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Cerebral Palsy cases

 

B v Guy’s & St.Thomas’ NHS Trust

Paul McNeil applied to Mr Justice Calvert Smith for an interim payment to cover the cost of purchasing a suitable property and providing 24 hour care to B.

 

 

 

B’s mother said “...Mr Paul McNeil came into the picture two years ago when all hope of justice was lost. He has worked tirelessly and meticulously to ensure that our son [B] could have at least a better future...”.

B was born on 19 April 2002 at Guy’s & St Thomas’ Hospital. He suffers from cerebral palsy which was caused by admitted obstetric negligence. B’s injuries are very severe and he is totally dependent on his family for care and support which he requires on a 24 hour basis.

The solicitors acting for Guy’s and St Thomas’ Hospital, having accepted blame for his cerebral palsy as a result of medical negligence in November 2006, refused to provide funds to enable B and his family to move to appropriate accommodation and to provide suitable care.

The dispute was resolved after a hearing before Mr Justice Calvert Smith who ordered that the Defendants pay the sum of £850,000 to cover these costs on or before 8 October 2007. The Defendants argued that O was asking for too much money, notwithstanding their acceptance of B’s needs, including that this present home was not suitable for him or his carers. Mr Justice Calvert Smith awarded the whole sum asked for.

Since the hearing, the parents have purchased a house and it is presently being updated for B’s needs.

Cerebral palsy

Full case details

S v North Middlesex Hospital NHS Trust (2004)

Paul McNeil acted for S in connection with a claim for medical negligence arising out of his birth and delivery at the North Middlesex Hospital on 20 November 1995. S has significant developmental delay, poor vision and serious behavioural problems. He also has some degree of motor dysfunction.

His mother was admitted to hospital on the evening of 19 November 1995 and was appropriately monitored with a CTG trace. By about 00:30 hours the next day, the trace indicated severe fetal distress, such that steps should have been taken to deliver S by emergency caesarean section.

In fact delivery did not take place until 01:35. There was also a delay in resuscitation by the paediatricians.

The claim was investigated notwithstanding that S’ injuries were not those usually associated with lack of oxygen during labour.

A letter of claim was served on 11 July 2002 and the defendant subsequently admitted that there had been negligence in failing to deliver S by 01:00 hours on 20 November 1995. However, the Trust vehemently denied that the negligence caused S any harm.

Proceedings were issued in October 2003 and the trial was fixed for the Autumn of 2004.

The defendant initially offered to settle the case on a 50% discounted liability basis and later a 66% discounted liability basis. These were rejected by the claimant on the basis of the strength of the paediatric advice, which was that the majority of his injuries were caused by the delay in delivery.

On 28 July 2004, the court approved a settlement agreed between the parties. The defendant accepted that if delivery had taken place by 01:00, S would have been born with damage limited to motor dysfunction. He would have suffered, at worst, mild cerebral palsy, with no learning or visual problems and no challenging behaviour. But for his cognitive and visual damage, S would have been able to live independently and hold down a job. Judgment was entered on that basis. In addition, the defendant agreed to make an interim payment in the sum of £700,000 to cover a rehabilitation package agreed between the parties to include the appointment of a psychologist, case manager and the purchase of suitable accommodation. The amount of damages S is to receive is yet to be decided.

The case was conducted with the benefit of Public Funding.

D v Oxford Radcliffe Hospitals NHS Trust (2003)

Oliver was born at the Horton General Hospital on 9 February 1995. His mother had been admitted to hospital the previous day expecting twins. She was then 34 weeks pregnant.

At about 04:48, William (twin 1) was delivered “easily”.

Oliver was noted to be in a compound presentation of both hand and vertex. The obstetrician, having twice unsuccessfully tried ventouse delivery with a silastic cup, then proceeded to emergency caesarean section.

Oliver was eventually delivered by caesarean section at 0530. He has dystonic athetoid cerebral palsy, caused by acute fetal asphyxia.

The claim alleged that the doctors should have delivered Oliver and his brother by caesarean section immediately, in the light of the persistent (and deteriorating) severe bradycardia on the CTG at 03:00 on 9 February. This would have taken about 30 minutes to achieve and both twins should therefore have been delivered by 0355.

It is thought that although Oliver suffered very severe physical injuries, he is of normal intelligence and it is hoped that with special schooling he will be able to make significant achievements notwithstanding his undoubted communication difficulties.

After negotiations between the parties the case eventually settled in the sum of £3.4 million, the settlement being approved by Mrs Justice Cox. Paul McNeil conducted the case with the assistance of Public Funding (formerly known as Legal Aid).

 

G v The West Surrey and East Hampshire Health Authority (2002)

Paul McNeil acted for Portia Gumbs in connection with a claim for medical negligence arising out of her birth and delivery at the Frimley Park Hospital on 30 March 1992. Portia suffered from dyskinetic cerebral palsy complicated by a rare congenital abnormality described as Klienfelder’s syndrome. The latter involves a normal male chromosome configuration of XY, but with an additional X chromosome. Unusually for this condition, Portia is being brought up a female and her male organs have been removed.

