal action in the ACT Supreme Court alleging negligence in relation to her post-operative care.
She said ACT government, as the manager of the hospital, had breached its duty of care by failing to apply the heat blanket.
She alleged that because the wound was not maintained at a proper temperature the wound suffered necrosis.
The pleaded cause of action relied on the surgeon's explanation.
The case appeared for directions in March last year - almost two years and five months after it was started and 20 months after it had been served on the government.
But a report by a medical expert said the problem had not been caused by the post-operative temperature, but inadequate surgical technique and a failure to treat the necrosis earlier.
The revelation meant Ms Smith sought to amend her lawsuit to include the cause as the surgical technique and all post-operative care.
Lawyers for the government opposed the application to amend, arguing the changes meant the original cause of action had been abandoned, to be replaced with a new one.
They also argued that the defendant would suffer prejudice, because records of the pre-surgery consultation were no longer available and therefore it could not defend itself against the new causes of action.
The defendant said Ms Smith had deliberately delayed collecting expert evidence before the limitation period expired.
"In my view the new post-operative care claim clearly arises out of substantially the same facts as the post-operative temperature claim," Master Mossop wrote in the judgment.
"Both relate to different aspects of the post-operative treatment of the plaintiff. The position in relation to the method of surgery is less clear.
"However, although it is possible to divide the hospital admission by reference to the operation on the one hand and post-operative care on the other, I do not think that it would be appropriate to say that in a claim against a single defendant the cause of action arising out of the operation did not arise out of substantially the same facts as the post-operative care."
The matter was listed for directions next week.
