Causation

Garcia v East Lancashire Hospitals NHS Trust [2006] EWHC 2062 (QB)

Counsel: For the claimant: Michael Redfern QC, John McNeil For the defendant: Stephen Miller QC, Suzanne Lambert Solicitors: For the claimant: Forbes (Accrington) For the defendant: Hempsons (Manchester)

G brought a claim for clinical negligence against the defendant NHS Trust, which concerned the management of her mother’s pregnancy and labour. G was born 12 days after the date on which she was due, and a cardiotocograph (CTG) had been carried out on a routine basis at various stages before the birth. The CTG traces, over a period of time, indicated significant abnormalities, and when she was eventually delivered by caesarean section, G suffered breathing and other difficulties. It was apparent that at some stage she had suffered a stroke, and G’s long term prognosis was not good. She suffered severe left hemiparesis, learning difficulties and epilepsy. The defendant NHS trust admitted breach of duty in that it had failed to deliver G at least 26 hours sooner. However, the case turned on causation and the issue as to whether G’s injury would have been avoided if she had been delivered at the optimum time. On G’s behalf it was argued that the abnormalities on the CTG traces were an indication of chronic partial hypoxia which had been caused by placental insufficiency. It was contended for G that hypoxic-ischaemia co-existed with the stroke which had been caused as a result of chronic partial hypoxia before her delivery.