This was Joanne's* first full term pregnancy at age 31. She was classified as low risk and had an uneventful antenatal period. Her estimated due date was 23 September 2019.
She attended routine appointments, all reported to be normal.
At 39 + 4 weeks, Joanne made three calls to the birth centre with a history of contractions becoming stronger each time. On the first occasion, she was advised to take paracetamol, have a hot bath and monitor the contractions. On the second call, she reported shorter and stronger contractions and bleeding. On the third call, she reported reduced fetal movements due to the pain. She was advised to attend hospital and have a sugary drink on the way.
Joanne arrived at Darent Valley Hospital at around 1pm. She reported experiencing contractions 3:10, and a history of vomiting. A urine test identified ketones. A vaginal examination was performed and she was admitted, put on a drip and given Pethidine.
At around 5pm, Lucy's heart rate was assessed using a Doppler and recorded as 140bpm and Joanne was recorded to be 2cm dilated.
At around 7pm, Joanne was transferred to the antenatal ward. Her BP was raised on three separate occasions, which was noted at the handover. A doctor was called but was unable to attend to review.
A CTG was commenced at around 8pm. Decelerations were noted and the CTG was categorised as "suspicious".
The CTG was reviewed at 8.30pm and again noted to be suspicious but no action was taken, and it was discontinued at around 8.40pm when Joanne was transferred to the labour ward. The handover did not document the raised BP.
The CTG was recommenced and noted to be bradycardic. Obstetric review and a further examination was requested. When the midwife examined Joanne, her waters broke and thick meconium was noted. Neither the CTG nor fetal heart rate was recorded.
A doctor attended to review and Joanne was noted to be fully dilated. The fetal heart rate was recorded as 70-80 beats per minute. She was transferred to theatre, by which point the fetal heart rate had dropped further.
A decision was made to deliver by Category 1 Caesarean section under general anaesthetic. Prior to commencing the C-section, the doctors attempted to listen to baby's heartbeat via Doppler, but none was detected.
Baby Lucy was delivered with no signs of life. She was noted to be pale, floppy, and no heart rate was detected. Thick meconium was noted. She underwent 41 minutes of resuscitation before a decision was made to stop.
A post mortem identified acute hypoxia as the cause of death.
The matter was referred to the Health and Safety Investigation Branch (HSIB) for investigation. This identified 17 separate failings and safety recommendations, including the following:
- The mother reported that her baby was not moving when she called for advice in early labour. On arrival in the unit the mother’s perceptions of the baby’s movements were not considered.
- The reduced movements were not discussed with an obstetrician and a CTG was not performed.
- The mother’s attendance with reduced movements was not managed in accordance with local or national guidance.
- There was an incomplete handover between the antenatal and labour ward teams, and this led to a loss of information sharing between staff.
- The CTG was not assessed or categorised
Arti wrote to the Trust inviting them to make an early admission of liability on the basis of the above. Breach of duty was admitted a few months later.
Arti proceeded to obtain expert and witness evidence, and prepared a schedule of loss, which she sent to the Defendant and invited an offer of settlement. The Defendant's first offer was 1/3 of the pleaded case, and was swiftly rejected.
Further negotiations resulted in settlement six months later and before proceedings had to be issued.
At the end of the case, Joanne said:
"Losing my daughter was the worst thing that ever happened to me. Losing a healthy baby during labour due to mistakes made by the medical staff fills you with a grief and despair that no one can prepare you for. Had these mistakes not been made, I would have left the hospital with a perfectly healthy baby girl. Fighting for the justice of my beautiful daughter has been incredibly hard.
Arti Shah fought my case diligently and with great compassion. She listened and really heard what we had to say. Seeking legal advice when you have no legal background was daunting and having to relive the moment over again made it even more challenging. Arti made us feel comfortable talking about everything that we had gone through - she was professional but warm and amiable. We can’t thank Arti enough for the care and tenacity she showed during this difficult process.”
* names changed
Contact usFor further information about stillbirth claims and medical negligence compensation claims, please call Arti Shah on 03304606739 or email firstname.lastname@example.org.
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