Girl (7) might not have brain injury if delivered 10 minutes earlier, court hears

A girl with cerebral palsy would probably not have suffered any, or any severe, brain injury had she been delivered ten minutes earlier, it has been claimed before the High Court.

Faye Walsh, now aged seven, has, through her mother Martina, of Letterfrack, Co Galway, sued the HSE and two consultant obstetricians alleging negligence and breach of agreement in relation to the management and circumstances of her birth.

The child was born at University Hospital Galway on August 15, 2011.

The defendants deny the claims against them in proceedings before Mr Justice David Keane.

Mrs Walsh, for the purpose of her pregnancy with Faye, was a private patient of Dr Una Conway, a consultant obstetrician.

Dr Conway and Dr Declan Egan, the second defendant obstetrician, operate private medical practices at Brooklawn Practice, Brooklawn House, Galway West Business Park, and also practice as consultants in the Galway hospital.

Mrs Walsh wanted a private obstetrician at the birth for reasons including she had one previous birth by casearean section and had suffered serious abdominal injuries in a road accident in 2008, the court was told.

The HSE denies negligence and pleads delivery of the baby by Kiwi cup – vacuum assisted delivery using a plastic or metal cup attached to the baby’s head – was reasonable. It also pleads delivery was not unreasonably delayed.

A core dispute in the case concerns the birth arrangements and whether the risks of a vaginal delivery were fully explained. The defendant obstetricians say the options and risks were explained, that Mrs Walsh wanted and agreed to a vaginal delivery, and that was a reasonable course of action.  

Mrs Walsh claims she understood Dr Conway was on annual leave in August 2011 and would be unable to attend the birth but was told Dr Conway and Dr Egan worked “as a team” and Dr Egan would attend. 

The defendants deny Mrs Walsh was told Dr Egan would attend and claim she was provided with a Brooklawn practice information sheet stating, in the absence of Dr Conway or Dr Egan, her delivery would be supervised, for an additional fee, by a covering consultant obstetrician on call for the hospital. 

The plaintiff claims, despite alleged requests by Mrs Walsh and her husband, neither defendant obstetrician was called to the hospital when or after Ms Walsh went into labour about 11pm on Sunday August 14, 2011.

The court heard the on call hospital obstetrician was summoned to the hospital from his home around 4.30am on August 15.

An obstetric registrar was also called and applied a Kiwi cup to the baby’s head. The on-call obstetrician, noted to be present at 4.50am, completed the delivery of the baby at 4.55am.

Faye was born in very poor condition and required immediate resuscitation. She has spastic quadriplegia, is non verbal, a full time wheelchair user and will require 24 hour care for the rest of her life, the court heard.

Most of her care is provided by her parents and she is a “happy, content and smiling child” who gets on well at her community primary school and loves the TV cartoon Peppa Pig, the judge was told.

Opening the case, Denis McCullough SC, for Faye, said their claim was, had one of the defendant obstetricians attended the labour, Faye would have been “promptly rescued” and an urgent forceps delivery completed within ten minutes of a decision to do so. Their case was that would have saved the baby at least ten minutes of hypoxic ischemia and, according to his side’s experts, left her “uninjured or virtually uninjured”.

Mrs Walsh was in pain after delivery and surgery was carried out during which a uterine scar rupture, a “well recognised risk” of vaginal delivery after an earlier CS delivery, was repaired, he said. It is believed that rupture caused profound hypoxic ischemia which damaged the baby, he said.

The case is expected to last a number of weeks.

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