Family Join Medical Negligence Lawyers In Campaigning To Improve Maternity Safety And How Learning Is Communicated Across The NHS

A couple are calling for lessons to be learned after their son was left permanently disabled following delays in delivering him during birth.  

During an antenatal appointment at 34 weeks Lucas Whitehouse’s mum Rebecca, of Enfield, was told that her baby was in the breech position. At her 35+3 week appointment, Rebecca was advised by midwifery staff said that her baby was cephalic. At her final antenatal appointment at 37+3 weeks Rebecca requested an ultrasound to confirm the position of the baby, but instead of arranging one, she was advised that she would have a consultation with an obstetrician three weeks later, who would decide whether a scan was necessary.  

After Rebecca’s waters had broken staff at the birthing centre believed Lucas was in the normal birth position despite the midwives performing an examination, which should have identified that the baby was in the breech position and Rebecca should have been admitted to the labour ward and reviewed by the obstetric team, an NHS investigation report said.

Couple raise concerns with midwives

After nearly four hours in the birth centre, Rebecca and her husband raised concerns with the midwives and a midwife performed an examination and felt Lucas’ toes. Staff suspected Lucas was being born feet first (a footling breech) and transferred Rebecca to a labour ward. 

When an ultrasound confirmed Lucas was a footling breech, Rebecca was initially consulted and prepared for a caesarean section. However, upon arrival in theatre, the consultant advised Rebecca that a natural delivery was the safest option. Hospital policy and Royal College of Gynaecology (RCOG) guidelines relevant to the particular circumstances of this delivery stated a caesarean should have been carried out. RCOG guidelines said a caesarean should have been performed within 30 minutes of Rebecca arriving on the labour ward, an NHS investigation report found. 

Lucas was delivered an hour and 14 minutes after mum and baby arrived on the labour ward on 12 July, 2014. His head was delivered nine minutes after his body during which time Lucas was starved of oxygen.

Lucas had to be resuscitated and after two failed attempts he was intubated after 11 minutes. Circulation was restored at 17 minutes and Lucas took his first breath after 29 minutes. 

Parents ask medical negligence lawyers to investigate maternity care 

Lucas has been diagnosed with cerebral palsy and global development delay. Now aged eight, Lucas is none verbal and communicates using signs and a communication device. He has cognitive problems and will become frustrated when he can’t communicate quickly. 

Rebecca and her husband Dan, who were aged 34 and 33 at the time of the birth, instructed expert medical negligence lawyers at Irwin Mitchell to investigate mum and baby’s care under North Middlesex University Hospital Trust. 

Lucas receives settlement which will fund life-long care he needs

After a letter of claim was served on North Middlesex University Hospital NHS Trust, the Trust admitted liability and subsequently apologised to the family nine months after Lucas was born. Following discussions the Trust agreed a settlement with the family which will fund the specialist lifetime care, therapies and support Lucas requires. 

The settlement will be managed by Irwin Mitchell’s Court of Protection team to ensure it lasts for the remainder of Lucas’s life. 

Hospital Trust investigation finds 38 care issues and factors

A Root Cause Analysis Investigation Report by North Middlesex University Hospital Trust found 38 issues and factors in the family’s care. These included not sending Rebecca for a scan to confirm her baby’s position at 37 weeks, a delay in diagnosing Lucas was breech, not following Trust and RCOG guidelines as well as poor documentation of what happened by all staff. Training was also highlighted as an area of concern. 

Irwin Mitchell represents hundreds of families nationally who have been affected by issues in maternity care. It is campaigning to improve maternity services across the country and contributed to the Health Committee’s Maternity Safety Call for Evidence.

Expert Opinion

“This is a tragic case which resulted in Lucas suffering devastating but avoidable injuries which will affect him and his family for the rest of his life.

“The settlement has been carefully calculated and means Lucas will receive the lifetime care and support he requires because of his complex needs.

“While we welcome the Trust’s co-operation in this case and apology, the family would rather not be in this position.

“Lucas’s case is a stark reminder of the life-changing consequences families can be left to face because of maternity failings.

“Every second counts when delivering babies in distress and it’s vital that lessons are learned so other families don’t have to suffer the pain that Rebecca and Dan have had to endure. We’ll also continue to campaign for improvements in maternity safety nationally.” Auriana Griffiths - Partner

Family raise awareness of cerebral palsy to help others

Rebecca and Dan are supporting World Cerebral Palsy Day on 6 October. As part of their support Rebecca has set up an Instagram account telling Lucas’s story and charting the things he enjoys but also the challenges he faces. The account @lucas_cpjourney also aims to provide help and support to other families experiencing the same issues.

