Maternity Claims

1
Maternity Claims

• Chris King
• Technical Claims Manager, NHSLA
• 11th 18th March 2009
• John Mead
• Technical Claims Director, NHSLA
• 19th March 2009

2
Maternity Claims

• Placental abruption leading to heavy vaginal
  bleed
• Transfer by ambulance, arriving at AE by 0016
• Not triaged until 0033 despite heavy bleeding
• Not transferred to maternity unit until 0045
• Delivery by caesarean section at 0130
• Standard 4, criterion 10 - Admission to Emergency
  Department

3
Maternity Claims

• Failed attempt at delivery using forceps
• Failed attempt at delivery using Ventouse
• Second failed attempt at forceps delivery - cord
  prolapse and severe bradycardia
• Eventual delivery by emergency caesarean section
• Standard 3, criterion 3 - Operative Vaginal
  Delivery

4
Maternity Claims

• Midwifery led unit with support from GP
  obstetricians and Trust anaesthetists
• Sudden deterioration in foetal heartbeat
• Vaginal delivery in poor condition
• Delay in resuscitation - intubation at second
  attempt
• Standard 5, criterion 2 - Neonatal Resuscitation

5
Maternity Claims

• Pre-eclampsia
• Fit followed by heart attack - 20 minutes cardiac
  arrest
• Failure of medical and nursing staff to react -
  panic
• Crash team unable to gain access to maternity
  suite - change of door code
• Standard 1, criterion 10 - Skills Drills

6
Maternity Claims

• Trial of scar following previous caesarean
  section
• Syntocinon
• Uterine rupture and delivery by emergency
  caesarean section
• Standard 2, criterion 5 - Use of Oxytocin
• Standard 2, criterion 3 - Continuous Electronic
  Fetal Monitoring

7
Maternity Claims

• Fifth pregnancy
• Fibroid discovered during course of third
  pregnancy
• Booking in summary prepared without review of
  earlier records
• Standard 4, criterion 3 - Clinical Risk
  Assessment (Antenatal)