Settlement In Neonatal Death Case

30 Apr 2024 | Nicholas Leahy
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Settlement in fatal medical negligence case against King’s College Hospital NHS Foundation Trust

Nick Leahy, Associate in our Clinical Negligence department, recently settled a fatal medical negligence claim against King’s College Hospital NHS Foundation Trust, following the tragic death of his client’s baby boy at just 9 days of age. Our client’s baby, Patryk Bielaszka, was born at the Princess Royal Hospital and suffered hypoxic-ischaemic encephalopathy secondary to an antepartum haemorrhage, from which he was unable to recover. There was a failure in the antenatal period to diagnose vasa praevia, a condition in which fetal blood vessels cross or run near the internal opening of the uterus, and which means they are at risk of rupture when the supporting membranes rupture.

Failure to Diagnose

Our client had booked in for her pregnancy on 15 April 2019, and was placed on a low risk antenatal pathway. She had a previous history of gestational diabetes and following a OGTT at 28 weeks of this pregnancy, she was diagnosed with gestational diabetes again and referred to the specialist diabetic team. She was placed on oral metformin.

During an ultrasound scan on 6 August 2019 a low lying placenta was diagnosed and Mrs Bielaszka was then reviewed by an obstetrician in the ANC. A plan was made to review her further following an ultrasound scan at 31+5 weeks.

At 27+6 weeks, Mrs Bielaszka travelled to Poland and she had an ultrasound scan whilst there, on 12 August 2019. This ultrasound scan showed a low-lying placenta and noted the presence of a vein across the cervix. She was informed by the Polish doctor that this meant she would need to deliver by caesarean section or her baby would not survive.

Mrs Bielaszka reports that on her return to the UK, she informed her treating doctors and midwives about the results of the Polish scan, but that she was told no further monitoring was required. She pleaded for a caesarean section but her concerns and wishes were not acknowledged.

On 12 September 2019 at 32 weeks, Mrs Bielaszka was seen in the community ANC and it was noted that the ultrasound scan which she had attended at 31+5 weeks (6 September 2019) had shown that the placenta had moved and was no longer low lying. She was told her birth plan would depend on the location of her placenta. Eventually, a plan was made for Mrs Bielaszka to have an induction of labour at 38+1 weeks, and she accepted this. She was therefore booked in to attend on 23 October 2019.

Mrs Bielaszka was admitted for induction of labour on 23 October 2019, as planned. The induction of labour process was commenced, however at 19:00 that evening Mrs Bielaszka reports that she had informed the staff that she was feeling very unwell and that she had felt a push in her abdomen. She said it felt as if her baby was pushing down and that the pain felt different to normal.

After this, Mrs Bielaszka continued to have contractions, which were painful. We are instructed that Mrs Bielaszka tried to again inform the staff at this point that the pain she was experiencing was more in her abdomen and was different to normal labour pains. She feels that the staff did not really understand what she was saying and that they were dismissive of her concerns.

At 02:18 on 24 October 2019, Mrs Bielaszka pressed the buzzer by her bed and reported that her waters had broken. It was noted that clear liquor was seen draining. Her baby’s heart rate was measured as 120bpm. She was given the call buzzer and told to press this again if she required any assistance.

Shortly before 08:04, Mrs Bielaszka and her husband noticed that she had vaginal bleeding. At 08:04, Mrs Bielaszka’s husband reported to the midwifery staff that she had experienced bleeding from her vagina. Mrs Bileaszka was attended to by midwifery staff following this report and they observed a large amount of fresh blood. It was documented as being approximately 300mls with a blood clot (a significant antepartum haemorrhage). The emergency buzzer was pressed to summon the obstetric team, who arrived promptly.

Following this, Patryk was delivered by emergency caesarean section. Following his delivery it was noted “it is documented in the medical records: “placenta delivered, placenta complete, velamentous and vasa praevia very clearly seen on placenta. Placenta sent for histology”. Patryk’s APGAR scored were recorded as 1 at 1 minute, 2 at 5 minutes and 5 at 10 minutes. The APGAR score at 20 minutes was 1.