Rebecca said: “After I was told that Lucas was in the breech position I was concerned and raised this at follow up appointments, including at 37 weeks when I was told that I didn’t need a scan as Lucas was not in the breech position. After my waters broke medical staff reaffirmed that Lucas was not breech. I recall them saying that his head was engaged and it would not be long until he was born.

“Despite this I knew something wasn’t quite right and we raised this while I was having contractions. However, I put my trust in what I was being told. It was only after nearly four hours when I had the urge to push and nothing was happening that staff started to suspect that something wasn’t quite right.

“Finding out afterwards that Lucas’s injuries could have been avoided if the correct guidelines had been followed and staff were properly trained has been the hardest thing to accept. 

“It’s difficult not to think that when Lucas needed help the most he was badly let down.

“Despite everything he’s been through we’re so proud of Lucas. He’s an absolute fighter and we feel so blessed that he’s our son. Each day he amazes us with the courage and determination he shows to not be defined by his condition. His laughter would make anyone smile. 

“All we want is for him to have the best life possible. Knowing that the support and care Lucas needs is guaranteed for the rest of his life is a huge relief. 

“We just hope that by speaking out we can help prevent other families having to go through what we have.” 

Following Lucas’s birth he was transferred to another hospital for specialist treatment. He was then transferred to another hospital closer to home and he was allowed home at around six-weeks-old.

Family's struggle to get answers from health authorities

Dan added: “When Lucas was born he was taken away. We weren’t told anything for two hours and didn’t get to see him for three hours despite repeatedly asking. We knew immediately he was in a really serious condition. We had discussed names before he was born and had not yet decided but we named him immediately after he was born as I was concerned that we may not see him alive again as between the time his body was delivered and his head was delivered his body had turned blue. 

“Natural deliveries of breech babies can happen safely with staff that are properly trained and do a great job. We just believe that mums should be aware of all of the pros and cons so they can make the most informed decision about what’s best them for in their particular circumstances and that training for breech births across the NHS needs to be made consistent.

“The last few years of trying to get all of the answers as to what went wrong at times felt a real struggle. It’s a very complex system and we were faced with a lot of conflicting information from those involved in Lucas’s care during the Trust’s investigation.  I had several meetings with people from the Trust, the CCG, NHS England, NHS Improvements, the CQC and one with Jeremy Hunt before finally getting answers about how problems at the trust were being dealt with or in reality how we believe they often weren’t.

“We can’t thank enough the staff in the neonatal units at the other hospitals for the amazing care they provided to Lucas. Nothing was too much trouble and they treated us with compassion. We just feel upset that things need not have turned out like they have if Lucas received the care he should have at North Middlesex University Hospital. During our daughter’s birth at another hospital two years later the staff were amazing and did everything they could to help us get through a tough time given the problems we had at Lucas’ birth”

Find out more about our expertise in supporting families affected by cerebral palsy and other birth injuries at our dedicated medical negligence section. Alternatively to speak to an expert contact us or call 0370 1500 100.

Background

Rebecca was told her baby was in the breech position during an appointment at 34 weeks. Around a week later at a follow up appointment she was told her baby had turned into a normal birth position. 

At a further appointment when 37 weeks’ pregnant Rebecca raised concerns about the position of her baby but was told that he was definitely head down, his head was engaged and they expected her to give birth soon. However, no scan was arranged to confirm Lucas’s position.

After Rebecca’s waters broke on 12 July, 2014, she attended hospital and staff said Lucas was in the head first position. Rebecca was sent home and told to re-attend hospital when her contractions were more frequent. 

She and Dan returned at 4pm and she was transferred to the birthing centre as her preference was for a water birth and her pregnancy was deemed low risk. Triage checks were incomplete.

Her labour progressed. Following an examination at around 7.45pm after Rebecca and Dan raised concerns, midwifery staff suspected Lucas was in the breech position. Before this it had seemed that because it was deemed a low risk birth checks that were standard procedures were not done. Rebecca was transferred to the labour ward, arriving at around 8pm.  An ultrasound confirmed Lucas was in the footling breech position. A registrar suggested an emergency caesarean was their preferred option of delivery, the Trust’s Root Cause Investigation report said.

To avoid delay Rebecca’s care was handed over to an obstetrics consultant however he was not immediately available. 

Lucas should have been delivered within 30 minutes of the handover to the obstetrics team, the report added.

The consultant reviewed the case in theatre at 8.15pm and decided to proceed with a natural delivery. 

Lucas’s body was delivered first at 9.05pm. At 9.12pm forceps were applied to assist with delivery of the head. Lucas was fully delivered two minutes later at 9.14pm.

After being resuscitated he was transferred to intensive care and placed on a ventilator. Lucas was transferred to another hospital overnight and in total Lucas spent around six weeks in hospital.  He is expected to need 24 hour care for the rest of his life.