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Written by Susan Brown

Boyes Turner’s cerebral palsy specialist solicitors have negotiated a liability settlement for a young man who suffered moderately severe, dyskinetic cerebral palsy arising from the mismanagement of his birth.

The profound hypoxic ischaemia (lack of oxygen) which caused our client’s permanent brain injury occurred in the last few minutes of his mother’s labour. Over a period of 20 minutes, the defendant NHS hospital staff failed to monitor the baby’s heart-rate properly. They incorrectly interpreted the heart-rate which was being picked up by the CTG monitor as a normal fetal heart-rate, without realising that the monitor was picking up the maternal heart instead of the baby’s. Having misinterpreted the CTG trace, they failed to recognise that the baby was in poor condition which led to delay in his delivery.  

Our client was permanently brain damaged and is physically (but not mentally) disabled. As his intellectual capacity is preserved, he approached us as a young adult and was able to instruct cerebral palsy specialist, Susan Brown, directly rather than through a Litigation Friend.

Investigation of the case was hampered by difficulties with evidence, as can often happen after a lengthy passage of time. Vital contemporaneous evidence was contained on the CTG (cardiotocograph) traces from our client’s mother’s labour. CTG traces taken from fetal heart-rate monitoring in labour provide us with a minute-by-minute account of what happened. They show the maternal contractions and the fetal heart-rate as the baby tries to cope with the stresses of labour in the time leading up to delivery. Abnormalities on the trace, such as reduced beat-to-beat variability, fetal heart-rate decelerations, elevated baseline (tachycardia) or slowing down (bradycardia) of the baby’s heart-rate all alert us to the fact that the fetus is suffering from lack of oxygen. On seeing these signs, the obstetric team should expedite the baby’s delivery by carrying out an urgent instrumental delivery (forceps) or caesarean section.

As specialists in birth trauma and cerebral palsy, Boyes Turner’s solicitors always call for and analyse our clients’ CTG traces. However, in this case, the medical notes were over 20 years old. They were also poorly completed, with untimed, incomplete and illegible CTG traces with vital evidence missing from the critical, last few minutes of labour.

Susan Brown and her team of medical experts worked together to reconstruct those vital few minutes, based on the limited information that she had about the rest of the labour and our client’s condition at birth. Without adequate proof of negligence by the obstetric and midwifery staff in those final minutes when the injury occurred, the case would not have succeeded.

The case settled on the basis of an 85% liability judgment for the claimant. Our client’s immediate needs will be met by an interim payment whilst Boyes Turner’s cerebral palsy team work with our experts to value the claim.