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Total Damages: £40,000 (£40,234.38 RPI)

Trial/settlement date: 22/7/2014
Age at trial: 38
PSLA: £30,000 (£30,175.78 RPI)
Type of Award: Out of Court Settlement
Court: Out of Court Settlement
Age at injury: 34
Sex: Female

The claimant, a 38-year-old woman, received £40,000 for the personal injuries sustained during labour in November 2010. She suffered injury to her vaginal wall and urinary bladder, underwent an emergency caesarean section, developed a vesicovaginal fistula, had an E. coli infection, and suffered dyspareunia and depression.

Clinical Negligence: On April 7 2010, at nine weeks gestation, C had her antenatal booking visit. It was documented she had her first child by emergency caesarean section for “fetal distress”.

On November 11 she attended the labour ward of a hospital of the defendant trust (D), with a history of uterine contractions since 16:00.

On November 12, 2010 at 03:40, a plan was made in respect of the claimant (C), who was in labour, to allow one hour of passive descent prior to active pushing at 05:00.

At 07:12 C was transferred to the operating theatre for trial of instrumental vaginal delivery. Manual rotation to occipito-anterior position was attempted and forceps applied. As no descent was noted with two pulls with the forceps, the procedure was abandoned. Caesarean section operation documented that methylene blue dye check was performed. Neonatal examination record confirmed that the baby had a right medial sub-conjunctival haemorrhage.

C was reviewed in the postnatal period following her discharge from hospital by the community midwifery team and was diagnosed as having lack of urinary bladder control from nine days after birth. Twenty-three days after the birth C continued to experience urinary incontinence and also had a “numb spot on the left buttock”. A referral was made for her to see a consultant obstetrician and gynaecologist. A CT urogram and cystogram subsequently confirmed a vesicovaginal fistula. After conservative management for vesicovaginal fistula failed, C required surgical repair of the vesicovaginal fistula by the urology team. Repair of the vesicovaginal fistula was performed through an abdominal incision.

C continued under the care of the gynaecology team for management of deep dyspareunia following vesicovaginal fistula.

C sustained injury and brought an action against D alleging that it was negligent in (i) not performing an elective caesarean; (ii) incorrectly applying forceps blades on a mal-rotated fetal head; (iii) applying inappropriate traction force.

Liability admitted for the bladder damage and fistula but it was denied that there should have been an elective a caesarean section or that damage to the baby's face was negligent.

Injuries: C suffered injury to her bladder.

Total injury duration: permanent

Effects: C suffered injury to the anterior vaginal wall and urinary bladder. She underwent an emergency caesarean section, developed a vesicovaginal fistula and had an E. coli infection. She suffered dyspareunia and depression.

C suffered incontinence for nearly four months until she underwent surgery, and painful sexual intercourse was ongoing. She has to void her bladder by the clock as she had no feeling of urgency when her bladder was full; that was permanent.

Prognosis: C was off work for almost a year. Her depression was having an effect on her work and prospects of promotion. C was able to return to work after about a year, part time initially. The depression was ongoing and counselling was required. Having to void by the clock was permanent.

Out of Court Settlement: £40,000 total damages

Background to 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: £30,000.

Future loss or earnings and other future expenses: £10,000.

Dutton Gregory LLP, (Bournemouth) for the claimant.

LTLPI 24/02/2015 (Unreported elsewhere)

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

Document No. AM0202624