Hospital not negligent in the monitoring of premature baby’s breathing

Hospital not negligent in the monitoring of premature baby’s breathing

In the case of Aspinall v Secretary of State for Health (2014) allegations were made of negligent hospital care following the premature birth of a baby at 32 weeks.

At 9.55 pm on 8th April 1982 John Apinall (the Claimant) was delivered prematurely by caesarean section at a hospital for which the Defendant had legal responsibility. The Claimant was born in a poor condition and showed no signs of life other than a slow heart rate. He was intubated, successfully resuscitated and transferred to the Special Care Baby Unit. Over a 45 minute period between 11.30 pm on the 8th April and 12.15 am on the 9th April the Claimant deteriorated to a perilous state. It was common ground that his ventilation tube had slipped out of position by 12.15 am. Although the tube was reinserted and the Claimant received intensive care, he developed hyaline membrane disease (a stiffening of the lungs) and at some point suffered a bleed in the brain. The resulting brain injury left him with asymmetric diplegic cerebral palsy, cognitive, behavioural and physical problems, and epilepsy.

The Claimant’s case was that although he had stopped breathing at about 11.30 pm, the attending doctor failed to check or otherwise notice that his chest was not moving in time with the ventilator over the crucial 45 minute period. According to the Claimant’s medical expert, it was probable that the ventilation tube had slipped out of place by 11.30 pm and the Claimant only survived because he received a small amount of oxygen from the displaced tube.

Dismissing the claim, the High Court held that the doctor had not been negligent in treating the Claimant between 11.30 pm and 12.15 am. The theory of the Claimant’s medical expert was no more than speculation. A more likely theory was that the ventilation tube had become dislodged in a non-negligent way nearer to 12.15 am when the doctor checked it for secretions. It was almost inconceivable that the doctor and nurses in the Special Care Unit could have monitored the Claimant over 45 minutes without noticing that his chest was not moving.

The Court concluded that there had been no breach of duty and, in any event, the alleged breach did not cause the very sad outcome.