Erbs palsy negligence news


60 seconds with a medical negligence lawyer

Over the following year we will be sharing a series of question and answer articles about our day-to-day lives in the medical negligence team. This week, it’s Rachel Makore's turn, a solicitor in the team.

Rachel qualified in April 2016 and joined the medical negligence team at Boyes Turner in November 2016. Rachel’s clients have suffered obstetric and gynaecological injuries, Erb’s palsy, pressure sores, disability resulting from delayed diagnosis and treatment of cancer. She acts for the bereaved spouses and children of patients who have died as a result of negligent medical care.

What made you choose a career in medical negligence?

The driving force behind my decision to study law and specialise in claimant medical negligence work was my desire to help David, rather than Goliath. I have a keen interest in medicine and enjoy using my skills and expertise to help our clients get back on their feet or live a more fulfilling and stress free life following a medical accident. I find it incredibly satisfying to be in a position which allows me to guide clients through the legal process which I know many will find daunting and overwhelming.

Which personal skills does it take to succeed at this type of work? 

It is really important for a medical negligence solicitor to have empathy, be able to show understanding and have the ability to remain calm in stressful situations. As the majority of the medical accidents we deal with cause life changing injuries which devastating consequences to our clients and their families, I ensure that I always bear that in mind and treat them sensitively and patiently.

What is the most rewarding part of your work? 

I recently met with a young client’s Mum on a case where the hospital had admitted liability. She told me how relieved she was to know that, as a result of the compensation, her son, who has cerebral palsy, would be looked after and taken care of for the rest of his life when her and her husband were no longer able to. She was excited to be able to move into a more appropriately sized and adapted home which could cater for her son’s needs. I could see how much that meant to her and to know that the work I had been a part of had helped was incredibly rewarding and made me realise even more how important the work we do is for people.

8 yr old awarded £525,000 compensation following erb's palsy injury sustained through birth negligence

On 11 March Helen*’s mother was admitted to the defendant hospital, to be induced.  Her progress was slow, and so syntocinon was given to speed up the labour.  By 4pm Helen’s mother was fully dilated and she started active pushing at 6.15 pm. 

At 7.25 pm the obstetric registrar reviewed the situation and decided to attempt to deliver Helen using ventouse.  The ventouse was first applied at 7.30 pm, but Helen wasn’t delivered until 8.03 pm.  Suprapublic pressure was not applied, and although shoulder dystocia was noted, the McRobert’s manoeuvre was not performed.

Helen was reviewed the day following her delivery, when it was noted that he had a limp right arm.  She was referred for physiotherapy.  She subsequently developed Erb’s Palsy, and was found to have damage to her spinal cord.

Helen underwent two operations at 6 month’s of age, which improved her elbow flexion, hand function and relocated her right shoulder. However, she still has weakness during elbow flexion and was unable to reach her face with her right hand.  As a result she will experience difficulties with most aspects of daily living for the rest of her life.  She is also at risk of depression and anxiety, and would be handicapped on the labour market.

Helen’s parents brought a claim against the hospital, who admitted that the care provided during her delivery was negligent.

A settlement of £525k was negotiated for Helen.

Vanessa Wand, an experienced birth injury negligence claims lawyer at Boyes Turner, commented on the outcome:

“Unfortunately we have experience of dealing with cases very similar to Helen’s, where injury caused during delivery causes Erb’s Palsy and lifelong issues”.

England sees massive baby boom in 2012

It has been reported in the Telegraph recently that England faced the biggest baby boom in 40 years as 20,000 more children are expected to have been born this year than last year, which put significant strain of midwifery services as warned by The Royal College of Midwives (RCM).

The Telegraph quoted the Chief Executive of the Royal College of Midwives saying that, “the demand this is placing on the NHS is enormous.” She was also quoted saying that NHS maternity services, especially in England, are on a knife-edge: “We have carried shortages for years, but with the number of births going up and up and up. I really believe we are at the limit of what maternity services can safely deliver.”

