Last updated Sunday September 23, 2007
A significant part of my work involves clinical (medical) negligence for claimants. Set out below are cases in which I have been involved in the recent past.
MH
Failure to perform a vaginal examination and attach a fetal scalp electrode when there was loss of satisfactory contact with the CTG monitor - failed to heed pathological late decelerations - failed to call for medical presence - failed to auscultate - failed to see or heed significant fetal distress. Those failures caused significant delay in delivery, during which time the Claimant suffered hypoxic ischaemic encephalopathy and transient renal impairment. She now has severe tetraplegic cerebral palsy. Her claim settled in 2005 for £3.5 million.
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Negligence - Failure to auscultate (because scrubbed up) - failure to do episiotomy (time saved 5 minutes?) - the time which could have been saved if proper auscultation had taken place. Was a paediatrician present? How soon after? What was the resuscitation. The time which could have been saved. The midwife's general practice of auscultation.
Causation - Clear liquor. No meconium. Cord round neck, or not?
Limitation
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AW
Cerebral palsy - trouble with the cardiotocograph - bad trace - but the nature of the trace (interpreted by the neuro-radiologist) suggested that the damage had been done to the fetus before admission to hospital (without negligence).
BC
Cerebral palsy - hypoxia - delay in delivery.
ISM
Negligence - Pre-operative arterial insufficiency - aortic surgery in 2000 - anaesthetic management - faulty arterial cannula - cuff and arterial line monitoring - swings in blood pressure - hypotension - "overshooting" by drug management.
Causation - questionable movement of the limbs following surgery - deterioration during the night.
KD
Born in 1983 by Caesarean section following failed attempts by Neville Barnes and Kiellands forceps. Liability admitted in 2001. Severe athetoid cerebral palsy.
JC
Born 1995 - hypoxic ischaemic encephalopathy grade 2 caused by severe peri-natal asphyxia. Judgment in 1999. Settled for £3.9 million in 2004.
JA
Shoulder dystocia - cord tightly round neck - poor midwifery notes - inadequate fetal heart recording. Liability admitted 13 years after birth. Cerebral palsy.
KL
Born in 1995 following emergency lower segment Caesarian section after failed attempt to deliver by Neville Barnes forceps. Cephalo-pelvic disproportion. History of primary infertility - no mandatory indication for an elective CS. Some negligence admitted, which would have caused delivery to be a few minutes earlier. No sufficient pelvic assessment. Abnormal fetal heart rate and high fetal head were strongly suggestive of CPD. Synotocinon prescribed when contra-indicated.
Liability admitted shortly before trial.
Quadriplegic cerebral palsy of the dystonic athetoid variety, typical of severe, profound asphyxia of short duration.
Infant three weeks old - section of small intestine removed - on paediatric annexe after operation - instructions to be monitored closely - neglected over two weeks leading to inadequate fluid balance - saggital sinus thrombosis causing severe brain injury.
Breach of duty and causation in issue, until the day before our summary judgment application, when a full admission was made.
Claimant now 34 years old!
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OM
Child aged about three taken into hospital with an acute abdomen - paediatric management overnight inadequate, leading to severe brain injury.
Breach of duty and causation eventually admitted, after we had submitted detailed questions.