Liability settlement and interim payment after twin to twin transfusion (TTTS) caused cerebral palsy

This case has now been settled, read the updated case study here.

Boyes Turner’s cerebral palsy lawyers have secured a liability settlement and £250,000 interim payment for a boy whose brain was severely damaged when there was a failure to treat twin to twin transfusion early in his mother’s pregnancy.

Twin to twin transfusion syndrome (TTTS)

Twin to twin transfusion syndrome (or TTTS) is a condition affecting identical twins sharing a single placenta (monochorionic twins) in which abnormal blood vessel connections in the placenta allow the blood supply to flow disproportionately to one twin. During TTTS, the donor twin is left undernourished and the recipient twin risks heart failure from blood overload and complications from a build-up of amniotic fluid.

Incorrect management of TTTS in monochorionic twin pregnancy

During the twin pregnancy, ultrasound scans revealed a monochorionic pregnancy in which the identical twins shared one placenta but had separate amniotic sacs. At just over 24 weeks of pregnancy, the consultant obstetrician noted that the antenatal scans suggested TTTS, but instead of referring the mother to a fetal medicine unit for treatment with fetal laser ablation (to seal the abnormal connections between the twins), he treated the pregnancy as if it were a dichorionic pregnancy delaying referral until 26 weeks gestation.

By the time the referral was made, the unborn twins were suffering from severe TTTS and it was too late for damage to the twins to be prevented by fetal laser ablation treatment. The twins were eventually delivered prematurely by caesarean section.

Hypoxic ischaemic brain damage from reduced blood flow during TTTS

Our client, the first twin, was born in very poor condition and needed ventilation. Head scans subsequently revealed that he had sustained ischaemic damage to his brain. The experts in the case subsequently agreed that he had suffered severe cystic periventricular leukomalacia probably caused by hypoxia (lack of oxygen) and reduced blood flow to the brain as a result of twin to twin transfusion syndrome.

Negligence admitted but causation denied

The defendant admitted that there should have been a referral to a fetal medicine unit for treatment at 24 weeks of pregnancy but not that there would have been fetal laser ablation treatment in time to avoid the brain injury.

At a round table meeting, the defendant initially refused to enter into any settlement discussions. However, after  further negotiations we were able to secure a liability settlement at 50% of full value, removing the litigation risk to our severely disabled client and guaranteeing that the family will receive substantial compensation to help with his fulltime care.

Our client has severe spastic quadriplegic cerebral palsy with cortical visual impairment and severe learning difficulties. He has been fed by gastrostomy and requires full time life-long care for all his needs. We have obtained judgment and an interim payment of £250,000 to help meet our client’s immediate needs whilst we work with his family and our experts to assess the full value of his claim.

If your child has cerebral palsy or other serious neurological disability caused by medical negligence and you would like to find out more about making a claim, contact us by email at cerebralpalsy@boyesturner.com.