Nelsons recently represented a young mother in a clinical negligence claim relating to failures during the labour and delivery of her first child.
Our Client was expecting her first baby in 2017. In the early hours of 2nd November 2017, she began to experience intense pain in her back following each contraction and as the baby moved. Eventually, the pain became unbearable and our Client contacted the hospital and was advised to attend for an assessment.
The midwife felt our Client’s stomach and confirmed that the baby was lying in the back-to-back, or occiput posterior (OP) position.
Our Client was advised to return home and await more intense and regular contractions. She remained at home until around 2pm that day when she returned to the labour ward.
At around 3.45pm that afternoon, our Client had reached full dilation and was encouraged to commence pushing.
Our Client pushed for around one hour, but the baby was not moving down. The midwife, therefore, requested that the doctor attend.
A Junior Registrar came into the room to review our Client
It was decided that an instrumental forceps delivery was required. The midwife told the Junior Registrar that the baby was in the OP position, but the doctor carried out an examination and disagreed with this before then leaving the room.
The midwife left the room to obtain the necessary equipment for a forceps delivery.
The Junior Registrar returned to the room with a Senior House Officer. Our Client was advised that the Senior House Officer would carry out the forceps delivery, under the supervision of the Junior Registrar.
The Senior House Officer then attempted to apply the forceps to the baby’s head but failed.
The Junior Registrar took over and was able to apply and lock the forceps at 5.05pm. The Senior House Officer then took over again.
The midwife advised our Client that a contraction was coming and instructed her to push. With one push and one forceful pull from the Senior House Officer, the baby’s head was delivered at 5.06pm with no guidance from either doctor, no episiotomy and no support to the perineum. The head was born in the OP position.
The baby was fully delivered one minute later at 5.07pm.
It was immediately evident that our Client had suffered considerable perineal trauma.
It was later confirmed that our Client had suffered a fourth degree tear involving the complete disruption of the vagina, anal sphincter and walls of the anal canal. The tear extended 4cm along the rectal mucosa. The internal/external sphincters were completely divided with retraction on the right side. There was a high vaginal apex on the midline with a second apex on the right side and labial abrasions.
She underwent a repair of the tear in theatre.
As a consequence of the fourth degree tear, our Client had symptoms consistent with external sphincter dysfunction and also internal anal sphincter dysfunction.
Immediately after delivery, our Client commenced on Lactulose. She had no warnings of a bowel movement and had no control for several weeks. She underwent pelvic floor physiotherapy.
Prior to the events giving rise to her claim, our client and her husband had wanted a large family. As a result of the traumatic circumstances of the birth of their first child, our Client no longer felt that she could go through further pregnancies and decided not to have any further children.
Clinical negligence claim
Expert evidence confirmed that the baby was in the OP position throughout, but the two doctors involved failed to appreciate this. Had the OP position been recognised by the doctors delivering the baby, the course of events would have been different and the fourth degree tear would have been avoided.
As a result of the negligence, our Client suffered an avoidable fourth degree tear to her perineum. Had this not occurred, our Client would not, on the balance of probabilities, have suffered any significant change in her bowel function and would not, on the balance of probabilities, have had any problems with bowel function in the future.
As a consequence of the fourth degree tear, our Client had symptoms consistent with external sphincter dysfunction and also internal anal sphincter dysfunction. Both of these impacted her ability to work and her day to day life.
Furthermore, she suffered a psychological Adjustment Disorder.
The Defendant Trust admitted liability and causation, and settlement negotiations commenced.
A settlement was reached with our client accepting a six-figure sum in full and final settlement of her claim.
At the conclusion of her claim, our Client provided the following feedback of her experience with Nelsons:
“Fantastic, professional and empathetic service from Danielle. Will highly recommend Nelsons in the future.”