Penningtons Manches Cooper’s clinical negligence team has settled a claim against North West Anglia NHS Foundation Trust for failure to diagnose and treat severe anaemia, leading to the avoidable death of the claimant’s baby daughter.
Early on in the claimant’s pregnancy, it was identified that there was a high risk of haemolytic disease of the fetus and newborn (HDN), a blood disorder that occurs when a baby’s red blood cells break down at a fast rate. While HDN is not harmful to the mother, it can cause the baby to become anaemic and develop newborn jaundice and, therefore, the claimant underwent frequent investigations and her pregnancy was monitored closely.
On the whole, the claimant’s pregnancy progressed without concern. However, at around 33 weeks, there was some concern that the fetus was small for gestational age. In view of this, an induction of labour by 37 weeks was recommended. The claimant was subsequently admitted to Hinchingbrooke Hospital for an induction of labour at just under 37 weeks.
Following delivery, the baby was transferred to the special care baby unit for double phototherapy in view of elevated levels of potassium, sodium and bilirubin (a substance that is made during the normal breakdown of red blood cells). A few days later, the baby was noted to be jaundiced and her bilirubin remained elevated, but as her haemoglobin levels were considered normal, she was discharged from hospital.
Following the baby’s discharge, the plan was to monitor for jaundice compromise and to escalate if there was reduced feeding or an increase in jaundice. Over the subsequent days, it appeared the baby’s jaundice had improved, and she was doing well, albeit not gaining weight as expected.
However, just over a week after her discharge, the claimant became concerned about her baby as she was demonstrating signs of limpness and was off her feeds. The claimant attended A&E and it was noted the baby was in a poor condition. Bloods were performed which showed a significantly reduced haemoglobin level and, as a result, the baby was intubated and admitted to the special care baby unit for further monitoring. The baby required a blood transfusion, but sadly her condition deteriorated further, and she passed away the next day.
Following these events, the trust initiated an internal investigation and matters were also referred to the coroner, after which an inquest was opened and a hearing was held. The primary cause of death was noted to be severe anaemia. The clinical negligence team at Penningtons Manches Cooper was instructed by the parents to represent them at the inquest and to investigate a clinical negligence claim.
The investigation report and inquest highlighted a number of failings in the care that the claimant’s baby had received. Specifically, it was found that there was a failure to appropriately monitor the baby’s haemoglobin levels and thus appreciate the significance of the fact that the baby had HDN. There was also a failure to arrange earlier paediatric review before the baby’s condition deteriorated. The coroner considered that there was a risk future deaths could occur unless action was taken to amend national and local guidelines in respect of the monitoring and treatment of infants at risk of haemolytic disease. Therefore, a prevention of future deaths report was commissioned.
In view of the various errors and failures identified in the investigation report and during the course of the inquest, Penningtons Manches Cooper invited the trust to make early admissions with regard to liability. Essentially, the trust was invited to admit that, but for the above failures identified, an earlier diagnosis of significant anaemia would have been made, and the baby would have been admitted and treated before her condition became life threatening. The trust subsequently responded with an offer to settle the claim and, while this did not come with a formal admission of liability, the offer reflected that the defendant recognised there were risks to them in terms of liability, and the offer was subsequently accepted.
Amy Milner, senior associate in the clinical negligence team, who handled the case, said: “This was an extremely sad case of numerous failings by the trust, where the subsequent tragic outcome could have been avoided. The investigation report commissioned by the trust identified a number of potential failings in respect of the care provided to the claimant’s daughter, and once matters were referred to the coroner, he was extremely proactive in terms of his own investigation of the matter, with the outcome of the inquest trying to ensure that such a sequence of events does not happen again.
“These events have been extremely difficult and distressing for the parents and while no amount of money can make up for what happened, the sensible approach taken by the trust, the recovery of damages and the outcome of the inquest provided the family with answers to their questions, and are some achievements in this tragic case.”