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Human Cost: Cerebral Palsy from Birth Asphyxia (r

Demonising doctors for possible errors will make healthcare and medical practice more dangerous, Rotunda Hospital conference told - 12 September 2013

Demonising medical professionals for possible errors in obstetrics and birth injuries will only make healthcare and medical practice more dangerous, a conference on Cerebral Palsy prevention was told today.  Open and honest communication about adverse events was essential for learning and to help prevent further birth injuries within our maternity hospitals.

The remarks were made by Michael Boylan, of Augustus Cullen Law, speaking at a unique conference involving clinicians, families, solicitors and public agencies held today (12th Sept)  in The Rotunda Hospital in cooperation with the State Claims Agency.   

Cerebral Palsy arising from lack of oxygen to the brain at the time of birth is one of the more common birth injuries.  About 6-8 cases each year (10-15%)  of all cerebral palsy cases happen because of asphyxia – and many of them are preventable.  It costs the State on average €45m each year in litigation - equal to the annual budget of a busy maternity hospital.

Dr Sam Coulter-Smith, Master of the Rotunda, said that absence of senior clinicians in labour wards was a substantial contributor to these injuries happening at time of birth.   

"Junior doctors and other personnel lacking the necessary experience and seniority are being asked to make decisions surrounding the birth and the healthcare of the mother and baby.  There needs to be 24/7 cover of labour wards by senior consultants to address this problem.  Given how current consultant contracts are structured whereby they are available only from 8am-8pm, and on-call for the remainder of the time, assembling a team in the necessary time when an emergency arises is sometimes very difficult."

Dr.Coulter-Smith said that the purpose of the conference was to bring together a range of voices across the issue and focus on preventing and reducing the number of cerebral palsy injuries due to birth asphyxia every year. 

The cost in human terms of cerebral palsy is enormous for the children and their parents.   The conference heard from William and Kay Dunne, whose child, William, suffered cerebral palsy when he was born in Holles Street in 1982.  They talked about what had occurred and their experience of the legal case they took - the first birth-related medical negligence case in the state.

Dr Peter McKenna, Clinical Director of the Rotunda, said the Dunne's testimony was essential to building understanding and approach to birth injuries for medical professionals.   He acknowledged that the Dunne's story may well make medical professionals uncomfortable, but more importantly, it would make them think.

"If we're so smart, how come we cost so much? Cerebral Palsy litigation cases make up the smallest number of cases brought against the State Claims Agency, but they represent the biggest cost, (60%) because of the injuries involved, and the length of time taken to resolve the cases.  We have to be able to improve on that, both in reducing the human cost for children and their families, as well as the costs to the State," he said. 

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