The main allegations concerned the conduct of the obstetric team during the labour. Portia was in breech position and there was an abnormal fetal heart reading. We contended that this should have lead to an expedited delivery by way of caesarean section particularly in view of the difficulties associated with breech delivery. The defendants denied liability principally on the grounds that their experts viewed the heart trace as “suspicious”, but no more. There was no requirement to expedite delivery.

Proceedings were issued in June 2001 with a trial fixed for February 2003. Liability was never admitted but a negotiated settlement was achieved in the sum of £2,000,000, which was approved by the court in December 2002. The claimant accepted a discount for the risks of litigation.

 

R v The Greenwich Healthcare NHS Trust (2001)

T was born at the Greenwich Hospital on 16 December 1992 at 30 weeks gestation. Although premature, his weight was good and his head circumference was above the 97th centile.

In accordance with responsible practice, T was electively intubated and transferred to the special care baby unit. Subsequently, T developed severe spastic quadriplegic cerebral palsy sustained as a result of periventricular leukomalacia (PVL).

The claim was unusual because the PVL occurred as a result of hypocarbia, a deficiency of Carbon Dioxide in the blood. His case was that an analysis of his blood gases should have been undertaken in the evening of the day of his birth. In fact, such an analysis took place at around midnight and indicated that T was at risk of hypocarbia. Instead of accepting the results, the Registrar decided that there was “a mechanical fault” in the ventilator. Accordingly, the ventilator settings were not reduced and resulted in T being exposed to excessive amounts of oxygen and diminished carbon monoxide for a period of over 9 hours.

Paul McNeil was instructed by the parents of T initially to pursue a claim in relation to the obstetric management. However, further investigations revealed the potential claim in relation to the paediatric management of the ventilation settings. Proceedings were issued in January 2000 and initially the claim was defended both on breach of duty and causation. Ultimately, negligence was conceded (in relation to the later allegation) but there remained considerable difficulties on causation i.e. precisely when the PVL occurred.

The trial was fixed for 29 January 2001 with an estimated time of three weeks. On 25 January, the defendant agreed to settle the claim for £2.25 million together with an indemnity against any private educational costs limited to £120,000.

 

B v Hillingdon Hospitals NHS Trust (2001)

B was born at the Hillingdon Hospital on 7 December 1984, FFW being instructed in 1998. We alleged that there was negligence by the midwifery staff in failing to recognise signs of fetal distress on the CTG some three and a half hours before birth. It was contended that a consultant obstetrician should have been called and delivery should have been achieved some one hour 45 minutes earlier.

After years of denial (to the previous solicitors) the Health Authority in its defence accepted negligence but not causation. The case was unusual in that B suffered from severe brain damage causing profound intellectual impairment, but no motor disability. Although he attended a special school, he was, by far, the most physically able at that school.

The case was fixed for trial for 16 July 2001 and settled a few days before in the sum of £1.6 million.

 

P v The Royal Free Hospitals NHS Trust (2001)

P and The Royal Free Hampstead NHS Trust, P was born on 13 November 1990 at a gestation of 34 weeks. Mrs P had an unrecognised placental abruption, which was evident from the significant abdominal pain which she suffered, together with abnormalities on the CTG. We contended that P should have been delivered about 25 minutes earlier.

Unusually, we were also advised by our experts that paediatric monitoring had been negligent in that P had suffered from hypoglycaemia, partly caused by the failure of the hospital to maintain intravenous infusion of dextrose when P visited her mother on the labour ward.

P suffers from mild spastic dyplegic form of cerebral palsy with epilepsy. She was able to attend normal school, although she sometimes needed assistance to undertake physical activities. Intellectually she was bright but had some difficulty with mathematics.

The claim was fixed for trial for 9 July 1991, but was settled shortly before in the sum of £450,000 which was paid into a private trust for the benefit of P.

 

R v The Royal London NHS Trust (1999)

R was born on 2 October 1994. During the delivery there was an abnormal fetal heart reading. This should have led to an expedited delivery. R suffers from severe spastic quadriplegic cerebral palsy, cortical blindness and marked developmental delay.

A settlement of £1.5m, plus costs was agreed, with the Trust also giving an indemnity of up to £500,000 in relation to future education.

 

L v Barking, Havering & Brentwood Health Authority (1996)

L was born on 21 December 1991. Syntocinon was administered during the labour, resulting in a deterioration in the fetal condition. The Syntocinon was correctly turned off. About 40 minutes later, after full dilation, the fetal heart reading began to deteriorate, and yet the midwife restarted the Syntocinon. This increased fetal distress and L was born just over an hour later by forceps delivery. L now suffers from quadriplegic dystonic cerebral palsy. The Syntocinon should not have been restarted. If it wasn't, L would probably have been born about 45 minutes later but without damage.

A settlement was agreed in the sum of £800,000, plus costs, and the child will receive an annuity in the sum of £26,250 until aged 19 and thereafter in the sum of £60,000.