Cerebral Palsy

Please click on the titles to read the following case reports:

F A v Worcestershire Acute Hospitals NHS Trust
A (A Child/Protected Party by Her Mother & Litigation Friend) -v- D NHS Foundation Trust
M.J. (A Minor) v Dr Hayward (1) and The Royal Berkshire NHS Foundation Trust (2)
P v West Berkshire Health Authority
J v a Health Authority
A.T. (minor) v a Health Authority
Murtough v Swindon and Marlborough NHS Trust (2005)

F A v Worcestershire Acute Hospitals NHS Trust

On 16 June 2003, the Claimant’s mother, who was approximately 32 weeks pregnant with the Claimant, attended the hospital with a suspected spontaneous rupture of the membranes. On clinical examination no evidence for this was found and she was discharged from hospital having had a high vaginal swab (HVS) taken. This swab was not reported until 21 June 2003.

In the meantime, on 18 June 2003, the Claimant’s mother was admitted to the hospital in labour and delivered the Claimant in the early hours of Thursday 19 June 2003. The Claimant and her mother were both discharged home on 20 June 2003.

Before being discharged, the Claimant’s mother noticed that her daughter was quite miserable and that she screamed when being picked up. She also developed a grunting noise but the Claimant’s mother was reassured by the midwives. The Claimant had significant problems with her breathing after discharge and seemed to be fitting. After a telephone call to the hospital, during which the Claimant’s mother was again reassured, the Community Midwife attended and realised that the Claimant was very ill. She arranged for her immediate admission to SCBU.

The Claimant suffered severe brain damage due to bacteria/septicaemia and meningitis caused by Group B Haemalytic Streptocuccus (GBS). The GBS was acquired from the Claimant’s mother’s genital tract and the symptoms started within 24 hours of her birth. Although the Claimant’s mother had signs of intra uterine infections soon after delivery with fever, tachycardia and a very high white blood cell count, neither she nor the Claimant were treated with antibiotics and were both allowed to go home on 20 June 2003. The Claimant was profoundly disabled from birth suffering from a mixed cerebral palsy with severe motor impairment, severe cognitive impairment and epilepsy. The Claimant was dependent on others for all aspects of basic care, the vast majority of which was provided by the Claimant’s mother. Tragically, the Claimant died aged 3 years and 3 months when an epileptic fit could not be controlled.

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A (A Child/Protected Party by Her Mother & Litigation Friend) -v- D NHS Foundation Trust

The claimant, an 11 year old twin, received a lump sum of £1,956,466 and periodical payments of two elements: the first was a payment for care and case management of £145,000 per annum from the age of 12 until she is aged 21, and £190,000 per annum from the age of 21 onwards, due to the negligent management of her delivery by the defendant in November 1997 which resulted in her sustaining brain damage. She suffered asymmetric mixed spastic dystonic tetraplegia, a very severe mixed type of cerebral palsy affecting her whole body.

The second element of the periodical payments was for future loss of earnings of £25,200 per annum from the age of 21 years until the age of 60 years or the date of her death (whichever is the earlier event).

The periodical payments order for future loss of earnings is linked to the ASHE median for all female full time employees in the United Kingdom. This is the first case in which the NHSLA has agreed to an earnings periodical payments order. The very carefully constructed Order will stand as the Model Order for a periodical payment for earnings.

It was also determined by the Court that any application for the release from a Peter’s Undertaking by or on behalf of the claimant has to be made to the High Court and not the Court of Protection, with “reasonable notice” of the application to be given to the defendant.

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M.J. (A Minor) v Dr Hayward (1) The Royal Berkshire NHS Foundation Trust (2)

In October 2008, the Claimant, a 12-year-old boy, received £1,800,000 for the injuries sustained during his birth in November 1995. In addition, the Claimant will receive index-linked annual payments for the rest of his life in relation to his care requirements.

On 9^th November 1995 the Claimant’s Mother, who was then approximately 24 weeks pregnant with the Claimant, attended an ante-natal appointment with the First Defendant, her GP. During this appointment the Claimant’s Mother was noted to have raised blood pressure.

On 20^th November 1995, the Claimant’s Mother attended an ante-natal appointment with a midwife, employed by the Second Defendant. It was again noted that the Claimant’s Mother had raised blood pressure.

The following day, on 21^st November 1995, the Claimant’s Mother attended a further appointment with the same midwife. It was again noted that the Claimant’s Mother had raised blood pressure.

