Claim over failure to interpret abnormal CTG traces leading to child’s stillbirth

We have recently achieved a settlement for a failure to correctly interpret abnormal CTG traces and facilitate a discussion around preterm delivery, leading to the avoidable stillbirth of a client’s child.

Our client was undergoing her second and much longed-for pregnancy at the time of the negligence. At 34+1 weeks she attended the day assessment unit with lower abdominal pain and occasional tightenings, suspecting she may have been in pre-term labour. It was considered to be pelvic girdle pain. A CTG was commenced at 10:19 hours and completed at 11:29 hours. The Dawes-Redman criteria were not met at 60 minutes. This was reviewed by a junior obstetric doctor and a physiotherapy referral was made.

Our client remained as an inpatient for CTG monitoring of her baby to continue. Over the course of this period, our client underwent six CTGs. The Dawes-Redman criteria were not met for three of these CTGs and concern were raised by staff about whether the monitoring was categorised as suspicious.

She had ongoing contractions, but pre-term labour was considered unlikely. Steroids were not considered. While corticosteroid injections were prescribed and neonatal doctors were asked to visit our client, no plans for a pre-term birth were made. Our client repeatedly requested further information regarding this, along with asking why she could not undergo a caesarean section or have labour induced; however no answers were forthcoming on this point.

Despite reporting reduced movements of her baby, a concerning ultrasound showing reduced growth velocity and continuing decelerations on the CTG monitoring performed over the course of her four-day inpatient stay, our client was discharged at 34+5 weeks. Cord compression was suspected in-utero, but this was not acted upon.

Follow-ups over the course of the next few weeks did not yield any further investigations into the suspicious CTG traces recorded during our client’s inpatient stay, nor was any action taken over the reduced growth of her baby shown on ultrasound scanning.

Heartbreakingly, at 37 weeks our client attended the maternity unit with contractions and her baby’s heartbeat could not be located. Our client laboured and her baby was born weighing 2575 grams on the 24th centile with no signs of life.

An HSIB investigation was undertaken into the death of our client’s baby, which revealed serious concern around the interpretation of the CTG traces undertaken during our client’s inpatient stay, along with the lack of accountability for her care by the professionals looking after her. Recommendations were made to the defendant for improvements, including a review of CTG traces by multi-professional senior clinicians and complex pregnancies receiving a named consultant who would assume responsibility for their management.

An early letter of notification was served on the trust, which admitted failings in the interpretation of the CTG traces during our client’s inpatient admission, along with a failure to discuss pre-term delivery with her or arrange increased fetal surveillance with regular Dawes Redman CTGs on an outpatient basis. A settlement was negotiated with the defendant to support our client with the costs of completing her much longed-for family and for psychiatric support with coming to terms with the loss of her child.

Grace Norris, an associate in Penningtons Manches Cooper’s medical negligence team who ran this claim and specialises in cases involving stillbirth and neonatal death, commented: “This was an immensely sad and difficult case for all the parties involved. My client remains devasted by this loss and the knowledge that the death of her child could have been avoided with the appropriate care. With a collaborative effort in negotiating with the defendant, I am glad for her and her family that we have been able to find some resolution to the questions and significant losses flowing from this tragic claim. Although the financial settlement cannot reverse the death of her child, hopefully it can support her with completing her longed-for family.”