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Fieldfisher hosts Meningitis Now event spotlighting high-risk students and young adults

16/03/2020
This February, at Fieldfisher's London office, Meningitis Now was joined by Public Health England and the NHS, Life for a Cure and Meningitis Research Foundation, plus corporates Pfizer, GSK and Boots to discuss raising awareness of meningitis among high-risk demographic - students and young adults.

Meningitis Now (MN) is one of the charities supported by the Personal Injury and Medical Negligence team.

Students, teenagers and young adults are the second most at-risk group in the UK for contracting viral meningitis due to the high level of level meningococcal bacteria they carry (1 in 4 people) relative to the general population (1 in 10). Given this high carriage rate, the risk of infection spread is proportionately higher, particularly because of the social habits of this age group, exacerbated when they congregate in large numbers, for example at university.

Babies and children under five are the most vulnerable age group.

The organisations represented at the event are all involved in raising awareness of the MenACWY risk and, since 2015, promoting vaccine uptake among young people. MN has deployed a successful strategy of targeting the influencers, parents and universities and has also actively targeted students directly.

They will share insight from various promotional activities and discuss ways to work together in the future to achieve the common goal of protecting students and young adults from meningitis.

The government introduced the MenACWY vaccine programme in 2015, comprising two components: a school programme targeting 14- 15-year-olds and a catch-up programme for those aged 18-25 focused on those going to university.

The former delivers an uptake rate of 80-85%, the latter around 40%. Given these uptake rates, MN estimates that approximately 1.2 million young people have missed the vaccine. Most freshers starting university during the past couple of years have been vaccinated. The risk for those aged 18-25 who formed part of the initial catch programme (now ended) has reduced as they age.

Large retailers such as Boots can have a strong impact in spreading information. MN has partnered with Boots for three years, during which time the chemist has carried awareness material in its stores and this year invested in the production and distribution of Meningitis Now branded signs and symptoms cards in all its 2,500 stores.

MN also helped Boots create a voluntary meningitis CPD (continuing professional development) programme for its pharmacists. Boots donates £1 for every child receiving the MenB vaccine. GSK, Pfizer, PHE and MRF have also carried out awareness activities.

Fieldfisher's involvement with meningitis generally takes the form of running cases where diagnosis of bacterial meningitis has been missed by practitioners, resulting in catastrophic and life-long brain injury. These cases tend to involved new-born babies.

The firm is committed to raising awareness of the disease to prevent avoidable tragedy and to hold hospital trusts to account where clear guidelines in diagnosing and treating the disease are not followed.

Senior Associate Caron Heyes settled a case several years' ago on behalf of a young girl left severely disabled because hospital staff at Darent Valley Hospital in Dartford failed to diagnose her condition shortly after birth. She was delivered by emergency caesarean when CTG monitoring indicated decelerations in her heart rate. Her mother had previously been induced and her waters broke 15 hours before the baby was eventually delivered healthy and well. Mother and baby were discharged home three days later with no antibiotics given to protect against possible infection considering the high-risk length of time from waters breaking to delivery.

Four days later, the mother rang the hospital concerned that her baby was crying incessantly with a weak cry and was not feeding – clear signs of meningitis. The mother was told to give the baby boiled water and wait for the midwife. She rang back a few hours later, very concerned the baby was getting worse. When the midwife still hadn't arrived by mid-morning, she telephone for a third time but was still told to wait for the midwife.

When the midwife eventually arrived, she told the mother to take the baby to hospital immediately. The midwife noted that the baby had not fed since 11pm the previous night, was pale and appeared jaundiced and had a temperature. Unfortunately, there was a further delay in treating her despite obvious and worsening symptoms of meningitis that resulted in brain damage and cerebral palsy.

The case revolved around failure to deliver the baby immediately decelerations were visible which caused her to acquire Streptococcus group B infection which could have been avoided. During the 15 hours after her membranes ruptured, the mother acquired infection and should have been given broad spectrum antibiotics before discharge. With competent care, the mother would have been advised to bring the baby to hospital when she telephoned three times and once at hospital, the baby should have been given IV antibiotics while her condition was investigated.

Caron said that several years after this case, she is currently running a similar claim involving Buckinghamshire Healthcare NHS Trust and a baby born in 2016 at Stoke Mandeville Hospital.

"In a similar situation, a mother's waters partially broke and she had a show but, despite clear risks, she was not given antibiotics to protect against infection. Six weeks later, she went to hospital with fully ruptured membranes and had a temperature and sore throat. She showed markers for infections and, at this point she was given antibiotics, but her waters were open for more than 28 hours before the baby was finally delivered, hours, 10 hours longer than stated in guidelines.

"The delay in delivering the baby boy of a mother clearly showing signs of serious infection, the baby's prematurity and low birth rate meant he was at high risk of developing meningitis – which he sadly did. He became seriously ill in the days after his birth and his parents eventually rushed him to A&E. Despite their calling ahead, no-one was waiting for them in A&E and the first consultant to see them diagnosed bronchitis. It was another day before the baby was taken to the John Radcliffe hospital and bacterial meningitis was diagnosed. By this time, he was experiencing seizures and was on a ventilator. His brain also swelled, requiring a stunt.

"He has since been diagnosed with right side hemiplegia and has little to no function on his entire right side, which severely impedes his mobility. In both these cases, had staff reacted to clear indications of bacterial meningitis, these terrible injuries caused to the babies would have been avoided."

Senior Associate Arti Shah is currently in the early stages of a case involving Sunderland Royal Hospital and a baby born in 2011. The baby girl has been diagnosed with bilateral dystonic cerebral palsy secondary to acquired brain injury caused by Group B Streptococcal Meningitis. She is severely disabled.

"The case involves the treatment given to the baby by midwives shortly after her birth on multiple occasions at the family's home. Despite presenting with obvious, worsening symptoms - hardly feeding, constant mewing, clear irritability, and increasing lethargy - the visiting midwives failed to properly examine her or consider that she was very ill.

"Eventually her parents rushed her to A&E where she was diagnosed with meningitis with septicaemia.  Her parents were told she only had a 50 per cent chance of surviving.

"As she has got older, her development has been a serious concern to her parents. She has delayed speech and had problems walking and was eventually diagnosed with brain injury attributed to the meningitis."

You can also read Mark Bowman's case involving the death of an eight-month-old baby at UCL hospital after symptoms of meningitis were ignored and he was discharged home with a diagnosis of tonsillitis. By the time meningococcal septicaemia was recognised, it was too later and he tragically died.

Partner Jane Weakley, who coordinated the Meningitis Now event with Arti, summed up the vital importance of hospital staff recognising and reacting quickly to meningitis:

"The cases we take on regarding meningitis have one thing in common – medical practitioners fail to recognise the risk of meningitis where there is a delay in delivering a baby and the mother becomes infected, passing it on to the baby.

"We’re very pleased to support Meningitis Now and their focus on teenagers and young adults. This current campaign runs hand in hand with the ongoing drive to make people aware of the risk of meningitis to newborns."

CEO of Meningitis Now, Tom Nutt, said after the event:

"I wanted to say an enormous ‘thank you’ to Fieldfisher for hosting our meningitis awareness meeting yesterday. The room far exceeded my expectations and the Fieldfisher team made us all feel so welcome. Thank you.

"The meeting went well. There was a good degree of consensus in the room that working together – as charities, industry and statutory bodies – makes sense… we have some clear next steps planned."

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