The Claimant’s Mother was next seen by her GP on 27^th November 1995. By this time the Claimant’s Mother was experiencing severe swelling to her fingers and ankles. She was diagnosed with pre-eclamptic toxaemia and referred immediately to Hospital, where she was admitted at 17.35. A CTG was commenced which was very abnormal and it was decided that the Claimant needed to be delivered by caesarean section urgently.

The Claimant was delivered by caesarean section at 20.12 on 27^th November 1995, at approximately 27 weeks gestation. The Claimant was in very poor condition upon his birth and required intubation. He remained in hospital until 30^th January 1996.

The Claimant alleged that the First Defendant was negligent in failing to act upon the Claimant’s Mother’s raised blood pressure on 9^th November 1995 and that the midwife employed by the Second Defendant was negligent in failing to act upon the Claimant’s Mother’s raised blood pressure on 21^st November 1995.

Had the Claimant’s Mother been referred to hospital between 9^th November 1995 and 21^st November 1995 then she would have had daily CTG monitoring which would have revealed abnormalities by 24^th November 1995 indicating that the Claimant should have been delivered early at this stage. The Claimant’s Mother would also have been administered steroids for 24 hours prior to delivering the Claimant which would have reduced the risk of injury to the Claimant.

As a result of the negligence of both Defendants the Claimant suffered pain and suffering, loss of amenity, reduced life expectancy and catastrophic injuries. The Claimant suffered severe antenatal hypoxia ischaemia between 25^th November 1995 and 27^th November 1995 and severe respiratory distress syndrome after his birth. As a result the Claimant suffered permanent damage to his brain in the form of Periventricular Leukomalacia and an intraventricular haemorrhage.

The Claimant suffers from spastic diplegic cerebral palsy, (primarily affecting his legs), moderate to severe learning difficulties and epilepsy. The Claimant is able to walk only with the assistance of a Kaye walker or crutches. He is unable to dress himself and is doubly incontinent. He is able to speak but is unable to carry on a conversation. The Claimant will be unable to live independently, will be unable to work and will not be able to handle his own financial affairs. The claimant's life expectancy was estimated to be reduced by 15 years as a result of his injuries.

Court proceedings were issued and witness statements and expert evidence obtained. Negligence was admitted by both Defendants however they contended that the Claimant would still have had problems with school failure (including learning difficulties), poor attention span, behavioural difficulties and motor in-coordination as a result of being born prematurely, and not as a result of their negligence. This argument was not accepted by the Claimant.

A settlement meeting took place in July 2008 and following negotiations the Defendant agreed to pay the Claimant damages in the form of a lump sum of £1.8 million and, in addition, index linked annual payments for the rest of the Claimant’s life of £54,000 until age 19, £105,000 until age 55 and £110,000 after age 55 to meet the cost of the Claimant’s ongoing care requirements. This is estimated to equate to £4.4 million total settlement over the Claimant’s expected lifetime. This settlement was approved by the Court on 16^th October 2008.

Simon Elliman of Withy King Solicitors was instructed on behalf of the Claimant in January 2004 and brought this significant claim to settlement within 4.5 years.

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P v West Berkshire Health Authority

The Claimant was born on 10^th November 1985 in the maternity unit of the Royal Berkshire Hospital, Reading. Mrs P was admitted to hospital at 3.00pm on 9^th November 1985. Vaginal examination showed the cervix to be closed and labour was not confirmed. On 10^th November 1985 at 4.00pm, Mrs P commenced labour. At 11.40pm, the foetal heart fell from a normal level and oxygen was given. At 5.00am on 11^th November 1985, the foetal heard became very slow, oxygen was given and the Senior House Officer was called. At 5.07am the Senior House Officer called the Registrar and the Paediatrician and the Registrar performed a Kiellands rotational forceps delivery at 5.14am. The Claimant did not breathe spontaneously initially and was intubated at 1 ½ minutes. Her first spontaneous gasp was recorded at 12 minutes. She was transferred to the Intensive Care Unit at Royal Berkshire Hospital where she was said to be in a critical condition. Her Apgar scores had been 1 at 1 minute, 3 at 3 minutes and 3 at 9 minutes. She had convulsions during her neonatal period and it was found that she had cerebral palsy and mental handicap. It was alleged that the Claimant’s condition was caused by negligence of the Defendants in the management of the birth and that her cerebral palsy and handicap was a result of hypoxic ischaemic encephalopathy, which was the result of birth asphyxia.