A recent study conducted by the RCM noted that more than 9 in 10 midwives did not think they could give women all the care they required.

Sita Vaghela, specialist birth negligence solicitor with Reading law firm Boyes Turner commented:

“It is worrying that in light of the baby boom and the shortage of midwives, it is likely that unacceptable standards of care and possibly negligent treatment may be provided to pregnant women across England, with devastating potential consequences of birth injuries and stillbirths.”

£170,000 awarded for Erb's Palsy claim

David was born after a complicated delivery. His shoulder became stuck against his mother’s pubic bone during the delivery (shoulder dystocia) and as a result, he was born with a brachial plexus injury.

David’s mother, Rita, alleged that the care David received during the delivery was inappropriate. The medical records were obtained, and showed that during the delivery, fundal pressure (pressing on Rita’s abdomen) was used inappropriately. If excessive pressure is applied on the mother’s abdomen, this can cause a risk of damage to the baby, as you are forcing the baby up against the pubic bone even more.

It was also alleged that excessive force was applied to David’s head during the delivery, meaning that the hospital staff were pulling and twisting his head in an effort to free the shoulder.

At the age of two, David suffered with a dislocation of his shoulder. There was a loss of blood supply to the bone, and David suffered necrosis (wasting) of the shoulder joint.

David was unable to raise his arm, and so everyday tasks like getting dressed and tying up shoelaces, became problematic for him. David still gets intermittent pain in his shoulder, for which he has to regularly take painkillers.

It was alleged that as a result of his injury, David was likely to suffer with reduced options in terms of his choice of career, work, education, sports and hobbies.

The claim was settled in the sum of £170,000 without the matter proceeding to trial.

Julie Marsh, specialist birth injury claim solicitor at Boyes Turner, commented on the case:

“Whilst it is clear that David suffered a significant injury as a result of the failings in his care at the time of delivery, and these did have a major impact on his life, he still regained some use and function in his arm and hand. It can be difficult to establish that negligent care caused an injury like this, but where the medical records indicate an extreme response to the problem, rather than careful management of the problem, it can be straightforward to show that reasonable care would not have resulted in an injury at all.”

NHSLA to set aside over £200 million for injuries to newborn babies

Official figures have revealed that the NHS Litigation Authority (NHSLA) will set aside over £200 million to address the claims that have been presented on behalf of babies who have sustained an injury as a result a failure of staff to recognise low blood sugar levels. These children have sustained brain damage, and in two cases, the children died, it has been reported by the Guardian newspaper.

The NHS Litigation Authority (NHSLA) figures were obtained by the Guardian and show that in England in the past ten years, it has received 79 claims for damages of harm to babies relating to undetected or untreated hypoglycaemia.

Damages of between £300,000, and more than £7m in 19 cases has already been paid. The Litigation Authority is currently defending 41 other similar actions.

Neonatal hypoglycaemia (where the blood sugar level is very low) is a rare complication of childbirth affecting between one and three of every 1,000 babies. If this condition is left untreated it can have devastating consequences.

In March 2011, the family of Louis Peers received a settlement worth more than £7m after they claimed that midwives at Birmingham Heartlands hospital failed to intervene for the first three days of Louis’ life, even though he was not feeding, a classic sign that a more serious problem was beginning.

The £200 million set aside is the NHSLA’s estimate of the total cost of settling the 60 claims, including damages and legal fees. Of that, £69.3m has been spent on the 19 cases which have been concluded and the other £166.1m is the potential cost of settling the other 41 cases. The figure is likely to rise once annual sums to cover damaged babies’ lifelong care needs have been made.

Better monitoring of babies blood sugar level is needed

These cases underline the fact that midwives and doctors need to be better in monitoring babies’ feeding and blood sugar level just after birth.

Peter Walsh, chief executive of the patient safety group Action Against Medical Accidents, has said:

“Whilst these cases are relatively small in number, the fact the effects are so catastrophic and they are so preventable should make them a ‘never’ event in the NHS. It’s absolutely essential the NHS stops these kinds of accidents happening.

