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Liability judgment for girl with severe cerebral palsy after her mother was sent home in labour
Boyes Turner’s birth injury specialists have obtained a liability judgment for a young girl whose brain was damaged leading to severe, disabling cerebral palsy of the utmost severity after her mother was negligently sent home by the defendant hospital in labour. The triage unit staff’s incorrect assessment of the mother as ‘low risk’ and their instruction to her to go home when her urine test results indicated a need for medical review led to delays in the delivery which, if properly managed in hospital, would have avoided all or most of our client’s devastating, permanent disability.
Sent home in labour
Our client was her mother’s first baby. The pregnancy was considered low risk and suitable for midwifery-led care. When her mother started having frequent, painful contractions the evening before she had been booked for an induction of labour, she telephoned the defendant hospital and was asked to go in. She attended the triage unit where she was noted to be contracting strongly with her cervix 1.5cm dilated. Urine tests were carried out which revealed ketones and protein in her urine. The fetal heart-rate (FHR) was normal at that time. Our client’s mother was told that she was in the latent phase of labour and, despite her request to remain in hospital, she was sent home for the night to rest before coming in for her booked induction of labour the next day.
Correct treatment would have avoided the baby’s brain injury
Correct treatment would have been to reassess her risk in the light of the abnormal urine test results and transfer her to the consultant-led ante-natal unit for medical review. If this had happened, she would have been in hospital when, shortly afterwards, her labour entered the second stage as the baby’s head descended rapidly and she felt the urge to push. The mother probably would have been examined vaginally to assess the progression of the labour and midwife would have regularly auscultated (listened to) the FHR. Within the time that it took the mother to arrive home, the FHR auscultation would have revealed abnormalities. The midwife would have called for an obstetrician and, whilst waiting for the doctor, would have encouraged the mother to push. If the baby had not already been born by the time the doctor arrived, the doctor would then have expedited the delivery using forceps or Ventouse.
Our client’s injury
Instead of transferring our client’s mother to the consultant-led unit for medical review, she was told to go home and during the short journey home she felt the urge to push. On arriving home, her waters broke and her partner called for an ambulance which took her back to hospital. The baby was delivered in hospital. At birth she had no signs of life. She was resuscitated by the midwife until the neonatal team arrived 3.5 minutes later. Her first detectable heartbeat occurred at 12.5 mins of age. She was transferred to the neonatal intensive care unit (NICU) for cooling and suffered seizures. She still needed nasogastric feeding at the time of her discharge home. She now suffers from severe spastic/dyskinetic cerebral palsy, epilepsy, and severe visual impairment. She has no useful hand function, is fed by gastrostomy and can only communicate by smiling or crying. She will be totally dependent on others throughout her life.
An MRI scan of our client’s brain revealed a pattern of damage indicating that she had suffered some mild, damaging, chronic partial asphyxia (oxygen deprivation) followed by an acute profound (highly damaging) asphyxia, which our experts believed occurred around ten minutes before birth and continued until she was five minutes of age.
Liability settlement and interim payment
The family approached Boyes Turner and we pursued the claim on the basis that correct treatment would have led to earlier delivery, avoiding all or the majority of our client’s severe disability. The defendant hospital admitted that they were negligent in sending our client’s mother home but denied that correct treatment would have avoided her severe disability. Our client’s compensation would, therefore, depend on the trial judge’s findings as to the sequence and timing of events in hospital if our client’s mother had not been sent home and the extent of our client’s residual injury.
Negotiations took place and we reached a liability settlement which guarantees to provide our client with 80% of the full value of her damages award. We entered judgment and secured an interim payment of £250,000 to meet our client’s immediate needs. The case has now been stayed until our client is old enough for her condition, future prognosis and lifelong needs to be properly assessed.
If you are caring for a child or young adult with serious neurological disability caused by negligence at birth or in infancy, contact us by email at email@example.com.
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DR PETER DEAR