Smith v Sheridan, Court of Appeal - Queen's Bench Division, April 14, 2005, [2005] EWHC 614 (QB)
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Smith v Sheridan, Court of Appeal - Queen's Bench Division, April 14, 2005, [2005] EWHC 614 (QB)
Case No: HQ03X00994
Neutral Citation Number: [2005] EWHC 614 (QB)IN THE HIGH COURT OF JUSTICEQUEENS BENCH DIVISIONRoyal Courts of JusticeStrand, London, WC2A 2LLDate: 14/04/2005Before :THE HON. MR. JUSTICE MCKINNON- - - - - - - - - - - - - - - - - - - - -Between :- - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - -SUSAN RODWAY QC (instructed by Anthony Gold) for the ClaimantJOHN GRACE QC and RICHARD PARTRIDGE (instructed by Radcliffes Le Brassueur) for the DefendantHearing dates: 30th November - 7th December 2004- - - - - - - - - - - - - - - - - - - - -JudgmentMcKinnon, J: 1. This is a clinical negligence case arising out of the circumstances of the claimant's birth on 11th May 1999. The claimant sues through his Father and Litigation Friend, Jonathan Smith. The defendant was the Consultant Obstetrician responsible for the care and management of the claimant's mother's pregnancy and the delivery of the claimant. This is the trial of liability and causation only as ordered by Master Yoxall on 29th September 2003:``As to whether or not the defendant is liable to the claimant by reason of the matters alleged in the Particulars of Claim and, if so, whether or not any of the injuries pleaded were caused thereby; and if any such injuries were so caused, the extent of the same''.2. The claimant was delivered by the defendant on 11th May 1999 by caesarean section. This was a first pregnancy in the claimant's mother after operative intervention for infertility. It was known that the claimant was lying in the breech position (buttocks first instead of head first) and the operative delivery was planned specifically to avoid the complications of a vaginal breech delivery which carries a significant risk of injury to mother and baby.3. The delivery of the claimant up to and including his mouth took place without complication. At that point there is no dispute that the claimant was wriggling and passing urine. It is the claimant's case that this is a clear indication of foetal well being up to this point. 4. The defendant then encountered difficulty with the delivery of the rest of the claimant's head. To overcome this difficulty the defendant applied Wrigley's forceps and pulled. The first pull had no effect. The defendant widened the uterine incision and pulled again. This is described in the operation notes made by the defendant himself as a ``hard pull''. 5. The claimant's head was then delivered but he was described as ``flat'' at birth, meaning that he was displaying no signs of life. The claimant's Apgar scores at delivery appear to have been nought. Apgar is a crude means of scoring from nought to two in five categories: respiratory effort, heart rate, colour, muscle tone and response to stimuli. Hence a full Apgar score is 10. At one minute the claimant's score was only 2, dropping to 1 at 10 minutes and rising to 3 at 15 minutes. At delivery, the claimant had been immediately transferred for resuscitation but this was not effective until about 17 minutes of life. Thereafter the claimant went on to develop classical signs of an acute hypoxic ischaemic insult.6. On 14th May the claimant underwent magnetic resonance imaging. This demonstrated widespread intracranial haemorrhage and ischaemic damage. The claimant is left severely brain damaged.7. It is the claimant's case that the defendant correctly chose to proceed by way of operation rather than vaginal delivery as this was a breech delivery. It is the claimant's case that when delivering a baby by means of caesarean section it is mandatory to make an opening large enough to deliver the whole of the baby, including the head. This should be effected without the need for any mechanical force with the baby being lifted out of the uterus. The main complaint is the failure of the defendant to make an adequate opening for the delivery. The first incision was a horizontal one in the lower segment of the uterus. This was of insufficient size. The defendant sought to extend the incision laterally using scissors but he still encountered difficulty. At this stage, the claimant contends, the defendant ought to have extended the incision vertically (with a so-called inverted ``T'' incision or similar). This would have had the effect of enlarging the opening sufficiently to avoid any trauma to the baby's head or brain.8. Having failed to make an incision large enough, the defendant then delivered the head with forceps and a ``hard pull''. The claimant maintains this ``hard pull'' was excessive and caused the tearing of the veins in the brain, leading to the bleeding and all the subsequent events ending in severe and permanent brain damage.9. As to causation, the claimant's case is as follows. The negligent manner of delivery caused tearing of the veins in the claimant's brain. This led to bleeding in the brain. This caused the baby to be born ``flat''. There was then a significan...See the full content of this document
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