Joanne’s Story: Multiple failures led to obstetric haemorrhage

Our client, a woman who was left needing multiple blood transfusions after medics failed to appreciate the risks she faced during her pregnancy, has settled her medical negligence claim against the defendant trust.

Timeline of events

Summer 2016

Joanne, who was in her early 30s at the time, found out she was pregnant with her fourth child. She was booked for consultant-led care as she had previously had three caesarean sections.

Winter 2017

Joanne visited the hospital due to headaches and visual disturbances. A medical examination came back normal, so she was discharged.

A couple of weeks later, Joanne had her first ultrasound, which recorded a major placenta praevia (where the placenta attaches low in the uterus). There was a discussion about the increased risks of childbirth and post-partum haemorrhages and the possibility of a hysterectomy. As a result, her booked C-section was brought forward and a course of antenatal steroids was administered.

Spring 2017

Joanne was seen with a history of vulval and abdominal discomfort. The examination came back fine and a CTG was noted to be reactive. Joanne was advised to return if the pain increased or she had any vaginal bleeding. Further ultrasound scans and CTGs took place over the next couple of weeks, which returned normal. A review of Joanne’s final ultrasound scan incorrectly noted that Joanne’s placenta was now low-lying.

The following month, Joanne attended the hospital for her booked C-section, which was performed under spinal anaesthetic. The operation notes indicate that the placenta was low-lying and described as percreta, which is when it attaches itself and grows through the uterus.

A consultant attended and identified that the bladder was friable and during its dissection from the uterine wall, it was perforated, which resulted in blood loss. A few hours after the surgery, Joanne’s blood pressure was low and the anaesthetist commenced a plasma expander. She has had two units of blood transfused.

A few hours later, the emergency buzzer was activated as Joanne was suffering from severe vaginal bleeding. She was returned to theatre and an interventional radiologist made the decision to proceed to hysterectomy to stop the bleeding.

The estimated blood loss was around 13l and in total, 16 units of blood were administered, along with nine units of plasma, two bags of platelets and five units of cryoprecipitate. Joanne was transferred to the intensive care unit post-operation.

Her recovery was complicated by an ileus, which was treated with a nasogastric tube. In addition, she suffered bed sores. She was discharged 10 days after giving birth.

How Lime Solicitors helped Joanne’s case

We issued a letter of claim outlining the multiple failures to the defendant trust, which admitted breach of duty and apologised for the care Joanne had received.

We then prepared a detailed schedule of loss in line with the expert evidence and quantified the case. An out-of-court settlement was secured.

A note from Natalizia Capizzi

“There was a failure to appreciate that Joanne had a major degree of placenta praevia and, as she had three previous C-sections, there was a significant risk of placenta accreta. Given the risks she faced, and as it is noted in her records that she had mentioned being sterilised, Joanne should have been strongly advised to undergo an elective caesarean hysterectomy.

“As this would have occurred as a primary procedure, she would have sustained significantly less blood loss. She would have still required a transfusion, but would have avoided the extensive obstetric haemorrhage, the need for a second procedure, admission to the intensive care unit, prolonged recovery and time away from her newborn. Ultimately, the delivery would have been less traumatic and more controlled.”