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Routine checks identified that Emma was diabetic, had a high
body mass index, carried an abnormal haemoglobin variant in
the form of sickle cell trait and was a light smoker. However,
these conditions were not cause for immediate concern and
her pregnancy continued as normal for 7 months.
On 8 October, Emma experienced stomach cramps. The NHS Direct
helpline referred her to her GP who suggested by phone that
Emma had indigestion and should take milk of magnesia. This
had no effect so, the next day, Emma visited the doctor in
person who found her blood pressure was unusually high, that
she was suffering from abdominal discomfort and nausea with
some frequency of bowel motions. The GP prescribed Gaviscon
antacid and asked Emma to return the next day to review her
blood pressure. When Emma did return (on 10 October), her
blood pressure was still high so her GP referred her to Northwick
Park Hospital where she immediately went.
At the hospital, Emma was seen by midwives who performed tests
which confirmed that her blood pressure was high and that
there was protein in her urine. It is relevant at this point
to note that Emma was not seen by doctors and that the midwives
failed to spot that she displayed the four signs of pre-eclampsia,
a condition that threatens the lives of both an unborn baby
and its mother. These signs are: a first pregnancy, diabetes,
high blood pressure and protein in the urine. The midwives
did not perform an ultrasound scan which would have revealed
restricted foetal growth, another symptom of her condition.
In addition, Emma claimed that from this point on there should
have been senior involvement, of at least Specialist Registrar
if not Consultant level in order to fully manage her problems
during pregnancy.
Emma was sent home with a request to return the next day for
continued tests. The next day (11 October), in addition to
stomach pain, Emma also suffered from fever and sweating.
She remained in bed with severe pain which caused her to pass
out a number of times. She continued to take her antacid,
but with no effect. Her condition meant that she could not
make her appointment to return to the hospital.
On 12 October, Emma's pain was such that she asked to return
to the hospital. She was sent to the delivery suite where
tests again revealed high blood pressure and protein in her
urine. On this visit she was seen by a doctor who concluded
that Emma was suffering from gastritis. Further antacids were
prescribed together with paracetamol and an acid blocker.
She was then discharged. The hospital failed to appreciate
her increased symptoms of pre-eclampsia and missed the opportunity
to diagnose the condition and take action. Whilst pre-eclampsia
can worsen rapidly, the hospital relied on blood tests that
were 48 hours old rather than taking new blood tests during
this visit. Emma should have been admitted at this time.
As Emma's pain continued, she attended her routine antenatal
diabetic clinic on 15 October where her blood pressure and
urine were checked. The midwife suggested here that Emma's
pain could be caused by a stomach ulcer. Emma alleged that
the midwife should have appreciated the symptoms of pre-eclampsia
and admitted her to hospital.
On 17 October, C was still in pain. She spoke to her doctor
who asked her to visit the surgery. However, the pain was
such that Emma was unable to move. She decided to wait until
her next antenatal appointment on 22 October.
At this appointment, a scan revealed that Emma's baby had
died. It also showed evidence of foetal growth restrictions
and that there was no fluid around the baby. Emma was transferred
to Northwick Park Hospital for induction. During this stay,
apparently, she was neglected for excessive amounts of time
(induction occurred two days later on 24 October) and that
during the birth she was only attended by a nervous trainee
midwife.
Additional issues arose in connection with the burial of Emma's
baby. She had agreed that the hospital should make burial
arrangements. The hospital did this and buried the baby in
a public plot. Emma was not aware that this would be done
and issues arose regarding exhumation and reburial
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Legal Proceedings
In November 2003, Emma instructed Charles Russell to bring
a claim for Clinical Negligence against the Trust. She was
granted a certificate of public funding to pursue her claim.
Chronology of case
Emma's claims as detailed above were set out in a Letter of
Claim issued on 6 December. A Letter of Response was received
on 24 February. In its response, the Trust accepted all of
Emma's claims apart from that relating to the failure to provide
senior involvement of at least Specialist Registrar level
on 10 October. The Trust claimed that Emma did in fact see
a Staff Grade doctor on that day. Despite this disagreement,
the Trust accepted that, on a balance of probability, Emma's
baby could have been saved if she had been monitored correctly.
Both parties instructed Psychiatrists to prepare reports on
Emma's current condition and future prognosis.
On 3 August 2005, Emma put forward a part 36 offer in the
sum of £120, 000. In December 2005 an interim payment
of £2,400 was made by the Defendants to cover the cost
of Emma's counselling and they rejected the offer of £120,000.
The Defendant's put forward a counter-offer of £40,000
on 1 March 2006. This was rejected by Emma and a further counter-offer
of £65,000 was put forward by her on 2 May 2006. The
Defendants then increased their offer to £47,400 (inclusive
of the interim payment) on 15 May 2006. The parties settled
the claim at £50,000 on 24 May 2006.
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