Court dismisses negligence claim over traumatic birth at Falmouth Hospital

A High Court judge has dismissed a medical negligence lawsuit brought on behalf of a now-teenage girl who was left with a permanently damaged right arm and other complications following a traumatic birth at the Falmouth Public General Hospital in Trelawny in 2009.

In a written judgment, Justice Tania Mott Tulloch-Reid ruled that the claimant failed to provide the expert medical evidence required to establish that the hospital staff breached the accepted standard of care.

The lawsuit was filed in July 2019 against the attorney general by the child through her mother and next friend, A.S. The claim alleged that negligent care during delivery caused severe and permanent injuries.

According to the mother, hospital staff failed to exercise reasonable care and skill during labour, did not properly identify that the baby was in a breech position or experiencing shoulder dystocia, failed to treat shoulder dystocia as an obstetric emergency, delayed treatment, did not summon a specialist, and failed to advise her during prenatal care of the risks involved or the option of a Caesarean section.

She contended that as a result, her daughter suffered oxygen deprivation, respiratory distress, paralysis of the right arm, a brachial plexus injury known as Erb’s Palsy, and cognitive and behavioural challenges

Significantly reduced prospects of a happy and normal childhood and restrictions in her activities of daily living for the remainder of her life as well as limitations in the scope of employment opportunities were also included.

During the trial, the mother testified that after being discharged from hospital on October 6, 2009, she returned the next morning in labour. A nurse discovered that the baby was coming feet first and attempted to manage the delivery, but difficulties arose. She said the baby’s body was eventually delivered, but the head became stuck. After 10 to 15 minutes, a doctor arrived and placed her “down to the edge of the bed” and pulled the baby out.

Upon delivery, the mother said the baby was not breathing or crying. When she later saw her daughter, she observed that “her right arm was not moving and was just hanging from her side”.

The claimant relied on evidence from consultant orthopaedic surgeon Dr Christopher Rose and consultant neurosurgeon Dr Randolph Cheeks, who both linked the injuries to excessive pulling during delivery and that no surgery or treatment could correct the damage. However, both doctors acknowledged that they were not qualified to give evidence on obstetric standards of care.

Her attorney, Katherine Minto, argued that the baby’s shoulder and head becoming stuck constituted shoulder dystocia, an acute, life-threatening obstetric emergency. She contended that excessive traction was used in attempting to resolve the emergency, resulting in tearing of the brachial plexus nerves and permanent paralysis of the right arm.

Minto submitted that any delivery technique involving excessive force could not reasonably be regarded as an acceptable standard of care in managing shoulder dystocia.

The attorney general conceded that shoulder dystocia occurred but denied that its management caused the injury. The State argued that the delivery was complex, involving a footling breech presentation and delayed labour, and maintained that the care provided met accepted medical standards. The defence also pointed to the absence of evidence from hospital records or staff indicating negligence.

Meanwhile, the court heard in the witness statement from psychologist Dr Kai Morgan, who assessed the child, that her deteriorating behaviour had led to her expulsion from school and being home for half a term. Morgan’s report indicated that the child requires placement in a special needs school, which typically entails high fees, and she continues to receive therapy at the University Hospital of the West Indies.

While the mother shared that the child lacked self-awareness, suffers from outbursts, and is on medication due to these outbursts, she was placed in state care from February 2024 to January 13, 2025, and is currently under two years of supervision following involvement with the Family Court.

Justice Tulloch-Reid emphasised that under the Bolam and Bolitho principles governing medical negligence, the court had to consider whether the actions taken were in line with what a responsible body of obstetric opinion would regard as reasonable. She found that only an obstetric expert could properly address that issue, and none was called.

While acknowledging the severity of the child’s injuries and the challenges she faces, the judge stressed that sympathy could not replace proof. As a result, the claim was dismissed.

The attorney general was represented by attorneys Stewart Stimpson and Rykel Chong, instructed by the director of state proceedings.

tanesha.mundle@gleanerjm.com