Medical negligence - what to expect?

[Minimalme]

I haven't a clue what I'm doing really but I can't let this lie until I have found out the truth.

My ds is 12 with ASD and an IQ under 70 (diagnosed learning disability).

I have just found out something related to his birth by CS which may have caused his disability.

I have requested his birth notes and contacted medical negligence lawyers who are looking at the details and will decide if there is a case.

I have no idea if the events which I want examined would have been recorded on the birth notes?

I imagine the most likely outcome is that I just get on with life always wondering if by choosing a CS, I basically ruined my child's life?

If I had known the risks I would never have agreed to a CS. They explained the maternal risks very fully but never that my baby could be harmed. I have had three CS and not once did anyone tell me what I've just learnt.

What do you hope to achieve?

Be very wary of no win no fee lawyers if they then ask for money up front. C sections are very safe, they are only performed where they believe it's safer than natural birth (you'll find dozens of threads complaining how they couldn't get one). Unfortunately things do go wrong with all medical procedures but choosing a c section over natural birth wouldn't be negligence. It's very upsetting having a child with developmental disabilities however you should be looking in the notes for things that actually went wrong due to mistakes rather than the procedure it's self. I'm not sure that's any help but I would also check your source of information about c sections, is it a pro natural birth group?

For balance I have a dd with autism and was born naturally without pain relief ...

I want someone to look at my notes and consider it from a medical perspective. I want to know if my son's disability was caused specifically by the Anaesthetist.

Have you seen the notes yet? Can you ask for a debrief with a senior midwife to unpick the areas of concern, even after 12 years?

Medical negligence lawyer here. Make sure you go to a decent firm. Have a look at APIL or AvMA panel members, the Legal 500 and Chambers and Partners to see who the best firms are. Birth injury cases are difficult and you don't want to go to a firm that is just "dabbling" in Medical negligence. Lots of the good firms have internal nursing/midwifery advisors who can do an initial review of the notes

Could you elaborate a bit more on what you think may have happened during your CS that could have caused his ASD and LD? I'm concerned about you getting taken advantage of by lawyers.
Have you spoken with and got advice from charities that provide support the conditions that he has to help you feel more informed?

Where did you find this new information?

IF there is a case then the solicitor will go through things with you. Wait until that happens, ime they were very clear and helpful and very realistic about the outcome.

What have you just learnt, and where did you learn it?

A good specialist lawyer will be able to tell you if you have a case or not.

It's unlikely a straight forward CS would lead to a learning disability. CSs are less likely to lead to law suits, which is why they are so frequent in the US.

I'm really curious as to what you've found out after 12 years. Was is something specific to his birth or just something more general about C sections and the risk of developing ASD / LDs?

@LynetteScavo

What have you just learnt, and where did you learn it?

A good specialist lawyer will be able to tell you if you have a case or not.

It's unlikely a straight forward CS would lead to a learning disability. CSs are less likely to lead to law suits, which is why they are so frequent in the US.

This would be my understanding too. Far less risk of hypoxia thus far less risk of brain damage, as the baby doesn't travel through the birth canal so won't get stuck.

Thanks for the replies, especially about finding a firm which has access to specialist Midwives to look at things objectively.

What I learnt about CS is that if there is prolonged maternal low blood pressure during the procedure, that can cause the baby to become starved of Oxygen.

I have had three planned CS and the Anaesthetist for the second one was training. He was very under reactive to my low blood pressure and I had to prompt him many times to correct it. The supervising Anaesthetist was stood in the corner of the room on his mobile phone throughout the entire thing.

I was used to low blood pressure during my first CS and experienced it again during my last one but never felt myself loosing consciousness or having to beg for help.

My son's AGPARs were good but he was a very under reactive baby, not crying or wanting feeds. By the time he was 11 months both my husband and I knew something was wrong.

It may be nothing to do with the CS but it is enough of a coincidence that I had a shitty experience with low blood pressure for me to want to find out more.

Also, I had CS because I have uncorrected hip dysplasia on my right side so became very immobile during my first pregnancy.

I chose to have a CS which is why I just need to know. I have always consoled myself that DS is who is was meant to be. The possibility that this life wasn't supposed to turn out this way is killing me.

And also, I know finding out won't make any difference, I love my son and am deeply grateful everyday for him.

But if this is a 'thing', then I don't want it happening to another child.

From my understanding of birth injury it is often lack of oxygen that causes it. But that causes damage to the brain that results in LD and often some degree of mobility such as cerebral palsy.