The NHS should ensure the lessons from these cases are learned and midwives are properly trained and there are enough midwives and consultants on duty to ensure babies are monitored … The human cost of these cases is incalculable”.

While midwives can make mistakes, the NHS’ shortage of midwives is “the biggest factor in these recurring problems of undiagnosed hypoglycaemia”, he added.

This is also further evidence that maternity staff need more support and training to help them spot the warning signs that a baby is becoming hypoglycaemic.

Professor Cathy Warwick, general secretary of the Royal College of Midwives, speaking to the Guardian said:

“Hypoglycaemia is something that in the majority of cases we should be detecting and preventing. New mothers should be educated so they can spot the signs of it developing, and be able to see a midwife any time they need to, when they are still in hospital or back at home, to ensure the condition is spotted and treated quickly.

It’s incredibly important that women are getting enough care in the postnatal period to ensure they have the information they need and that babies are getting screened and seeing midwives enough to pick up these problems, and that women are getting enough support with breastfeeding”.

Julie Marsh, expert neonatal negligence claim lawyer at Boyes Turner, commented on the news:

“It is a sad fact that a shortage of midwives and a lack of training and awareness to this issue can have devastating consequences for families who should be celebrating the happiest time in their lives. Where there are failures in care, these should be fully investigated to ensure that lessons are learned by all involved to prevent mistakes happening again”.

Brachial plexus injury - £55,000 compensation claim

During labour (in hospital) the obstetric registrar monitoring the birth process noticed a clear loss of fetal movement of the unborn child. As the labour developed, an epidural was administered and a syntocinon infusion commenced. Later an examination noted that the unborn child was in breech position.

As labour progressed, the attending midwife became concerned that the unborn child wasn’t moving and called for obstetric assistance. After an assisted birth, the child’s head was delivered but shoulder dystocia (where the shoulder becomes stuck against the pubic bone) prevented delivery of the torso.

Following delivery, the baby was diagnosed as suffering from right-sided Erb’s palsy as a result of the brachial plexus injury sustained during delivery.

The claimant alleged negligence against the hospital which led to the injuries sustained during childbirth. Liability was admitted.

The child made a good recovery but will suffer from restricted movement of his right arm for the duration of his life.

The case settled out of Court for £40k, including £7.1k for past care and miscellaneous expenses and £7.9k for future physiotherapy costs.

Julie Marsh, specialist Erb’s Palsy claim solicitor at Boyes Turner, commented:

“This type of injury can be very severe for the baby and, although not in this case, can result in a number of surgical procedures after birth, where a repair to the damaged nerve is attempted, sadly often with a poor outcome. Midwives and doctors are negligent if they fail to use alternative positions with the mother to ease the delivery and, if they apply excessive force to deliver the baby, causing an avoidable injury to the baby. This type of compensation claims can be very complex, as an assessment has to be made of the impact any long lasting disability will have on the individual’s career prospects, the care they will need for the rest of their life, and an ongoing therapies.”

Erb's palsy claim - £45,000 medical negligence compensation recovered

An eight-year-old girl has received £450k for injuries to her left brachial plexus sustained during her delivery in January 2001. She developed erb’s palsy and suffered a permanent loss of a significant range of movement in her shoulder, arm and hand.

On January 24 2001 she suffered shoulder dystocia (where the infant’s shoulder cannot pass the pubic bone) during her delivery at a hospital of the defendant trust. Hospital staff failed to place the mother into the McRoberts position to release the obstructed shoulder and used traction on the baby’s head, which caused damage to the nerves that run from the spine into the arm.

She sustained injury and brought an action against the hospital alleging that it was negligent in that the failure to adopt the McRoberts position constituted sub-standard practice and that had the McRoberts position been adopted she would have been delivered intact. The hospital admitted liability.

