N&N Hospital guilty of breach of duty after baby suffers brain damage
PUBLISHED: 16:20 05 December 2017 | UPDATED: 08:35 06 December 2017
A decision by staff at the Norfolk and Norwich University Hospital to send a high-risk mother home during the early stages of labour has been ruled as a breach of duty.
The woman’s son, who is now nine and known as “J”, sustained brain damage shortly before he was born at the hospital in March 2008.
As a result the boy now attends a special school because of learning and behavioural issues.
At a London High Court hearing, Mr Justice Foskett ruled the NNUH NHS Foundation Trust committed a breach of duty, meaning it was responsible for the brain injury. A financial settlement is yet to be finalised.
He said the main issue was whether the mother should have been allowed home from the hospital shortly after 6pm on the day her son was born at 37 weeks.
Mr Justice Foskett also looked at whether the claimant had not been advised strongly enough to return quickly to hospital when she experienced regular more painful contractions.
He said: “Had she remained in hospital it is agreed that the problem that led to the brain damage (the placental abruption) would have been identified and that the brain damage itself would have been avoided.”
The mother, who lived 30-40 minutes drive from the hospital, was considered to have a “high risk” pregnancy because her first child had been born by emergency caesarean section.
The pregnancy leading up to J’s birth had been “uneventful” and her waters broke at 8.30am on March 12 2008.
She went into hospital between 4-5pm that day and seen by the midwife at 4.40pm while in the first stage of labour.
She was monitored after noticing fewer fetal movements.
It was agreed she could go home, an option she preferred, by the midwife, who sought advice from two colleagues.
She arrived home at 6.45pm and it was later accepted there was “a step change in uterine activity at 7pm”.
J’s mother returned to hospital by ambulance at 9.13pm after becoming unwell and suffering “pain with contractions”.
Summing up, Mr Justice Foskett said: “I do not consider that J’s mother was fully and adequately advised about what to do and in what circumstances. Accordingly the advice fell below reasonable standards.”
But he called the midwife, who initially saw J’s mother, “caring”, “conscientious” and an “impressive person” who was “plainly dedicated” to her profession.
Mr Justice Foskett added: “The decision about what to do in the situation that confronted her that evening was taken in the rather informal way.”
He recognised conversations of this kind took place daily across hospitals.
“This case does demonstrate the need for proper records to be kept of the substance of those conversations, particularly in high-risk cases.”
Sandra Patton, head of medical injury for Ashtons Legal which represented J’s mother, said: “It has been a stressful time for the family but they are very relieved to have the court confirm what they have always believed, that it was not appropriate to send the mother home in this situation.
“Tragically, it was that decision that sealed the child’s fate. Now that we have the judgment we can ensure that, through an award of damages, the child will have what they need to live as independent and fulfilled a life as their disabilities will allow.”
An NNUH trust spokesman said: “We are grateful to the court for providing clarity to bring this case from 2008 closer to a conclusion. We offer our heartfelt and sincere apologies to J and his family and the trust fully accepts the findings made. Through NHS resolution, the trust will ensure that J receives the help and support he needs in future.
“All identified learnings from this incident will be shared appropriately within the trust as part of our drive for continuous improvement and in order to ensure the best care and experience for our patients.”