Obstetric Negligence – A Brief Layman’s Guide

Introduction

Clinical negligence claims arising out of obstetric treatment are highly specialised and need to be dealt with in a compassionate manner. The majority of these claims are bought on behalf of a baby who has been injured during the pregnancy, during birth or shortly thereafter (during the neonatal period).

The remainder of these claims are bought either on behalf of the mother or on behalf of the baby’s or mother’s estate (in the case of a fatal accident). In the case of a death caused by negligent treatment, an inquest may be required.

The medical and legal issues involved in obstetric claims are similar to those found in gynaecological negligence claims and a single case may involve both types of treatment. Expert evidence is obtained from a Consultant in Obstetrics and Gynaecological Medicine.
 
Obstetric negligence may result in a catastrophic injury. In such cases, you will also need to be properly advised on issues particular to that sort of injury including the appointment of a Receiver.

Many other claims arising out of obstetric treatment cause injuries which have less severe effects (for example, where a mother is given an inadequate anaesthetic block). The effects on the person concerned are no less important and deserve to be properly investigated.

What are the signs?

Whilst obstetric negligence can occur in a variety of unexpected ways, in our experience, certain mistakes crop up more frequently than others. The examples set out below are often clear with the benefit of hindsight but can be open to differing interpretations by your treating doctor at the time treatment is given. This is not necessarily wrong and can lead to difficulties arising in pursuing a claim for compensation if clear medical records are not kept at the time. Whilst you should be cautious, you can help by telling the doctor or nurse about any concerns that you may have about:

• A seeming lack of experienced supervision (for example, by junior staff in the interpretation of vaginal examinations and C.T.G. traces).
• Possible errors in the antenatal clinic.
• Poor preparation for the labour itself.
• Poor systems of control in the labour ward.
• Substandard management.
• Unhelpful attitudes exhibited by obstetric and midwifery staff (especially after an accident has occurred).
• Delay in recognising foetal distress and dysfunctional labour; in intervening swiftly enough to prevent damage occurring; and in implementing the correct procedures to avoid further problems.
• Poor communication from the treating medical team. This is the main complaint we receive from clients and, in many cases, good and effective communication by the treating doctors will allow matters to be satisfactorily dealt with in the hospital. A common example of this is simply that no one in the hospital has told the patient why the accident occurred. Many of our clients are pleased to receive an apology and a frank explanation after winning their case and there is often no reason why this could not be given at the time of the accident they have complained of.

Whilst a substantial proportion of obstetric negligence claims involve a whole host of errors, some do not. You should always consider asking for an explanation from the medical team or the hospital’s management if you have concerns about the treatment you have received. We do not advise you to attempt to tell the treating health professionals what to do. However, prevention is better than cure. Keeping a note of your questions and the responses you receive can often help later (particularly in emergency situations).

Consequences

There are a variety of consequences which can arise. These can result in injuries to the baby; to the mother; or to both. We have successfully represented many clients with such injuries.

Injuries to babies include:

• Cerebral palsy.
• Brachial plexus injury (e.g. Erb’s palsy and Klumpke’s paralysis).
• The ‘wrongful birth’ of a handicapped child (as a result of a failure to detect the abnormality causing the defect).
• Stillbirth or early neonatal death.
• Skull fractures and fractured bones.
• The failure to prevent Rhesus sensitisation.
• The wrongful termination of an otherwise viable pregnancy.
  

Injuries to mothers include:

• Anaesthetic awareness (including a failure to adequately relieve pain);
• The loss of childbearing capacity (e.g. through developing an infection);
• Incontinence (either faecal or urinary);
• The development of fistulae. Common types of fistula are recto-vaginal tears, ureteric tears and vesico-vaginal tears.
• A rupture of the uterus.
• The failure to remove abdominal or vaginal swabs (possibly leading to infection).
• Scarring (typically to the vagina or perineum) leading to difficult sexual intercourse.
• Brain damage or death (caused by eclampsia, anaesthesia or haemorrhage).
   

Conclusion

As with any medical condition, it is important not to jump to the wrong conclusion. Doctors are highly trained and cases of medical negligence are rare – we do not have a ‘compensation culture’ in the UK. Sometimes things do go wrong, however, and you should be prepared for this. In those circumstances, it may be appropriate to seek compensation after trying the official NHS Complaints Procedure. Legal Aid may be available to help you with the legal costs involved in investigating and pursuing a claim for compensation.

If you require additional information then we shall be happy to assist.

For further information, please contact:

Geoff Simpson-Scott
E-mail: geoffrey.simpson-scott@colemans-ctts.co.uk
Direct dial: 0208 296 7951