As a result of obstetric and neonatal negligence JKL suffered quadriplegic cerebral palsy and auditory sensory neuropathy caused by bilirubin encephalopathy. Bilirubin is a toxic substance to the brain and can build up in the blood and damage the brain if not treated. JKL is dependent on others with respect to all daily living activities. She is gastrostomy fed with limited independent mobility.
JKL was born at the Princess Royal University Hospital (PRUH) at approximately 34 weeks gestation in 2009 in relatively good condition, despite her prematurity. Her mother's pregnancy was complicated by her blood group being Rhesus negative which was different to the baby. The blood incompatibility meant that JKL's mother needed to be given anti-D treatment during pregnancy and to be carefully monitored. The Rhesus incompatibility meant that the baby could potentially develop a condition known as Rhesus haemolytic disease which can be life threatening. Her mother's pregnancy was also complicated by obstetric cholestasis, a condition which can cause itching and problems in the mother's liver.
As a result of both obstetric complications, the obstetrician at PRUH made a decision to urgently deliver JKL at 34 weeks. We alleged there was no need to do so. It was JKL's mother's case that had she received the correct obstetric care she would have delivered her baby in an alternative hospital with special neonatal facilities capable of caring for JKL and that this would have avoided her injuries. JKL's mother had wanted to deliver her baby elsewhere for some time. The obstetrician at PRUH also allowed the Claimant to be delivered before the correct dose of steroids had been given and allowed to take effect so as to protect JKL's lungs. The Defendant admitted this was negligent.
We also argued that the care then provided to JKL in the Special Care Baby Unit at PRUH was incompetent in that the neonatal doctors failed to correctly monitor the bilirubin levels and allowed the bilirubin levels to reach a level which was unacceptable in a premature and unwell baby with Rhesus disease. Our expert said there was a negligent delay in the Claimant receiving a total blood exchange transfusion. Blood exchange would have prevented the build-up of bilirubin to toxic levels in the body which passed into the brain. The Defendant's case was that it was not mandatory to do an exchange until a much later point in time when the bilirubin levels were well over 300 and that there was no national consensus on the required treatment.
No admissions were made. The case listed for a trial on liability in June 2016. The case was hard fought very close to trial. A settlement meeting took place just over a month before trial. The Defendant initially offered to settle the claim on the basis of 50% liability which was rejected. The Defendant increased their offer to 80% on liability but we still felt that this was an under assessment of the strength of the Claimant's case. Settlement on the issue of liability was agreed at 85% and this was approved by a Judge at the High Court on 7 June 2016. An initial interim payment was secured in the settlement order in the sum of £250,000.
JKL's parents went on to say:
"Over the last 6 years we could not have asked for any more support and guidance from Sam and her team. Living with a severely disabled child is stressful enough at the best of times without taking on an additional worries. Sam took control of our case from day 1 and guided us clearly through each and every step. She understood the pressures we were under as a family and never seemed to add to these. Her attention to detail and knowledge of our case was first rate and she was always available to talk us through what was needed from us and what was happening."
Image credit: David Martin / Princess Royal University Hospital: main entrance