B’s mother had had a relatively normal pregnancy, but, in the hours leading up to his birth, the CTG trace started to show signs of fetal hypoxia – a condition in which not enough oxygen-rich blood is fed to the brain and other vital organs. In B’s case, it is likely that his hypoxia was caused by his umbilical cord becoming wrapped around his neck.
Without a sufficient oxygen supply, brain cells are unable to survive and begin to die, causing irreversible brain damage. Therefore, signs of fetal hypoxia would normally prompt urgent investigations, including a vaginal assessment and fetal blood sampling to determine the severity of the condition. If the signs are severe then rapid delivery, usually by caesarean section, is warranted to relieve the baby of the hypoxia.
In B’s legal case against the hospital his family argued that the signs were not noticed or acted upon for a matter of hours and that once they had been recognised there were further delays in arranging a trial of instrumental delivery using a Ventouse Suction Cup. It was alleged that as a result of this, B’s hypoxic condition was prolonged, causing him to suffer significant brain damage and leaving him with permanent disabilities.
The clinicians did not realise that the baby was descending down the birth canal in the Occipito-Posterior position, facing backwards, as opposed to the Occipito-Anterior position, in which it should have been considerably easier to deliver him. This led to the Ventouse cup being applied to the fetal head in the wrong position.
The Trust denied liability for B’s brain injury, arguing that it was not negligent for their doctors to get the position of the fetal head wrong, and resisted the claim for a number of years, forcing the case to be listed for a trial at the High Court. A matter of weeks prior to the start of the trial, the Trust approached B’s family with a proposed financial settlement.
The compensation secured for B will go towards finding and adapting suitable accommodation and funding much-needed care and educational support.
“It is vital for trainee doctors to acquire hands-on experience on labour wards, but they should be carefully supervised when doing so. This case is a reminder that consultants overseeing deliveries should check the position of the fetal head sufficiently early, so as to avoid injuries such as those suffered by B.”
Sarah worked with David Hart QC on B’s case.