£14.1 million birth injury award achieved following failure to offer an earlier caesarean section

We have recently achieved a settlement for a capitalised sum of £14.1 million for our client, now aged six, who has cerebral palsy after sustaining a significant brain injury at birth. 

Our client’s story

Our client’s mother attended West Suffolk Hospital for her antenatal care. At 20 weeks’ gestation, she was advised that she had placenta previa (where the placenta blocks the neck of the uterus) and was told that this would require her to undergo delivery by caesarean section. At her 36-week ultrasound scan she was told that her placenta had moved in such a way that it would be possible for her to have a vaginal delivery. 

Our client’s mother attended West Suffolk Hospital on her due date for a pre-arranged induction of labour. The medical staff tried to break her waters but were unable to do so because her baby’s head was too high. They attempted to move her baby into a better position whilst simultaneously attempting to break her waters. She was told that her baby had been successfully moved and she was started on IV syntocinon to induce delivery. The following day, a pelvic scan was carried out and our client’s mother was advised that the fetal head was still presenting abnormally. She was only two centimetres dilated with no urge to push. 

A forceps delivery was attempted. On the first attempt, the baby’s heart rate dropped significantly. Despite this, two further attempts were made, unsuccessfully. Medical staff proceeded to delivery by caesarean section. Our client was born in poor condition; he was floppy and pale and his heartbeat was not detectable at first. His APGAR scores were 0 after one minute, 2 after five minutes, and 0 after 10 minutes. An MRI was carried out in the weeks following delivery, and our client’s parents were advised that he had suffered significant brain damage as a result of hypoxic-ischaemic encephalopathy.

How we helped

We investigated the circumstances surrounding our client’s delivery, and found that there was a negligent failure to offer our client’s mother delivery by caesarean section at an earlier stage in her labour. In particular, there was a failure to take into account and explain to her that: the CTG had become pathological; dilatation of her cervix after nine hours of syntocinon was still only two centimetres; and there was an abnormal suspected face presentation of the fetal head. 

Our case was that, had these risks and issues been properly explained to our client’s mother, and had she been offered a caesarean section at this earlier stage, she would have opted for this. Had she undergone an earlier caesarean section, our client would have avoided his brain injury, which our experts concluded was as a result of 22 minutes of acute profound hypoxia.

We secured an early admission of liability from the defendant trust, who admitted that there was a delay in delivering our client given the CTG abnormalities and abnormal presentation of the fetal head. They accepted that a caesarean section ought to have been performed at an earlier stage, thereby avoiding the acute hypoxic ischaemic injury sustained during delivery and the subsequent brain injury.

Following the admission of liability, we investigated the value of the claim by instructing experts in a range of different specialities to allow us to determine what his needs would be for the rest of his life, and how much compensation would be needed to meet these needs.

At the time of events, the family were living in two-storey council accommodation which was unsuitable for our client’s needs, with no space to store his specialist equipment. We managed to secure an initial interim payment of damages to allow the family to move into more suitable rental accommodation, and to access the therapies and treatments our client urgently needed. We then obtained a further significant interim payment for the purchase of a suitable property, to be adapted to meet our client’s needs. The property will now be purchased imminently, with the adaptations started as soon as possible.

Our client’s ongoing needs

Our client has dyskinetic cerebral palsy affecting all four limbs. He has a significant speech impairment, along with learning difficulties. He cannot walk independently and uses a walking frame and a wheelchair. His right arm is affected more than his left, and he has limited function in his right hand. Our client is PEG-fed, which means that he receives his nutrition through a tube going directly into his stomach. He is doubly incontinent and relies on others for his toileting and cleaning needs. Our experts consider that he will need 24-hour care for the rest of his life. 

He will also need specialist aids and equipment to maximise his independence, and require access to a range of treatments and therapies, including occupational therapy, physiotherapy, hydrotherapy, speech and language therapy, orthotics, and educational psychology. There is a chance he may need orthopaedic surgery for scoliosis, hip displacement and foot deformities. 

The settlement

We were able to resolve the case through negotiations, without the need to go to trial. We achieved a lump sum figure of £5.4 million, with annual payments for case and case management amounting to a capitalised sum of £8.7 million. As our client is unlikely to gain capacity to make financial decisions, our Court of Protection team is instructed to manage the deputyship, in order to handle the settlement in accordance with his best interests.

Rosie Nelson, associate in the clinical negligence team, comments: “After securing an early admission of liability, we managed to work proactively with the defendant to quantify our client’s claim in a relatively short space of time, securing initial interim payments to meet his most urgent needs. Our client’s parents have done an incredible job in tirelessly providing their devoted care and attention to him since his birth. It has been a significant struggle at times, and I am delighted that this settlement will mean that they can now be confident that his needs will be catered for throughout his life.”

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