At birth, Patryk was pale and floppy, with no respiratory effort, no spontaneous movement, and a heart rate of 60-100 bpm. Patryk was taken immediately to the resuscitaire where care was taken over by the neonatal team present in theatre.

Patryk was transferred to the local neonatal unit (LNU) for ongoing treatment including a blood transfusion, before being transferred to the regional NICU at King’s College Hospital in Denmark Hill, for specialist care and active cooling later that day.

Patryk remained at King’s College Hospital on the NICU over the course of the next few days and he was given an MRI scan of his brain at 7 days of age. This MRI scan reported “generalised signal change with patchy restricted diffusion which was consistent with generalised hypoxic ischaemic injury”.

Sadly, Patryk’s condition did not improve. He was reassessed after weaning off sedative medication and unfortunately, he showed no improvement in neurological function. At that point, the Children’s Palliative Care team (Evelina London Children’s Hospital) provided a symptom management plan to be used after redirection of care.

Following discussions with Mr and Mrs Bielaszka later that day, Patryk was extubated at 8 days of age. Patryk died at 05:05 hours on the morning of 2 November 2019 in the arms of his parents.

Inquest

An inquest was opened into Patryk’s death, however due to a combination of factors, including the COVID-19 pandemic and failure by the Trust to comply with orders which had been made by the Coroner, the inquest was delayed several times. The final inquest hearing took place in October 2023 over a period of 4 days. However, as the Trust failed to produce key witnesses at the inquest, including the doctors and midwives involved in our client’s care, Patryk’s parents informed the Coroner that they wished to play no further part in the inquest proceedings.

Civil Proceedings

Due to the ongoing delays with regards to the inquest proceedings, in March 2022 Mrs Bielaszka instructed Osbornes to send a Letter of Claim to the Trust at this stage. Nicholas Leahy, an Associate in the Clinical Negligence team, obtained expert evidence from a Consultant Obstetrician and Consultant Sonographer, which were supportive of our client’s case. A Letter of Claim was then directed to the Trust.

However, again the Trust delayed and failed to respond in accordance with the Pre-Action Protocol. Eventually, solicitors were instructed on the Trust’s behalf. Our client agreed to a number of extensions of time, before the Trust eventually served their response on 15 May 2023.

The Trust admitted that in light of the findings of the routine fetal anomaly scan on 3 July 2019, it was a breach of duty for a trans vaginal scan not to have been arranged at 32 weeks. Further, the Trust admitted that had this happened, this would have identified a vasa praevia and thereafter an elective caesarean section would have been performed between 34 weeks and 36+6 weeks gestation. It is clear, and was admitted, that in such circumstances Patryk would have been born alive and healthy, and survived.

Following this admission, expert evidence on Condition and Prognosis was obtained from a Consultant Psychiatrist, in relation to the psychiatric injury Mrs Bielaszka had suffered as a result of the negligence. Once this evidence was served, advice on quantum was obtained from William Young, barrister at Outer Temple Chambers in London, and following receipt of his advice, settlement negotiations were commenced.

Settlement Agreed

A settlement was agreed in March 2024, which provided for general damages for pain, suffering and loss of amenity, past and future loss of earnings, past and future care, funeral expenses, a statutory bereavement award, past and future treatment.

Following the settlement, Mrs Bielaszka stated:

“Nick is a professional, he helped us greatly in our difficult case against the NHS, he is patient and very helpful. I highly recommend using Osbornes Law”.

Nicholas Leahy, Associate in our Clinical Negligence team, said:

“This is a truly tragic case that has understandably devastated the lives of my clients”.

Patryk’s parents were ignored by doctors, despite them having independent medical advice which showed Barbara’s pregnancy was at risk. Patryk’s death was completely avoidable, yet my clients feel that their poor English is being blamed for leading to what happened in this case.

Sadly, I have acted in other cases in which parents’ limited command of English has led them to feel like their concerns are being ignored. My clients have understandably lost complete trust in the NHS as a result of these events”.

The case received media coverage, which can be found here:

Contact Osbornes Law

If you’ve suffered due to a medical procedure, our Medical Negligence solicitors are here to support you. Contact Osbornes Law by filling out the form below or calling 020 7485 8811 to speak to us about a birth injury claim or fatal negligence claim.

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