£14.1 million settlement secured for child with cerebral palsy after negligent delay in delivery

The Defendant admitted that they acted in breach of duty during the induction of labour in a vaginal birth after caesarean (VBAC) birth in failing to properly monitor the fetal heart rate following induction, causing a delay in delivery. Delivery 11 minutes earlier would have avoided the Claimant suffering neurological injury, due to severe hypoxic ischaemia.

There was an admission of breach of duty of care relating to the induction of labour and monitoring of the fetus thereafter, resultant in a delay in effecting delivery:

• The midwives should not have inserted a second dose of Propess without obtaining a senior clinical review first.
• Continuous CTG monitoring should not have been discontinued during labour, it was mandatory for this to remain in place. In circumstances of a trial of vaginal delivery after caesarean section where there is a risk of uterine rupture, CTG monitoring should be continuous.
• There was a delay in response to signs of fetal distress caused by uterine rupture which developed. The fetal heart rate should have been detected sooner and the obstetric registrar should have been called sooner.
• There was a further unacceptable delay in carrying out the caesarean section once a decision had been made to expedite delivery, caused by a lack of clarity on whether it was a category 1 or category 2 caesarean section.
• Cumulatively there was an 11-minute delay in delivery.
• The Claimant suffered an acute (near total), profound hypoxic brain injury at the time of his birth.

The Claimant was diagnosed with severe mixed dyskinetic cerebral palsy GMFCS Level V affecting all four of his limbs with dyskinetic movements involving his arms and hands. He has very limited functional mobility and requires full support with all transfers and is fully dependent on adults for all of his needs.

The Claimant also has severe cognitive impairment. It is likely that he will remain dependent on others for all activities of daily life, including washing, dressing, and toileting (nappy changing); and will require special education.

The Claimant has severe oropharyngeal difficulties leading to an unsafe swallow. All feeding is by gastrostomy.

His severe disabilities mean the Claimant will be highly unlikely to obtain remunerative employment or to have the capacity to make decisions regarding management of a large financial settlement.

As a result of the admitted negligence, his life expectation has been curtailed. The Claimant’s expert estimated life expectation to age 36.7 and the Defendant’s expert to only 27 years.

This case was settled out of Court for a lump sum of £7,000,000 and periodic payment orders (PPOs) of £220,000, increasing to £310,000 and £410,000.

The breakdown of general damages include pain, suffering and loss of amenity: £450,000. (Simmons v Simmons uplift applied.) Plus interest: £20,880.

The breakdown of special damages includes

• past care costs of £52,000;
• past accommodation costs of £195,000;
• past aids and equipment costs of £50,000;
• past commercial care £370,000;
• past case management costs of £87,000;
• past deputyship costs of £105,000;
• past therapies costing £45,000;
• past travel and transport £112,000.

• future care and case Management costs of £7,544,880;
• future physiotherapy costs of £135,720;
• future aids and equipment costs of £350,000;
• future assistive technology costs of £107,487;
• future occupational therapy costs of £115,473;
• future physiotherapy costs of £135,720;
• future physiotherapy equipment costs of £100,000;
• future speech and language therapy costs of £203,580;
• future transport costs of £176,387;
• future holidays costing £226,200;
• future accommodation costs of £2,777,138;
• future orthopaedic costs of £60,000;
• future education costs of £45,000;
• future deputyship costs of £452,920;
• future psychological therapy costs of £120,484, and;
• future loss of earnings of £193,116.