Neutral citation:
Judge:
Lambert J, High Court of Justice, Queens Bench Division
Counsel:
Hugh Preston QC (instructed by Simpson Millar) for the Claimant
Simon Readhead QC (instructed by Bevan Brittan LLP) for the Defendant
Hearing Dates:
2-6th December 2019
Date of Judgement:
10 January 2020
Subject:
Clinical Negligence, Obstetrics/Cerebral Palsy
Experts instructed:
Mr Duthie, Consultant Obstetrician, on behalf of the claimant
Mr Derek Tuffnell, Consultant Obstetrician on behalf of the defendant
Successful party:
Defendant
Legal cases considered:
Bolam v Friern Hospital Management Committee [1957] 1 WLR 583; Maynard v West Midlands RHA [1984] 1 WLR 634; Bolitho v City and Hackney HA [1998] AC 232
Guidance Referred to:
Nice Guideline “The Use of Electronic Fetal Monitoring” May 2001 ctgutbildning.se/…/NICE-guidelines-FHR-monitoring-2001.pdf
Case Summary:
The Claimant suffers from moderately severe asymmetrical four limb cerebral palsy as a result of a short period of hypoxia prior to delivery. Issues for the court were whether there was any breach of duty by the Consultant in the second stage of labour and had delivery been earlier would the period of hypoxia have been avoided or shortened. Was it was appropriate to perform a fetal blood sample rather than urgent delivery when there were signs of acute fetal compromise? Had the consultant not left the room would the consultant have been aware of fetal compromise at an earlier stage and delivered the baby?
The clinician’s decision to take a fetal blood sample instead of proceeding to immediate delivery was appropriate and reasonable.
There is also an interesting discussion on the use of guidelines to support the opinion of the expert. The NICE Guidelines concerning the use of electronic fetal monitoring were not intended to provide a complete compendium of either clinical definitions or management options. They were a practical tool but did not provide a substitute for clinical judgement
Thank you Lauren and agree completely that this was a fascinating case. Also, the first time as far as I know that the judgement recognised that unit work load may also affect care.