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Baby brain damage case highlights tragic consequences overlooking patients can have

The High Court has recently backed the family of an eight-year-old boy who was left with severe brain damage because maternity staff did not ensure he was fed regularly as a newborn*.

The case was heard before the court because Barking, Havering and Redbridge NHS Foundation Trust had denied any wrong-doing in relation to the post-natal care provided to Nilujan Rajatheepan. However the youngster, the son of Sri Lankan refugees, will now be compensated so that the cost of the extensive care he will need for the rest of his life will be covered.

Nilujan was born at the King George’s Hospital in July 2009. At the time, his parents spoke very few words of English. A few days after birth, Nilujan was discharged from hospital. The following day, a community midwife visited the home to find that he was pale, lethargic and had not been fed since the previous evening. Blood tests at the hospital revealed raised insulin and low glucose and this hypoglycaemic state had caused catastrophic brain injuries.

The judge said that the heart of the case was Mrs Rajatheepan’s lack of understanding of English and the reality is that no one had ever given her a clear and understandable explanation of the importance of feeding and how she should respond if she had concerns.

Mrs Rajatheepan did not tell anyone she could not understand because her English was so poor that she was unable to. The judge said that while initially he had found that surprising, on reflection ‘given her young age and lack of experience, the comparatively short time she had been in this country, the stressful situation she found herself in and the fact that she had been used to being accompanied by her husband or one of his friends it is not in fact so surprising’

The midwives who cared for her and Nilujan contended that they had no concerns as to Mrs Rajatheepan’s understanding of English. However the judge said this was in stark contrast to the records of the antenatal appointments, neonatal records and a letter from a consultant paediatrician who specifically referred to Mrs Rajatheepan being unable to speak English. This in itself speaks volumes and reveals that the postnatal midwives did not have a grip on the situation and manage it properly - with tragic consequences.

Even simple steps such as ensuring feeding advice was given to Mrs Rajatheepan in the presence of her husband who had a better grasp of English or arranging an interpreter would probably have changed the outcome of this case. It is difficult to understand how the midwives believed Mrs Rajatheepan did fully understand all advice given when concerns were raised by so many other clinicians at other stages.

Communication is absolutely crucial to patient safety and the reality is that if the midwives did not give it enough importance in this case it would only have been a matter of time before another tragedy occurred without this court intervention. In many of the medical negligence cases we deal with at JMW poor communication is a key issue and it’s something that many sections of the NHS need to get better at.

If you have had a similar experience please do not hesitate to contact a member of our clinical negligence team. Within the firm we have solicitors who speak a number of languages and our Lawshare partner firms are also available to translate in a number of different languages.

*Source: British and Irish Legal Information Institute 


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