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I v SALISBURY NHS FOUNDATION TRUST (2012)

View profile for Melanie Reynolds
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The claimant, a 26-year-old woman, received £28,000 for injury arising from the death of one of her twins in utero as a result of clinical negligence in August 2008. She developed post-traumatic stress disorder which impacted on her domestic, work and social life and her relationships with her partner and the surviving twin.

Clinical Negligence: The first pregnancy of the claimant (C) had been diagnosed as monochorionic diamniotic (MCDS) at 13 weeks' gestation, meaning that she was carrying identical twins sharing one placenta but with two sacs. The pregnancy was uneventful and serial growth scans confirmed appropriate and equal growth in both twins.

At 35 weeks' gestation on 25 August, 2008, C attended a hospital operated by the defendant (D) reporting spontaneous rupture of membranes and draining clear liquor. Maternal observations were unremarkable and a CTG was commenced. Both twins were confirmed to present cephalic and the plan documented by the registrar was to “admit, pain relief PRN, oral erythromycin”. CTG recommenced at 8.15 and was discontinued at 9.30. The midwife documented that “in view of business of Labour Ward, I am unable to be in the room all the time to keep hand on monitor”. The fetal hearts were auscultated twice during the day, at 11.45 and 15.15. A CTG was attempted at 23.00, but the midwife had “difficulty in obtaining trace”, documenting “twin 1? FH 105 bpm, twin 2? 156 bpm?? decelerations” in the notes, and “CTG inconclusive; very difficult to monitor babies”. A registrar performed a scan at 9:25 on 26 August but failed to document her findings. Despite the inability to monitor one of the twins, the attendant staff failed to organise an urgent scan and merely tried to “make an appointment for the claimant to be scanned”. An ultrasound scan was finally performed at around 12.30, confirming the death of twin 2.

C sustained injury and brought an action against D alleging that it was negligent in failing to provide reasonable care (i) in adequately monitoring the babies during the day on 25 August, which prevented earlier detection of an abnormal CTG; (ii) in the gross misinterpretation of the CTG at 23:00 on 25 August; (iii) failing to perform a category 1 caesarean section shortly after 23:00 resulting in the babies' delivery within around 30 minutes.

Liability admitted.

Injuries: One of C's twins died in utero and she suffered grief and developed post-traumatic stress disorder.

Effects: The condition had had an impact on C's domestic, social life and relationships, most notably her relationship with her partner at the time and the surviving twin. It had a moderate impact on her work.

The claimant was still tearful and having nightmares when she saw her GP in July 2010 some 21 months after her loss. She had had some therapy for her condition which she had found helpful. By 2012, the diagnosis of PTSD was still valid, although it was then mild. She underwent further counselling, which was ongoing, and her full recovery was expected within another 12 months.

The impact events would have on future pregnancies was hard to predict. On the balance of probabilities, there was a 25 per cent chance of the recurrence of symptoms, most likely flashbacks, in any future pregnancy.

Out of Court Settlement: £28,000 total damages

The case was settled on a global basis with no particular breakdown of damages. However, the following breakdown was estimated by the claimant's solicitors:

Breakdown of General Damages: Pain, suffering and loss of amenity: £26,200.

Breakdown of Special Damages: Travel and miscellaneous expenses: £1,800.

Dutton Gregory LLP for the claimant. NHSLA for the defendant.

LTLPI 30/7/2015

This Quantum Report was provided courtesy of Melanie Reynolds of Dutton Gregory LLP, solicitors for the claimant.