Previous solicitors acting for the Claimant issued proceedings on 24^th February 1992 and Leading and Junior Counsel were instructed. Upon the retirement of the Partner dealing with the matter, the papers were transferred to Withy King in February 1996.

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J v a Health Authority

On 9 June 1983 the Claimant’s mother, who was then pregnant with the Claimant, was referred to hospital because the claimant was in a breech position. This was confirmed on 17 June 1983 but it was decided not to turn the Claimant manually.

On 15 July the Claimant’s mother returned to hospital, having previously attended on 6 July following suspected contractions when she was told it was a false alarm and sent home. Contractions started at 12 midnight and she was sent to the ante natal ward. On 17 July the contractions stopped and she was again sent home.

On 19 July 1983 the Claimant’s mother was admitted to the labour ward with a history of regular contractions occurring every 10 minutes. An examination showed a breech presentation and CTG monitoring was commenced. However the monitor showed no accelerations or decelerations and a second machine was brought in with a scalp electrode attached to the breech presenting part. Both CTG machines were showing irregularities but these were attributed to machine malfunctions.

CTG monitoring continued and at 01.35 hours the midwife noted that the foetal heart rate was falling between contractions. By 02.19 hours the CTG showed a baseline rate of 155 beats per minute followed by foetal bradycardia. At 02.31 hours pm an episiotomy was performed and delivery was by Rhodes forceps with immediate resuscitation because the Claimant was not breathing.

The Claimant was taken to the Special Care Baby Unit where she remained for 2 ½ weeks. She now suffers from dyskinetic cerebral palsy manifested by athetoid tetraplegia.

The Claimant alleged that the Defendant had failed to heed to the significance of the CTG trace and failed to ensure the CTG was properly applied so as to give a proper trace. Furthermore the Defendant failed to deliver the Claimant when the CTG traces indicated fetal hypoxia and failed to move the Claimant’s mother to theatre in time for the Claimant to be delivered by breech extraction of caesarean section. As a result the Claimant suffered pain, suffering and loss of amenity.

Court Proceedings were issued and witness statements and expert reports obtained. The Defendant denied liability and causation and maintained that delivery could not reasonably have taken place before it did.

Following a detailed conference with experts on 20 September 2006, a Settlement Meeting took place on 22 September 2006. The Defendant ultimately agreed to pay the Claimant damages in the sum of £875,000.00 in full and final settlement of her claim.

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A.T. (minor) v a Health Authority

On 12 May 1988 the Claimant’s mother, who was then pregnant with the Claimant, was referred to the Hospital by her GP where she was assessed by a midwife and admitted under the care of a Consultant Obstetrician with an estimated delivery of 3 December 1988.

On 15 September 1988 and 4 October 1988, the Claimant’s mother suffered painless antepartum haemorrhages for which she was admitted to hospital and in each case discharged when the bleeding ceased. On 10 October she suffered a further haemorrhage and was re-admitted to Hospital. A CTG was maintained but there was no sign of foetal distress. The hospital staff assumed that the membranes had ruptured and the baby was delivered by Caesarean Section.

The Claimant suffered Periventricular Leukomalacia involving loss of a large amount of the white matter of his brain and secondary cortical quadriplegia. He was subsequently diagnosed with Cerebral Palsy and requires 24 hour care. His life expectancy is between 45-50 years.

The Claimant alleged that the Defendant had wrongly concluded that there was an emergency that required immediate delivery by caesarean section and that proper management would have involved promoting the foetal maturation until pregnancy had reached 37 weeks. As a result, the Claimant suffered pain and suffering, loss of amenity, reduced life expectancy and catastrophic injuries.

Court Proceedings were issued and expert reports obtained. The Defendant denied liability and causation and maintained that the decision to perform an emergency Caesarean Section at 32 weeks was a reasonable one and that the pregnancy would not have reached 37 weeks.

A round table settlement meeting took place on 16 January 2007. Following negotiations the Claimant was awarded agreed damages in the sum of £1,800,000.00.

Withy King took this case over from another firm of solicitors, and brought the case to settlement within 6 years of being instructed.

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Murtough v Swindon and Marlborough NHS Trust (2005)

QBD (Holland J) 24/2/2005

The claimant, a 7-year-old girl, received £1,535,000 for the brain injuries sustained during her birth in June 1997. The claimant suffered from spastic quadriplegic cerebral palsy and microcephaly. The claimant's motor abilities, vision and communication were all severely impaired and her life expectancy was estimated at 15 years.

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