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Delay in birth delivery causes hypoxic brain injury and baby death

delay birth delivery causes hypoxic brain injury baby death
https://seriousinjury.shoosmiths.co.uk
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When Mr and Mrs E lost their baby, L, at just a few hours old, they wanted to understand what had gone wrong and why. They approached Shoosmiths for assistance and we were able to investigate the circumstances surrounding their loss for them.

Susan Prior, partner at Shoosmiths Thames Valley office in Reading, acted for the family:

“This was a difficult case because there was evidence that baby L had suffered the effects of a non-negligent infection as well as a hypoxic brain injury caused by a negligent delay in his delivery). We needed to be able to prove that, despite the presence of the infection, had baby L been delivered sooner, he would have responded well to any resuscitation required and he would have survived.”

Read our guide here to material contribution.

Background

Baby L was Mrs E’s first pregnancy and her ante-natal progress had been uneventful. In early October 2015 she attended hospital, concerned about reduced fetal movements. She was reassured but attended again two days later, with the same concerns. She had a cardiotocography (CTG), which monitors the baby’s heart rate, and this was noted to be suspicious, and so she was admitted for induction of labour that day. Mrs E underwent an artificial rupture of membranes and, later, a Syntocinon® infusion was commenced, in order to start labour.

A review of the CTG shortly after the commencement of the Syntocinon® was concerning and there was a plan to review this again an hour and a half later. This review took place and the Registrar, as well as being concerned by the CTG, noted that there was no fetal movement on vaginal examination. A fetal blood sample was performed, which showed baby L’s lactate levels to be below normal. At this stage the Syntocinon® was increased. A further review of the CTG was done an hour later and was again considered to be suspicious. Mrs E was not having regular contractions at this time.

Half an hour later, Mrs E was having regular contractions but, despite this, she was, inappropriately, given two further increases of Syntocinon®. A further fetal blood sample performed an hour later confirmed that baby L was struggling and so a decision was made for a Category 1 (emergency) Caesarean Section. baby L was delivered with difficulty. When he was delivered, he was pale and floppy with no detectable heartbeat. He was not breathing.

Efforts were made to resuscitate baby L but his APGAR scores were 0, 0, and 0 at one, five and 10 minutes. His first heartbeat was recorded at 14 minutes of age and he began to take occasional spontaneous breathes. Unfortunately, baby L developed bradycardia (a slow heartbeat) a short time later and was, shortly after this, pronounced dead.

A post-mortem showed that baby L, who was otherwise a normally grown baby, had suffered a hypoxic brain injury and there was evidence of inflammation / infection of the placental membrane (chorioamnionitis) and the umbilical cord. There was an inquest, which highlighted some failures by the Hospital Trust and the medical cause of death was registered as “hypoxic brain injury and small placenta with acute chorioamnionitis and fetal inflammatory response.”

The claim

In order to investigate this matter further, we obtained supportive medical evidence from an expert midwife, an expert obstetrician and a neonatologist. These experts highlighted areas of negligence by the Trust and we sent a Letter of Claim under the Pre-Action Protocol for the Resolution of Clinical Negligence Disputes, setting out those failures and why baby L should have been delivered earlier. The letter included a claim for both Mrs E, because of the severe psychiatric trauma she sustained, and baby L.

The Trust admitted some failures but responded that baby L would “still have been poorly because of infection and the outcome would not have changed even if he had been delivered earlier.”

Unfortunately, the Trust maintained their denial of causation and so it was necessary for us to issue proceedings and serve them on the Trust. The Trust filed a defence, maintaining their previous denial of liability but ultimately agreed a settlement and provided a letter of apology.

Mrs E wrote:

“[We] are so incredibly grateful for everything you have done with seeing our case through and getting us the outcome we had hoped for all along… You will remember the one thing I personally always wanted was answers to fill those gaps and the 'what if's' and as part of that ultimately a letter of apology from the hospital. I can't still quite believe we have come to the end of the process and achieved all of this to which we are so truly grateful to you…I will forever be thankful for this as it has enabled both [of us] to gain the closure we have both wanted and needed.”

Mr and Mrs E were able to use some of the compensation that they received to help support the charities that had supported them. They made a donation to the national charity, Sands (the Stillbirth and Neonatal Deaths charity who support so many families in Mr and Mrs E’s position) and donations to various other local charities who provide support to families.

Susan Prior says:

“Mr and Mrs E’s case and their reasons for bringing a claim are not unusual. When families suffer a tragedy like this, what they really want is to be able to understand what happened, ensure that the hospital learn from their mistakes and for someone to say sorry. I am pleased that we were able to help Mr and Mrs E and that they were, in turn, able to help the charities who had provided them with support through this difficult time.”

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Disclaimer

This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2021

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