It was Eleanor’s first pregnancy and her ante-natal treatment passed uneventfully. Eleanor started to have contractions in the evening and arrived at the Birth Centre at the Whittington Hospital at midnight, at which point she was 2 centimeters dilated.
Having initially been seen by a midwife on admission, Eleanor was not seen again until 03:00 at which time the midwife performed another vaginal examination. Eleanor was told she was fully dilated at 10 cm dilation and was assured she would shortly give birth. Eleanor was moved to the birthing pool and given gas and air and by 03:20 was actively pushing. At 06.00 Eleanor had not delivered and was taken to the Delivery Suite in the Whittington. During the time since 03.00 Eleanor was not advised to empty her bladder and no further vaginal examinations took place.
In the Delivery Suite Eleanor was seen by an Obstetrician who realised that Eleanor's bladder was full, and it was promptly emptied. She also performed a vaginal examination at 06.30 and discovered that Eleanor membranes were still intact, and promptly broke them. Shortly after the membranes being broken, Eleanor was asked to start pushing again and the baby was born at 07:07.
Whilst Eleanor’s baby was uninjured, Eleanor herself suffered serious injuries in the form of damage to her pudendal nerve, perineal body, pelvic floor, urinary stress incontinence and a Grade 2 bladder prolapse (cystocele). Such injuries had a significant impact on Eleanor’s day to day life, and she was unable to look after her baby for a significant period of time and unable to return to work as promptly as she had planned. To date Eleanor still suffers as a result of her prolapse, in particular, and she is unable to take part in many of the activities that she used to enjoy.
On behalf of Eleanor it was alleged that the treatment she received was negligent as the NICE 2007 Guidance makes it clear that a vaginal examination should occur within one hour of the commencement of the active second stage of labour (which was alleged to have occurred no later than 3.20am). Had a vaginal examination been performed within the time frame required by the NICE Guidance, the membranes would have been ruptured and the bladder emptied, over 90 minutes earlier than was eventually the case. Delivery of Eleanor’s baby would have taken place by 05:00 as opposed to at 07:07, over two hours earlier.
It was further alleged that such time savings would have avoided or at least significantly reduced the birth injuries to the mother which Eleanor went on to suffer. Such allegations were supported by medical research which demonstrates a link between time spent in the second stage of labour and the severity of injury to the pelvic floor, with significant damage occurring after 2 hours.
Liability was vigorously denied by the Defendants throughout the case. The Defendants alleged that the active second stage had not in fact commenced prior to 05:15 and therefore the timeframe in which the vaginal examination took place was reasonable.
Medical reports were received from an expert midwife and urogynaecologist, who remained supportive of the case. Following their expert meetings with the Defendant experts, there remained significant disagreement between the parties, although the defendant’s urogynaecologist acknowledged the link between time spent in the second stage of labour and damage to the pelvic floor.
The case appeared destined for trial, which was due to commence on 03 February 2015. In spite of this, and the Defendants maintaining that they had a defence, the Defendants made an offer of significant compensation, which Eleanor accepted. The settlement will compensate Eleanor for the pain and suffering she has endured, and continues to endure, as well as the expenses and losses she has incurred, most notably her loss of earnings.
After the case Eleanor commented:
"I always knew that this was not a particularly serious or high-value claim compared to some of the other claims that Mark handled. In spite of this, I felt that my case was handled with the very highest professionalism; the time spent preparing the case, the level of detail, the attention received from Mark, the fast response times etc were all more than I expected.
"I was actually astounded and humbled by the amount of work put into the claim. I always felt valued as a client and the impression I have come away with is one of having received exceptional legal service. Mark handled the subject very sensitively while still tackling it head on, which was not easy to do given the nature of my injuries.
"Mark was able to focus clearly no the legal side of the claim while never losing sight of the personal element. When I first came to see him I could not see past the personal impact. Mark was able to narrow down those elements and focus on the damages we were seeking, including loss of earnings, which I had not even considered. I have also learnt a lot about my injury and future prognosis from the expert witnesses which I might not have otherwise which has also helped me to come to terms with it."
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