£250k for 39-year-old who suffered sepsis after negligent maternity care

What happened?

On 13 June 2014, the claimant was an inpatient at the hospital of the defendant trust, having recently given birth to her baby by vaginal delivery. At 1400 on 13 June, it was noted that the claimant’s perineum was very swollen and painful, and her blood pressure was very low. The medics took a full blood count, which revealed a raised white cell count.

At 1600 on 13 June, an Obstetric Specialist Registrar examined the claimant, noted her symptoms of pain, low blood pressure, tachycardia and tachypnea. The specialist considered these signs of a labial haematoma that required conservative management.

The claimant continued to deteriorate so that by 1940 on 13 June, her temperature was raised and her heart rate was 123bpm. The Senior House Officer (SHO) was made aware but did not review the claimant until 2130, at which point they made a plan for regular analgesia and observations.

Overnight, in the early hours of 14 June, the claimant’s symptoms should have triggered medical review, as her blood pressure was low and she had a pulse of 114bpm. However, a review was not carried out until 0615 hours. During this review the registrar noted that the claimant was feeling better although she remained in pain. On examination the haematoma was smaller in size. The registrar conveyed the warning symptoms of infection to the claimant and told her that she could go home whenever it was suitable for her.

So, at 14:40 on 14 June, the claimant was discharged from the hospital.

At 0829 on 15 June, the claimant was readmitted to the hospital by ambulance with increasing abdominal pain. The claimant commenced intravenous antibiotics at 1110 and at 1800 underwent surgery, which included a total hysterectomy and bilateral salpingo-oophorectomy (removal of ovaries and fallopian tubes). Following surgery she was admitted to ITU where she subsequently received treatment for acute kidney injury.

A microbiology report revealed the presence of Streptococcus group A.

The claimant remained in the hospital until discharge on 10 July 2014.

Our client’s experience

It is the claimant’s case that, because of the negligence, she developed systemic sepsis, acute kidney injury, required total hysterectomy and salpingo-oophorectomy and spent 12 days in ITU and 13 further days in hospital.

The claimant’s recovery was prolonged. She sustained post-traumatic stress disorder and required care and assistance both for her herself and for her children. Because of the acute kidney injury, the claimant developed stage 3a chronic kidney disease, is likely to develop symptomatic kidney disease at around the age of 60 years, and has a reduction in life expectancy of around six years.

Where negligence occurred

The claimant brought an action against the defendant alleging that its staff were negligent due to the failure to have regard to the claimant’s evolving signs and symptoms of infection. In particular, the defendant failed to arrange medical review on a number of missed opportunities on 13 and 14 June 2014 and discharged the claimant when it was unsafe to do so. In addition, the defendant failed to review the claimant within 30 minutes of her arrival at the hospital on 15 June.

The claimant's case with regard to causation was that if, at any point prior to 0950 on 14 June, the defendant had investigated and treated the claimant’s infection, including treatment with intravenous antibiotics, supportive therapy and surgery as necessary, the claimant would have made a good recovery and would have avoided total hysterectomy, salpingo-oophorectomy, systemic sepsis and acute kidney injury.

The defendant admitted that all reasonable obstetricians should have suspected sepsis given the findings described at review at 0615 on 14 June, but this would have resulted in treatment with oral antibiotics only. With adequate care, the claimant would have avoided the need for oophorectomy and her recovery would have been less protracted. However, the defendant argued that even with adequate care, the claimant would still have required a hysterectomy to control the infection and she would not have avoided her acute kidney injury.

Shortly after service of the defence, both parties agreed to a settlement for the sum of £250,000.