Poor fetal heart rate monitoring finally recognised as leading cause of brain damage by NHS

4th October 2019 Clinical Negligence

An issue we talk a lot about in the JMW clinical negligence team is cerebral palsy and the many ways brain damage resulting in this condition, can be caused.

Due to our specialist experience we are privy to the recurrent failures in maternity care that are leading causes of cerebral palsy due to medical negligence. They often paint a depressing picture of services that are overstretched, under-resourced and in urgent need of reform.

One issue that occurs more regularly than any other in our cerebral palsy cases is midwives or doctors misinterpreting the CTG heart rate monitor used during labour to check on the baby’s well-being in the womb often during more complex deliveries e.g. where it has been induced.

We have acted for countless children in need of lifelong 24-hour care because maternity staff were unable to correctly perform this most critical of duties. As a result signs that the baby was in distress and their oxygen supply was being compromised were missed and steps were not taken to deliver them urgently resulting in profound brain damage.

Despite the catastrophic consequences this issue has for children and the enormous financial cost to the NHS in compensation payments for lifelong care it is not something that is given much public exposure.

However this week we’ve seen several online news reports discussing poor monitoring and delayed delivery. This was after a report from NHS Resolution, the organisation that deals with medical negligence claims against the NHS, confirmed that this was the leading cause of foetal brain damage and accounted for 70 per cent of cases dealt with under the Early Notification Scheme (BBC, Daily Mail).

This may be the tip of the iceberg however because as my colleague Sally Leonards recently wrote about, in JMW’s history we have only had one cerebral palsy case dealt with by the scheme despite working on a high volume of cases. In most of our cases the NHS chooses to, at least initially, defend the case vigorously.

While this report from NHS Resolution is welcome it is nevertheless frustrating that this issue has continued without any action to address it despite thousands of children having their lives devastated. There is nothing new in the report as far as solicitors dealing with cerebral palsy cases are concerned but what is new is a long overdue appreciation of how far reaching this issue is.

What is clear to us as specialist solicitors is that more training in CTG interpretation is needed for maternity staff, particularly midwives, who have responsibility for such an important, but often complex, task. Will the NHS stump up the funding required for this? That remains to be seen but the need to get a grip on this issue has never been more pressing.

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Eddie Jones is a Partner and Head of Department located in Manchesterin our Clinical Negligence department

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