The clinical negligence team at Penningtons Manches LLP has recently settled a claim against Imperial College Healthcare NHS Trust for the failure of staff at Queen Charlotte’s and Chelsea Hospital to arrange an induction of labour following a spontaneous rupture of membranes at 37 weeks gestation, leading to the avoidable death of the claimant’s son.
The claimant was booked in for antenatal care at Queen Charlotte’s and Chelsea Hospital when she was at nine weeks gestation. Her care was considered low risk as the results from her anomaly scan appointments at 18 and 21 weeks were normal.
Whilst the antenatal care pathway for the trust included a plan for visits at 25, 28, 31, 34 and 36 weeks, unfortunately the claimant did not have any further antenatal follow up at the hospital from 21 weeks and was not seen again until she presented to hospital at 37 weeks gestation when she noticed a change in her baby’s movements. She was reviewed by a midwife who performed a CTG to check the wellbeing of the baby. Whilst the CTG was considered normal, the claimant raised concerns that her waters had broken. Despite the contemporaneous medical records confirming that the claimant’s waters had indeed broken, she was reassured and discharged home with no follow up arranged. She was not advised to return to hospital within 24 hours for induction of labour if labour had not started spontaneously within this time, nor was she told to expect labour to progress.
The claimant did not attend hospital again until two weeks later, having noted decreased fetal movements and greenish discharge. She was seen by the on-call consultant and following an ultrasound scan, an intrauterine death was confirmed.
Following these events, the trust carried out an internal investigation which highlighted a number of failings in the care the claimant received when she presented to hospital at 37 weeks. Specifically, it was found that there was a failure to arrange a date for the claimant to return to hospital for review and induction of labour following her waters breaking. Unfortunately the fact that an investigation had been carried out and the results of this investigation were not communicated to the claimant. It was not until she had instructed Penningtons Manches that a copy of the investigation report was seen, which added to the claimant’s anguish about the care she had received.
The claimant was, understandably, extremely upset not just at the totally unexpected loss of her baby, but to discover that she should have been advised to return to hospital within 24 hours to induce labour, and that the midwife should have arranged follow up at this point.
She subsequently instructed Penningtons Manches to investigate a clinical negligence claim on her behalf as she had concerns as to why she had lost her baby and whether anything more should have been done when she attended the hospital at 37 weeks. Following receipt and review of the claimant’s medical records and serious incident investigation report, the clinical negligence team instructed a consultant obstetrician to prepare a report commenting on breach of duty and causation. This report was supportive and identified a number of concerns about the antenatal care the claimant received, specifically when she presented to hospital at 37 weeks. The expert considered that had the appropriate follow up been arranged, the course of events would have included a plan being made for induction of labour, meaning that delivery would have occurred no more than four days later. He believed that if this happened the claimant’s son would have been born alive.
Penningtons Manches prepared and served a formal letter of claim to the trust and was able to secure a full admission of liability soon after. The trust acknowledged the failings in the claimant’s care and accepted that, had these failings not occurred, her son would have survived.
Following the admission by the defendant, Penningtons Manches took steps to quantify the claim. After negotiations were carried out with the defendant, a settlement was achieved.
Amy Milner, associate in the clinical negligence team who handled the claim, said: “This was an extremely sad case involving numerous failings by Queen Charlotte’s and Chelsea Hospital. It was clear from the outset that the antenatal care our client received was lacking, with various appointments having been missed and no attempts made to contact her in order to arrange follow ups. While it is a credit to the trust that liability was admitted quite swiftly, these events have been extremely difficult and distressing for our client who has understandably found it hard to accept that her son’s death could easily have been avoided. It was extremely disappointing that the trust did not share the findings of the internal investigation with our client and her husband. Instead she sought legal advice to get answers which could have been provided in an open fashion by the trust itself.”