Hospital admits catalogue of errors caused baby’s brain damage 

25/04/2014

A mother has called for lessons to be learned by a London hospital after her baby boy suffered devastating brain damage caused by a catalogue of errors by maternity staff.

Ayub Abdirazak is just three but it is already clear that he will be severely disabled due to appalling mistakes that were made during his delivery at Chelsea and Westminster Hospital. 

He cannot walk independently or speak and is likely to be dependent on others for the rest of his life after his brain was starved of oxygen as a result of the failures.

After his case was taken on by Beth Reay, a specialist solicitor at law firm JMW, Chelsea and Westminster Hospital NHS Foundation Trust admitted liability for Ayub’s brain damage. 

Ms Reay said that after investigating the care provided to Ayub and his mother Idil Osman she had identified almost 30 separate mistakes by maternity staff, many of them extremely serious. 

The failures included: 

Failing to treat Ayub’s delivery as high risk despite the fact that he was in the breech position, was premature and his mother had to undergo an emergency C-section in a previous pregnancy. 

A breakdown in communication between the midwife caring for Ayub’s mother and the doctors in charge of her care, which resulted in vital information not being passed on and the failure to appreciate that an emergency C-section was required.

Failures by the obstetric team to review the heart rate monitor during the ward round. 

Failure by the midwife to act upon serious abnormalities on the fetal heart rate monitor, which showed worrying signs that Ayub was in distress.

Ms Reay commented: “There was a shocking catalogue of errors made during Ayub’s delivery and this has had catastrophic consequences for him. Many of the errors are very worrying as there was a clear lack of appreciation of obvious warning signs that he was in danger.

“His mother and father are completely devastated and cannot believe that this has happened to their baby. Nothing can now be done to turn back the clock and they have been left to come to terms with the fact that if an appropriate standard of care had been given and guidelines followed Ayub’s brain damage would have been avoided. This was not ‘one of those things’, it was completely preventable.

“However I am pleased that although there are many challenges ahead for the whole family a significant part of their legal battle has been won. I will now continue to work with the trust to negotiate a compensation package that will enable Ayub to access the help he needs to cope with his disabilities.” 

Ayub’s mother Idil Osman, who lives with her husband and Ayub’s father Ahmed Yusuf and their eldest son Ayman, four, in Shepherd’s Bush, commented: “Ayub is a dearly loved little boy but the fact remains that his future will be shaped by the fact that these terrible mistakes were made. We just want to try to make sure lessons are learned from his case to try to prevent other babies from suffering similar errors. That would at least give us some peace of mind.”

Idil, a former hospital laboratory biomedical scientist who is currently studying for a Masters degree (MSc) in Medical Radiology at Imperial College London, continued: “We always felt that something had gone badly wrong during his delivery. Now that the trust has admitted this it is a relief, however it also sad that our worst fears have been confirmed and Ayub’s brain damage was avoidable with better care.”

Idil and Ahmed, who works for London Transport and is studying part-time for a degree in network engineering, discovered they were expecting Ayub in September 2010 and the pregnancy progressed normally. However on 13 March 2011 when Idil was just 34 weeks pregnant she awoke in the early hours of the morning with contraction type pains. As the intensity of the pain increased an ambulance was called and Idil arrived at the hospital at 7.18am. 

Idil was put under the care of maternity staff who, after doing an initial assessment, failed to recognise the risks associated with the premature labour, Ayub’s breech position and the fact that Idil had a C-section for her previous pregnancy. As such the labour was not treated as high risk. 

The midwife carried out an important examination which showed that Idil was almost fully dilated. When the doctors came to assess Idil, the midwife failed to communicate this vital piece of information to them and they planned a non-urgent caesarean section.  

On several occasions the midwife responsible for most of the labour failed to recognise signs of fetal distress on the heart rate monitor. She therefore did not call for a senior doctor when this should have been done urgently. 

At one point at approximately 9.20am Idil was told she would be taken for a C-section and given a spinal block. However this was abandoned at 10am due an emergency elsewhere in the maternity unit. 

Poor monitoring and interpretation of Ayub’s fetal heart rate monitor meant his serious condition was not picked up on. When a doctor examined Idil at about 10.15am it was revealed that she was fully dilated and an adequate fetal heart rate reading was finally taken which showed severe signs of distress. A decision was finally taken to deliver Ayub by emergency C-section and he was born at 10.30am. By this stage it was too late to prevent his brain from being permanently damaged. 

JMW’s own investigation established that the damage to Ayub’s brain occurred in the last 15 to 20 minutes before he was born. If the worrying signs of fetal distress had been picked up by the staff caring for Idil, Ayub would have been delivered over an hour earlier and his brain damage would have been avoided.

A serious untoward incident report done by the hospital following Ayub’s delivery highlights this failure as one of the main problems that caused the delayed delivery. It also states that there was poor communication between team members and that the labour was not prioritised as it should have been.

The hospital’s investigation was completed when Ayub was only four months old, but the findings were never shared with his family and they only found out that an internal investigation had been carried out after instructing JMW to investigate Ayub’s case. The hospital’s failure to tell the family about the findings of the internal investigation added significantly to their distress.

Ends

For more information or to arrange an interview, please contact Kelly Hindle on the details below:

Kelly Hindle

D. 0161 828 1868

E. Kelly.hindle@jmw.co.uk 

Note to Editors

JMW Solicitors LLP is a leading Manchester law firm and offers a broad range of legal services to both commercial and private clients.JMW’s Clinical Negligence team is headed up by leading lawyer, Eddie Jones.  



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