The Claimant, a 47-year-old woman, received £40,000 in relation to medical treatment provided following the birth of her child in November 2004. She suffered a post-partum haemorrhage, which required surgical intervention, and psychiatric injuries – CB v Southampton University Hospitals NHS Foundation Trust 12.02.10 (settlement date)
On 5 November 2004 at 11.55 am, the Claimant (aged 42) attended a hospital of the Defendant trust in labour. She was noted as being 7cm dilated. The Claimant's labour progressed very slowly. The baby was delivered at 11.15 pm and it was noted that the attending midwife delivered the placenta by controlled cord traction following administration of Syntometrine. That was disputed by the Claimant who alleged that she had instead used excessive force and jerky movements and in doing so had caused the Claimant to suffer significant pain. The placenta was checked and rechecked following delivery and it was noted to be complete, although bi-partite.
The Claimant's condition deteriorated and at 2.00 pm the following day her husband saw that she had lost a significant amount of blood and called for help. She was taken to theatre where a piece of the placenta was removed. She remained in theatre for several hours before the bleeding was controlled and in total she lost 3,200ml of blood. She was treated on the high dependency unit and discharged home on 14 November.
The Claimant subsequently suffered from bilateral hip pain, post-traumatic stress disorder and a moderate depressive episode in a recurrent depressive disorder. She was unable to care for her newborn baby, including being unable to establish breastfeeding, because she was too weak. She remained vulnerable to further depressive episodes and her prognosis was uncertain.
The Claimant alleged that the Defendant was negligent in failing to:
- actively manage her early labour by rupturing her membranes at 3.20 pm.
- manage the delivery of the placenta appropriately and as a result failing to deliver the complete placenta causing her to suffer a haemorrhage.
- recognise that the placenta was not complete on delivery.
- monitor her adequately after delivery, recognise the haemorrhaging and/or to call for obstetric assistance resulting in significant blood loss.
The Claimant also alleged that as an older first-time mother, her pregnancy should have been managed as high-risk but was not.
The Defendant admitted that it had failed to progress the Claimant’s labour by rupturing the membranes early but it argued that doing so would not have led to earlier delivery. The Defendant acknowledged that the placenta had not been complete on delivery but contended that the failure to recognise that was not a breach of its duty and that the midwife had not used an inappropriate method to remove the placenta. The Defendant admitted that it had failed to monitor the Claimant following delivery and that adequate monitoring would have reduced the blood loss.
This case highlights the importance of post-delivery monitoring. In this case the reason the Claimant bled was unrelated to age but due to the fact that she had a retained placenta. It is, therefore, vital that trusts have systems in place to ensure mothers who have recently delivered are carefully monitored to detect any postpartum abnormalities, regardless of their age.