Stewarts act for C, a seven-year-old girl who sustained life-changing injuries caused by Group B Streptococcus Meningitis, which developed shortly after her birth. Interim payments have been secured for C, whilst the claim is stayed to allow her long term prognosis to be determined.
Amy Heath reviews C’s case to date.
C was her parents’ first baby. C’s mother had an uneventful antenatal period but for the diagnosis of gestational diabetes at 29 weeks.
In view of her gestational diabetes, C’s mother was admitted for a planned induction of labour at 38 weeks. The induction took place, and C was born at 6pm on the following day with the assistance of a ventouse. When C was born, she was in a poor condition and required resuscitation.
Following resuscitation, C established regular breathing and was transferred to her mother for skin-to-skin contact. C was noted to be grunting, and there was a plan to review her in 15 minutes.
At 6.45pm, a paediatric review took place, which erroneously recorded that there had not been a prolonged rupture of membranes. In fact, they had been ruptured for 20 hours by the time of C’s birth. The paediatrician recorded a plan to monitor C overnight.
C had difficulty feeding overnight and was not interested in breastfeeding. By 8.45am the next morning, her temperature was 36 degrees, and she was noted to be pale. Skin-to-skin contact was advised. At 9am, a paediatrician reviewed C due to her low temperature and was immediately concerned. C was referred to the neonatal unit, where probable sepsis was diagnosed.
C deteriorated and required intubation. Further investigations confirmed a diagnosis of Group B Streptococcus Meningitis.
A claim was brought against the hospital trust for a failure to recognise that C had two clinical indicators present at birth, which, according to its own guidelines, mandated a partial septic screen and commencement of antibiotics within one hour. In addition, there was a failure to carry out appropriate observations and a failure to recognise the significance of C’s reluctance to feed overnight.
Following its investigations, the trust made full admissions of liability in its letter of response, along with an apology. The trust conceded that its own guidelines had not been followed: a partial septic screen should have been performed following C’s birth and intravenous antibiotics given. Had they been, C would not have developed meningitis.
C has profound injuries. She has global developmental delay, cortical visual impairment and a sensory processing disorder. C has profound impairment of communication and is hypersensitive to loud noises, which cause her to become distressed. She has significant care needs both at home and in the community. The unpredictable nature of the outside world can cause C to become dysregulated, leading to her challenging behaviour and potential flight risk. At home, C requires help with all her personal care and is doubly incontinent.
Interim payments have been obtained for C to allow her family and deputy to appoint a case manager. The support provided by the case manager has been invaluable. She has supported C’s family to find appropriate therapists to manage C’s complex needs, recruited support workers and set up a care package for C. She also liaises with C’s specialist school and the local authority to ensure C’s needs are being met.
With the help of interim funding, specialist equipment has been purchased for C on the advice of a specialist occupational therapist. In future, a house purchase is planned to allow C sufficient space for a sensory room with suitable equipment as she grows and to provide room for her support workers.
Communication has been a major challenge for C, and enabling C’s communication will be key to improving her quality of life. C was non-verbal when a speech and language therapist and occupational therapist first became involved. With their input, C is now developing some communication at home with her family and support workers. Being able to communicate her needs will have lifelong benefits for C.
C’s long-term prognosis and needs cannot be determined at this stage. Her claim will therefore be stayed for a number of years so her development can be reviewed. During this time C will continue to have access to interim payments to ensure her ongoing needs are met.
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