YI suffered hypoxic ischaemic encephalopathy as a result of asphyxia at birth. The birth asphyxia was caused by the negligent management of labour up to and including the birth. In particular it was alleged that:
- the pregnancy was midwifery led rather than consultant led
- there was a failure on the part of the midwife to ensure that there was effective and continuous CTG monitoring in place
- the midwife should have called for obstetric assistance at an earlier stage and that she failed to interpret the CTG trace as pathological mandating the need for earlier obstetric intervention. Appropriate obstetric intervention would have led to an earlier delivery and YI would have been born without injury
Sadly YI died from complications of cerebral palsy in September 2010 and the claim proceeded as a Law Reform Act claim with the father acting as Administrator for the estate of YI.
The case was strenuously fought up until a few days before trial. The Defendants did not accept that an earlier delivery would have altered the outcome. They took the view that the severe acute asphyxia was caused by the tightening of the cord around YI's neck and this would have happened at whatever time YI was delivered. In addition they did not acknowledge that there was a pathological trace but rather that the CTG was of a normal advance in labour and therefore no need for urgent attendance of an Obstetrician. They say that this would have been highly interventionist and would not have been adopted by the majority of Obstetricians.
The expert evidence between the parties Midwives remained at odds. The Defendant's Midwife would not agree that it was mandatory to call for obstetric assistance 43 minutes prior to the actual delivery. The Obstetricians differed over the issue as to when it was mandatory to make a decision to deliver. Our expert Obstetrician was of the view that it was mandatory to make a decision to deliver by 17:30 and that delivery could have been achieved within 15 minutes of the decision giving a birth well before 18:23 thereby avoiding the injury from the damaging bradycardia.
Both parties Paediatricians agreed that delivery anytime before 18:23 would have avoided injury.
Following the experts' meetings, the crux of the case became clear. Essentially the case was going to turn on a finding of fact as to when the ventouse would have been applied and delivery achieved in order to avoid the damaging bradycardia. Depending on whose view was accepted either the period of damaging bradycardia would have been avoided or it would not.
In the end the claim was compromised on the basis that we had a 60% chance of success on the finding of fact in our favour. We valued the case on full liability at £260,000 and settled for the sum of £180,000.