PI Brief Update

MC & JC Birmingham Women's NHS Foundation Trust [2016] EWHC 1334 (QB) - Natasha Jones, Bevan Brittan

13/07/16. This was a birth injury case which involved a claim bought by mother and son relating to an alleged delay in the management of JC's delivery on 13 February 2010. JC suffered brain damage as a result of an acute profound asphyxia and MC (mother) suffered a massive post partum haemorrhage resulting in an emergency hysterectomy. Quantum was agreed subject to liability in relation to MC's claim and the trial proceeded in respect of liability only.

MC was induced at term following an admission to the antenatal ward for raised blood pressure and concern of evolving pre-eclampsia. It was alleged that there was a failure to adequately consent the Claimant mother; there was inadequate monitoring of labour/fetal condition and a delay in transfer to the delivery suite. One of the key features of the Claimants' claim was that inadequate staffing and resources led to the injuries. It was a very busy shift on the evening in question, the ward having been short staffed in the afternoon. The Trust's own internal investigation report acknowledged the antenatal ward was extremely busy and not offering enhanced support to mothers in early labour.

On causation the Claimants sought to argue that earlier monitoring should have been in place and had that been the case it would have resulted in an earlier transfer to delivery suite and earlier delivery avoiding the PPH and brain damage. On medical causation, the experts disagreed on the underlying cause of the hypoxia and the PPH.

Giving Judgement f or the Defendant, the Judge found on breach that MC had been properl y consented. Further, there was no evidence that she would have elected to delay induction even if she had not been properly consented. He also found that the Defendant's care did not fall short of that reasonably expected in terms of assessment and monitoring. On causation he was unable to make a rational or logical choice between the stark alternatives offered by the parties on the cause of the hypoxia and PPH. As such, the Claimants had failed to discharge the burden of proof on both breach of duty and causation. He concluded by saying:

"It is perfectly understandable that those who suffer such tragically adverse outcomes will tend to assume that the doctors and midwives are to blame. This is particularly so where the unfamiliar context of an extremely busy antenatal ward is apt to give the impression of a lack of appropriate support. Nevertheless, the law is clear. Professionals, doctors and midwives alike, are to be found to be in breach of duty if the decisions they make fall outside the range of reasonable opinion and cause injury and loss. In this case, they did not and the claim must fail"

Natasha Jones
Bevan Brittan

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