‘Lucas’, 11

Lucas suffered severe brain damage due to poor monitoring of his heart rate during labour, leading to a diagnosis of cerebral palsy. Read Lucas' story below:

Labour and delivery

Lucas’ mother had a straightforward pregnancy and was admitted for an induction when she was 12 days past the baby’s due date.

As her labour progressed, there was some difficulty with maintaining the continuous monitoring of the baby which occurs during induction of labour. Given these difficulties, there should have been the application of a fetal scalp electrode so that this constant observation of his condition could be maintained.

However this wasn’t applied and the labour progressed. As a result, Lucas suffered a period of severe lack of oxygen (known as acute profound hypoxia) which led to a brain injury. If the fetal scalp electrode had been in place, the difficulties he was having would have been clear and he would have been delivered earlier.

First days

Lucas was born by caesarean delivery with no heart rate and required inflation breaths and cardiac compressions to revive. There was no improvement so about a minute of being born a crash call was put out. His heart rate improved after six minutes of being born and regained colour by seven minutes of age.

Lucas remained in hospital for 10 days, before being discharged home. On the Neonatal Unit, Lucas has some seizure activity therefore he was given Phenobarbitone, medication to reduce seizures. He was also actively cooled and rewarmed to protect his brain from further damage and placed under ventilation for three days following his birth.

An EEG, a test that measures electrical activity on the brain, was reported as abnormal. An MRI scan of the brain was also performed prior to discharge home which showed uncertainties.

Lucas’ diagnosis

Due to the lack of oxygen when he was born, Lucas now has dystonic cerebral palsy and developmental delay.

His mobility is significantly impaired, he is unable to walk and struggles to sit without support and assistance and has poor head control. Lucas is also unable to eat without assistance and his food needs to be cut up in very small pieces to prevent choking.

Lucas has severe dysarthria which impacts his speech and makes communication very difficult, this is particularly frustrating as he struggles to communicate with strangers and is a very friendly sociable child.

Despite these hurdles, he has a remarkable persistence and wish to communicate and loves meeting new people and engaging with sports and outdoor pursuits.

JMW’s investigation

Lucas’ family contacted JMW before he was a year old and Angharad, a partner specialising in cerebral palsy cases, listened to their personal recollection of what happened during labour and treatment of Lucas following his birth. As well as getting to know how Lucas had been affected by his condition and the impact on his life so far.

Angharad, who has built a close relationship with the family over the years whilst working on their case, sought expert evidence to address Lucas’ care at the time of his birth.

It was established that Lucas’ cerebral palsy was likely to have been caused by sudden severe hypoxia of approximately 10-20 minutes in duration. This also meant that earlier delivery would have likely improved or made the difference to Lucas’ life and if the fetal scalp electrode had been applied 10-15 minutes earlier then this would have prompted an earlier medical review and delivery.

Angharad put together a a strong case and received an admission of liability and apology from the hospital Trust. We thereafter sought expert evidence as to Lucas’ needs and went on to achieve a financial settlement to meet his needs for life.

Liability

The Trust admitted liability and stated that when the CTG became illegible a fetal scalp electrode should have been applied 10-15 minutes earlier.

If this was the case, the fetal scalp electrode would have likely shown a decrease in Lucas’ heart rate and a decision to deliver would have been made sooner which would have avoided the acute hypoxic ischaemic injury.

They also issued an apology for providing care below the acceptable standard during her labour.

Cerebral palsy compensation awarded

Following receipt and detailed consideration of extensive medical expert opinion, we were able to work towards a settlement of Lucas’ case in the capitalised sum of around £16.8million to cover Lucas’ care, therapy, equipment, accommodation and extensive long term needs.

This will enable Lucas’ needs to be met and the family to have the security that funds are in place for the rest of his life to maximise his independence and access to support and items which will assist and empower him. The family are now able to look for a new house which will better suit Lucas’ needs and feel secure that as he gets older, he will be able to live a life to his full potential.