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Written by Susan Brown

Boyes Turner’s cerebral palsy specialists have secured an admission of liability for an eight-year-old girl with quadriplegic cerebral palsy. The child, who was healthy at birth, suffered a brain injury when hospital staff failed to recognise and treat her early symptoms of group B streptococcal infection. The delay in recognising her infection and treating it with intravenous antibiotics led to the development of group B streptococcal meningitis and permanent disability.

When the baby was eight weeks old, her mother took her to the GP because she was crying unusually loudly. She was unsettled and seemed to be in pain and was reluctant to feed. The GP noted diarrhoea and that the baby was otherwise well. The mother followed the GP’s advice, taking the baby back to the defendant hospital’s A&E department when she became increasingly concerned. In A&E the baby was examined by a doctor and blood samples were taken to check for clotting abnormalities and infections.

The baby was observed throughout the night. She was feeding and her vital signs (temperature, pulse, respiratory rate and oxygen saturation) were noted as normal. A blood sample taken after her admission to the ward at 1am revealed an abnormally high white blood count – a strong indication of significant bacterial infection. The blood test result should have been communicated urgently to the paediatric team and intravenous antibiotics given to the baby within an hour of the result but the paediatricians remained unaware of the result throughout the following day.

Untreated, the baby’s condition deteriorated over the next few hours. Her temperature and heart-rate rose, her oxygen saturation levels dropped and she refused to feed. For three hours the nurses repeatedly requested that a doctor should come and check the baby. When the consultant paediatrician finally arrived, in the absence of the blood test results he failed to consider the concerns expressed by the nurses or that the baby’s high temperature might be an indication of infection. If he had done so he would have ordered a septic screen which would have indicated infection and prompted treatment with intravenous antibiotics.

By midday the baby was becoming less responsive and there were signs of mild brain swelling. A CT scan was taken but interpreted as normal. By the afternoon she was still suffering from oxygen desaturations and was irritable, making jerking movements and whining sounds. She was fed by naso-gastric tube. Her condition continued to deteriorate until a lumbar puncture and septic screen was ordered by the paediatric registrar at 11pm. Intravenous antibiotics were finally started for late onset neonatal sepsis an hour and 40 minutes later. Analysis of the cerebro-spinal fluid (CSF) from the lumbar puncture confirmed meningitis, initially thought to be streptococcus pneumoniae but later confirmed to be group B streptococcal meningitis.

The baby was treated for seizures and sent to ITU. An MRI scan confirmed that she had suffered a severe brain injury. She now has quadriplegic cerebral palsy, post-meningitis hydrocephalus requiring a ventricular peritoneal shunt, hearing and visual impairment, speech and feeding difficulties, and epilepsy.

Boyes Turner’s clinical negligence lawyers acted for the claimant with the benefit of Legal Aid, as her severe neurological injury was caused by negligence within the first eight weeks of her life. Our specialist solicitors investigated the claim and secured an admission of liability from the defendant NHS Hospital. Judgment will now be entered and an interim payment obtained to help meet the child’s immediate needs whilst we work with experts to value the claim.