Settlement of clinical negligence claim for failures in management of post-delivery bleeding

Posted: 09/06/2014

The Penningtons Manches clinical negligence team has recently agreed the settlement of a claim against Queen’s Hospital (part of Barking, Havering and Redbridge NHS Foundation Trust) for the failure to diagnose and appropriately treat the claimant for a post-partum haemorrhage following the birth of her son in April 2011.

The claimant was admitted into hospital in labour. Her baby was delivered without complication and without the need for any medical intervention. However, upon delivery, she suffered extensive blood loss which was estimated by her midwife as approximately 500mls. As the claimant’s blood loss was considered to be within “normal limits”, the midwife did not deem it necessary to seek any senior input from a doctor. Unfortunately, the claimant suffered further incidents of excessive blood loss, which caused her to collapse on a number of occasions, one episode resulting in a loss of consciousness. Despite the claimant reporting feeling weak and dizzy to the extent that she was unable to care for her new-born baby on a number of occasions, no action was taken by the midwives on the ward throughout the course of the day. Sadly, after being encouraged to self-care and mobilise by the midwives in spite of her condition, the claimant collapsed and fell later that evening, when she sustained a fracture to her ankle.

During the course of the claim, medical evidence was obtained from an expert midwife and an expert obstetrician and gynaecologist. Both experts were unequivocal in their view that, while the initial extent of blood loss as recorded was borderline normal, fainting after a normal delivery was not normal and a doctor’s input should have been sought immediately following that and when the blood loss continued. Our experts were of the opinion that, had a doctor been called upon, bloods would have been taken which would have revealed low haemoglobin levels. The claimant would then have received earlier treatment and one-on-one care and assistance because of the risk of faintness and collapse, which would have avoided the later fall.  Interestingly, our experts highlighted that the extent of blood loss following delivery is frequently under-estimated and their view was that it was likely that our client had, in fact, suffered in excess of 500mls of blood loss, which would have mandated earlier intervention.

We subsequently wrote to the defendant’s representatives whereby we set out the allegations of negligence in our client's care and why we considered those failings resulted in her fall and injury. Liability was denied and the defendants sought to dispute our client’s evidence on certain points.  Given the credibility of our client, the strongly supportive expert evidence that we had obtained and the rejection of the trust of settlement offers made by the claimant, once we had fully assessed the injury via further medical evidence, we issued and served court proceedings against the trust.

Following this, the defendants indicated a wish to enter negotiations and, after a period of negotiation, a settlement was reached.

Naomi Holland, an associate in the clinical negligence team, who ran this case said: “This is a very sad case where, despite presenting symptoms that clearly mandated a doctor’s review around 15 hours before her fall and careful management thereafter, our client was left untreated, causing her much distress especially as she was unable to care for her new-born baby. This case highlights the importance of early diagnosis of post-partum hemorrhage and for proper assessment of blood loss after delivery. Failures to manage this situation properly can put both mother and baby at risk.

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