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GBS awareness month 2016: Undiagnosed GBS clinical negligence case study

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    In the last of our series of blogs for GBS awareness month, Kerstin Kubiak looks at how we investigate a clinical negligence claim involving a failure to diagnose and treat GBS infection in a neonate using a real case example.

    By Kerstin Kubiak

The charity GBS Support seeks to highlight in their awareness month information and guidance on GBS (also known as Group B Streptococcus and Group B strep) to expectant mothers and medical staff. This is in an effort to encourage women to get tested for GBS infection so that, if they test positive for the infection, they can be properly treated during labour in an effort to avoid their newborn becoming systemically unwell due to this acquired infection.

This blog follows those of my colleagues who have written about the charity’s “Why guess when you can test” campaign, the current guidelines for testing and treatment of GBS infection, and the impact that undiagnosed GBS infection can have.

This case study explains what went wrong in the medical care of one expectant mother with GBS infection and the consequences suffered by her newborn son as a result of medical failures. The names of the child affected and his family have been changed in order to protect their identity.

The circumstances of the case:

John’s mother was at term in her pregnancy when she attended a hospital local to where her partner was working, a different hospital to where she lived and her pregnancy was being managed; the hospital took a high vaginal swab and discharged John’s mother as she was not in established labour. The following day John’s mother went to her own maternity unit in labour and on admission was noted to have a fever. She informed the hospital of her admission the previous day to a different unit but no efforts were made to contact them to check on the test results. Had they done so they would have been advised of a positive (very high level) test result for GBS.

In addition to this failure in communication, the maternity unit failed to place John’s mother on intravenous antibiotics to treat her very high temperature. They also failed to give antibiotics to John after he was born in light of the fact that he was likely to have been exposed to the infection which had caused his mother’s high temperature in labour (which had not been treated).

After John was born he was discharged from hospital. The following day he showed signs of distress and was rushed into hospital. A lumbar puncture revealed that he was suffering from meningitis subsequent to GBS infection. He went on to suffer a significant brain injury and was diagnosed with cerebral palsy.

John’s injuries mean that he will be dependent on 24 hour care for the remainder of his life and he will be totally wheelchair dependent once he reaches early adulthood. He will be unable to obtain employment and will not have capacity to manage his own financial affairs.

How the case was investigated:

John’s parents approached me for assistance when John was 6 years of age, as they were desperate for help in caring for him. We were able to secure legal aid funding to investigate the claim and obtained independent medical reports from an obstetrician, midwife, neonatologist, microbiologist, paediatric neurologist and neuro-radiologist. The experts confirmed that, in their opinions, the hospital was negligent in failing to ensure John was treated with antibiotics after his birth and if he had been his meningitis and brain injury would be been entirely prevented.

We served a Letter of Claim on the hospital setting out the allegations of negligence against them; the hospital then investigated the allegations and admitted liability in full for John’s injuries.

We were successful in securing compensation of £3.25 million for John alongside annual periodical payments for the remainder of his life for the costs of his care, which will increase to £208,000 per year when he reaches 19 years of age and has left full time education. This settlement will ensure that John has access to suitable and specifically adapted accommodation, care, therapies and anything else he needs for the rest of his life.

John’s family would have done anything possible to have preserved the health of their child; they felt they needed to pursue a claim on his behalf to ensure John would be well cared and provided for into his old age.

This case demonstrates how a simple failure to prescribe low cost antibiotics can have such a devastating impact on a child and his family.

We fully support Group B Strep Support’s campaign and have tried to do our part this month by raising awareness of this infection, the simple test available and importance of preventing the infection from passing to newborn babies.

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