Do you have evidence of the LD being caused by damaged to the brain that can be as the result of oxygen?

Remember that autism isn't known to be caused by lack of oxygen but those who have brain injury can be diagnosed as autistic (if that makes sense).

My ds has a physical disability (originally thought to be CP but it's a genetic condition) and also autism. He was also born by EmCS but I don't have any records of my BP etc (I did feel fine throughout).

I know if ds did have CP I wouldn't have assumed CS but the kidney infection I had second trimester as it's a known risk factor.

But I also know if I had any thought that the birth itself could have caused brain damage that caused the resulting disability id want it investigated.

So I agree for you to find a reputable firm who will do an initial investigation into whether your ds autism could be a result of birth injury - and look for the evidence of this as a first point of call.

I hope you get some answers and closure.

Thank you @itsgettingweird

If I thought the hospital would take my concerns seriously then I would go down that route, but I don't trust them to be objective.

My ds has an ASD diagnosis at 2.5yrs and while he definitely does have it, I always thought something else was going on. His LD was diagnosed just a few months ago and he also has other physical conditions which I can't find an answer for.

Part of this is sheer desperation for someone to take notice of my son - he has just been rejected (for the third time) for a paediatrician referral via the GP.

It is the NHS' view that they diagnosed him with ASD and that is that. No more help/further examination needed.

You need to push on from that then. Push on from the ASD and LD, what else needs diagnosis?

I get that re "he has asd and therefore everything anything he has well call asd (even if it's not even part of the diagnostic criteria)".

If you want further investigations it's always worthwhile finding the nice guidelines and contacting PaLs at the hospital who refused the referral and pointing out why they should be accepting it.

I do see why you want answers and to explore the possibility, but from what you have said a medical negligence claim isn't what you're after. Have you contacted pals about the lack of referral? A birth reflections appointment? There are impartial routes that might be more fruitful.

How low is low, OP?

With blood pressure, if it's low enough to cause issues, you probably wouldn't be in a position to be prompting the anaesthetist.

Problems with oxygen flow would also likely lead to physical issues such as cerebral palsy which I'm not sure if he has? I'm not sure of an association with low oxygen and ASD, although I could be wrong.

It might be worth an independent review if your notes just to put it to rest in your own mind though.

From knife to skin to delivery will generally be less than 15 mins for an elective section. In utero babies can actually survive certain Levels of hypoxia for some time without being damaged. Labour and vaginal birth for instance is a hypoxic event.

For your BP to have been so low during those 15 mins that it affected your oxygen levels to such an extent that it would affect fetal oxygenation levels to such an extent to cause long term brain damage seems extremely unlikely. You would have been unconscious and there would have been serious concerns about your health.

By all means get the notes reviewed but please as others have said get a reputable firm. I think you might find it hard to prove anything. I also think it’s very unlikely that your decision to have a CS caused this and I hope that maybe by exploring this you can stop blaming yourself.

This.

The time from surgery starting, to baby being delivered, is normally pretty short. It would be unlikely that what you describe would have caused foetal hypoxia sufficient to cause brain damage.

By all means have a chat with a medical negligence solicitor to see if they think you have a credible claim, but I'd worry that the process of initiating legal proceedings would be hugely stressful and might well adversely affect your wellbeing. It is a hugely stressful process and can really affect how people process trauma and move on with their lives. Personally I would only do it if I had a very strong case. With the greatest of respect, I fear you probably don't, and the downsides of taking legal action will probably outweigh any upsides. But take advice from a solicitor, otherwise you'll always be wondering 'what if'.

In what way did you have to prompt the anesthetist because when I had my section she was recording every single blink let anyone anything else?

This is exactly the case medically. We are in the process of a birth injury claim and my advice is to see a medical specialist legal firm like Irwin Mitchell, who would request legal aid if their is a viable case. They have in house experts who would look at the medical notes and give an opinion. Do NOT request them yourselves, as they may go missing or you receive a limited amount. Not paranoia just reality.

If APGARs were good at birth hypoxia would be less likely, and as above the time of reduced oxygenation is important. A baby can withstand no oxygen for 10 minutes and the following 20 minutes will have degrees of injury usually (no always) visible on an MRI scan. A CS is usually relatively quick and oxygen levels would need to be seriously low for an extended period.

By all means ask for the records to be reviewed but please don't blame yourself for something that was unlikely to have caused the issues. I am very much in favour though of learning what happened and what could have been different to give you peace of mind.