Child suffers catastrophic kernicterus brain damage due to community midwife errors
‘Simon’, 7
Eddie Jones, a partner specialising in kernicterus cases at JMW, obtained £22 million in compensation for a boy who suffered negligent treatment of jaundice and went on to develop the condition. The money will enable ‘Simon’ to access a lifetime of specialist 24-hour care, a house adapted to his disabilities and achieve financial security given he will never be able to work for a living.
Midwife visit
Simon was born perfectly healthy and he and his mother Pamela left the maternity hospital the following morning. They were visited at home that afternoon by a community midwife while Simon was still less than 24 hours old. The midwife noticed that Simon was slightly jaundiced. As such he required a blood test to monitor the level of bilirubin – the substance that causes yellowing of the skin and eyeballs and can cause brain damage- in his blood. A sample should have been either taken by the midwife or at the hospital and sent for urgent analysis. However the midwife took no action and advised Pamela that Simon would have a more thorough check at home by a midwife the following day.
The next day a different community midwife arrived to check on Simon and Pamela and carry out the examination. The midwife noticed that Simon was moderately jaundiced, which was an increase from the day before but as she did not review yesterday’s notes, she was not aware of the progression. She should have referred Simon straight to hospital so that he could be seen by a paediatrician and have his rising bilirubin measured and treated with phototherapy or a blood transfusion. The second midwife concluded that Simon was fine and left.
Lack of urgency
On the third day another midwife visited who said that if Simon’s jaundice was worse the next day then he should have a blood test. However this was not done.
The following day the first community midwife to attend Simon and Pamela returned and noticed that he was still jaundiced but failed to take urgent action to ensure he was tested and treated in hospital, despite the risk of significant harm being caused.
By the next day, Simon was and he was feeding poorly and his urine was dark orange. The midwife who came to see him said that he needed to have his bilirubin level checked but did not give the parents the impression that the situation was urgent so initially a plan was agreed to do it the next day.
However, over the course of the day Simon deteriorated and when his parents contacted the midwives for help, they were advised to take him to hospital. Once there, Simon was found to be very ill and was taken to the neonatal intensive care unit. His bilirubin level was very high and he was given phototherapy and later a blood transfusion. This brought the bilirubin under control however Simon had already suffered severe kernicterus brain damage by the time treatment was started.
Simon’s parents were given the devastating news that as their baby grew, he would have severe developmental delays and would become significantly physically and cognitively disabled. Therefore Simon would be dependent on others for the rest of his life.
JMW’s investigation
Having read about another child this had happened to, they contacted Eddie Jones of JMW, who acted for that child and specialises in finding answers and compensation for children and families affected by kernicterus.
Eddie conducted a comprehensive investigation into Simon’s care by the community midwives. Calling on leading independent medical experts to give their opinion Eddie found it had been negligent of the midwives not to test Simon’s bilirubin when his jaundice was first noticed and make a hospital referral. The experts agreed that without the delay of several days Simon would have avoided brain damage.
Kernicterus compensation
On the weight of the evidence obtained by Eddie's investigation the hospital trust admitted negligence and apologised to Simon and his family.
After careful assessment of Simon’s lifelong care needs and requirements for his accommodation, transportation and therapy, Eddie negotiated a compensation settlement totalling £22 million for Simon.
This will provide 24-hour care for the rest of his life and will also ensure he has financial security as he will never be able to work for a living.
There were several missed opportunities to take action on Simon’s newborn jaundice due to a lack of awareness of the national treatment guidelines. Hospitals need to ensure midwives who attend a jaundiced baby know what to do as this was a completely preventable tragedy.
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