As a result of the negligence, she suffered from a fractured right humerus (upper arm bone), hypoxic ischaemic encephalopathy, right-sided subarachnoid haemorrhage with cerebral oedema, paralysis of the diaphragm and a total left-sided brachial plexus injury. In respect of the brachial plexus injury, she sustained nerve root avulsion and rupture of the spinal nerves; all nerve roots were affected. After treatment, her general condition improved but the brachial plexus injury persisted. When she was four months old she underwent nerve graft surgery, and when she was four years old she underwent tendon transfer surgery to the left wrist and hand.

She developed erb’s palsy and has severely impaired function in her left shoulder, elbow, forearm, wrist, hand and fingers. Those parts are smaller and weaker than on her right and, in effect, are merely a prop by which light objects can be steadied. She is unable to place her hand to her mouth or head and she has very little grip or dexterity in her left hand and fingers. The nerve graft surgery did not improve function. She is restricted in her daily living activities and will be unable to find employment requiring physical strength, manual dexterity or bi-manual tasks.

Sadly, her injuries are permanent.

The matter settled out of court for a total sum of £450k.

Erb's palsy claim - £280,000 compensation for 10 yr old boy

A 10 year old boy has been awarded £280k in compensation for injuries to his left brachial plexus sustained during his delivery in May 1999. The boy developed Erb’s palsy and suffered permanent impairment of function in his shoulder, arm and elbow.

On 15 May 1999, the boy suffered shoulder dystocia during his delivery at the defendant hospital. The boy brought a medical negligence claim against the hospital, alleging that it had been negligent in (1) failing to perform appropriate manoeuvres to release the shoulder (2) failing to predict that there was a high risk of shoulder dystocia, given the mother’s high BMI and the boy’s likely birth weight. The hospital denied liability.

When the boy was two years old, he underwent release and relocation surgery and a humeral osteotomy. When he was four years old he underwent a further procedure to remove the metalwork.

The boy sustained damage to the nerves supplying his hand and fingers and severe damage to those supplying his shoulder and elbow. He suffered a medial rotation contracture in his shoulder and a dislocation. He also suffered impairment of the function of his left shoulder and elbow and his left arm was shorter than his right and is restricted in activities of daily living. His injuries are permanent and will affect his future employment.

Health Board apologises to family of Erbs Palsy boy

The parents of a Pembrokeshire boy, left with severe physical birth injuries as a result of errors made by health care professionals, have received a formal apology from Hywel Dda Health Board after a five-year battle for answers.

Four and a half-year-old Matthew Griffiths, from Haverfordwest, suffers from a severe left-sided Erbs Palsy, a condition that affects the nerves in the arm. This is most commonly caused as a result of damage to the brachial plexus during a traumatic delivery.

As a result of mistakes made both before and during Matthew’s birth, he has been left with a severely deformed upper limb and a life- long disability in his left arm.

Problems first arose when Matthew’s mum, Diane Griffiths, developed gestational diabetes during pregnancy. Her condition went undetected and as a result baby Matthew was 10lbs 1 oz at birth.

During Diane’s labour at Withybush Hospital, Haverfordwest, Matthew’s shoulder became impacted behind his mother’s pelvis after his head had been delivered.

Hywel Dda NHS Local Health Board has now accepted liability for Matthew’s injuries, paving the way for a future settlement which is expected to be a six figure sum.

A spokesman for the health board said: “Hywel Dda Health Board apologises for this incident and any distress caused to the family. Lessons have been learnt and action undertaken to address failings.”

Commenting on the case, top medical negligence solicitor Susan Brown said: 

“We act for a number of children who have suffered Erb’s palsy as a result of errors made at the time of their delivery. The severity of the injury can vary greatly with some having no useful function of the affected arm at all. Often the negligence is in allowing the mother to proceed to a normal delivery, but sometimes it is because staff at delivery fail to carry out standard procedures to deal with the emergency situation that arises when the baby becomes stuck in the birth canal.”

The service was personal, professional and considered. I was treated so kindly and in the end I knew that not only had I found the right organisation but also the right person.

Boyes Turner client

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