Life after settlement: one year on from settling a £10.96 million claim for a child with cerebral palsy

A year ago, the clinical negligence team at Penningtons Manches Cooper achieved a successful settlement for an 11 year old boy who suffered brain damage arising from his mother’s antenatal care at St George’s Hospital in London. He was diagnosed with cerebral palsy with extensive periventricular leukomalacia (PVL) at 14 months of age.

Background to the claim

His mother attended hospital on 21 May 2012 with preterm premature rupture of membranes (PPROM) at 30+5 weeks’ gestation. In accordance with the defendant hospital trust’s own guidelines, she was not prescribed antibiotics. She developed chorioamnionitis (intra-amniotic infection) and went into labour at 31+3 weeks. The claimant suffered PVL and was subsequently diagnosed with cerebral palsy and visual disturbance. 

We obtained expert evidence demonstrating that the claimant’s mother should have been prescribed antibiotics (erythromycin) for 10 days following the PPROM in accordance with the Royal College of Obstetricians and Gynaecologists (RCOG) guidelines, to prevent infection. Had erythromycin been prescribed, our experts confirmed that it would likely have prevented the fetal inflammatory response resulting from chorioamnionitis, in turn avoiding the brain damage caused by PVL. 

The defendant denied that it was a breach of duty to fail to prescribe erythromycin; this was a deliberate decision taken in accordance with their own guidelines and following the results of a clinical trial comparing use of antibiotics with placebos for women with PPROM and no signs of infection. The defendant also denied that prescribing erythromycin would have avoided the claimant’s brain injury, as it was more likely that he had already suffered the injury before his mother’s admission at 30+5 weeks’ gestation. 

The claimant’s condition

The claimant, now aged 12, lives with bilateral spastic cerebral palsy (GMFCS level 4), with his legs being more affected than his arms. He cannot walk independently and instead uses a walker and a wheelchair. His severe squint at birth was surgically corrected, though he still has an alternating right sided squint and wears glasses. The claimant has learning difficulties, issues with executive functioning and impaired social interaction, and his behaviour can be difficult to manage, with emotional outbursts. He needs specially adapted accommodation and round the clock care, along with various therapies and treatments. 

Settlement 

This was a very difficult case to prove on liability, which was ultimately settled with the claimant agreeing to accept 50% of the damages as assessed by the court. We negotiated a settlement without the need to go to trial, for a total sum of £10.96 million, which included a lump sum of £4.1 million, along with lifelong annual payments for care and case management. As the claimant is a minor, his settlement is being managed by a deputy.

What the settlement has achieved

Now a year following settlement, we caught up with the claimant’s mother to see how their lives had changed following the award of damages.

At the time of settlement, the claimant and his family were living in a two-bedroom maisonette, which was too cramped for him to mobilise using his walker or wheelchair, and did not have enough space to store his equipment. The family identified a suitable property last year, which they purchased with the help of the deputy. It has now been specially adapted to meet the claimant’s needs and they have recently moved in. The claimant’s living space, including a bedroom and ensuite bathroom, is on the ground floor. His bathroom is set up as a wet room with a height adjustable sink. He has a playroom downstairs along with a therapy room; he also has a low profiling bed, and a hoisting system which has been set up in the bedroom and bathroom. He is reported to be very happy in his new house and has adjusted well. 

The claimant’s parents are delighted that since the house move he is now willing to use his walker by himself without encouragement, and wants to use it to walk everywhere. Before the move he was reluctant to use the walker, but now he has the space to use it without restrictions, he is much more confident. The kitchen and living room are open plan, which allows the claimant’s parents to supervise and interact with him whilst they cook meals, making the routine at home much easier for them to manage. Now that the house has been adapted, a care team will be employed shortly. 

The claimant has also received an Innowalk – a piece of equipment resembling a cross-trainer which enables supported movement for those with limited ability for independent movement. His mother says that it has been amazing. He incorporates it into his daily routine and she has noticed a huge difference in his confidence when mobilising, along with improvements in his fitness and digestion. 

Frequent input from a physiotherapist and an occupational therapist is given to the claimant, and he is now able to use his therapy room to do his daily stretching exercises. The claimant is also seeing a psychologist regularly, which his mother reports is working really well. He is learning to manage his frustration and anger and is beginning to better recognise his emotions.

The claimant began at a local SEN school last year. His mother reported that it took a bit of time for him to adjust, but he is now very happy. Every day he leaves school beaming. He is growing more confident, and coming out of his shell. Although he still prefers adult company, he is making friends. He particularly enjoys swimming, which he does every other week. 

“It has been a very intense year since settlement”, the claimant’s mother says. “We didn’t realise the impact of finally having a suitable property. Before, we were so limited, and it made a huge contribution to my son’s frustration. When you can’t really move around, the power is taken away from you. My son is building up more independence and now wants to use his walker which is amazing to see. This settlement has opened up so many more opportunities for us as a family. Seeing my son thriving and living a more fulfilled life is all we have ever wanted, and now with this settlement his future is much brighter. Thank you!”

Rosie Nelson, senior associate in the London clinical negligence team, comments: “It is wonderful to see the impact a settlement of this kind can make. I am delighted to hear how the claimant is progressing well in his new home, where he is able to grow more confident and independent.”

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