Instructions were received to represent a child who suffered a serious nerve injury to their left arm during a complicated delivery. The Defendant disputed both the standard of care provided during the birth and whether the actions of the clinicians had caused the injury. Following extensive medical and rehabilitation evidence and preparation for a six-day trial, the claim was settled at mediation for £600,000. The settlement was subsequently approved by the Court.
Summary
The Claimant was born at 36 weeks following a delivery complicated by shoulder dystocia, a condition in which a baby’s shoulder becomes trapped after the head has been delivered.
The Claimant was subsequently diagnosed with a serious brachial plexus injury affecting three nerve roots in their left arm. The brachial plexus is a network of nerves that carries signals between the spinal cord and the shoulder, arm and hand. Damage to these nerves can affect movement, strength and function, with potentially lasting consequences for independence and everyday activities.
The Defendant disputed liability and causation throughout much of the claim, maintaining that the injury had resulted from the forces of labour rather than negligent clinical management. Following extensive expert investigation and preparation for a six-day trial, the case was resolved at mediation for £600,000, subject to Court approval.
Context
The allegations concerned the management of the delivery after shoulder dystocia became apparent.
It was alleged that appropriate assistance was not called promptly, recognised techniques for resolving the complication were not properly used, and excessive traction was applied during the delivery. These allegations were central to the Claimant’s case that the injury could have been avoided had the delivery been managed appropriately.
The Defendant accepted that the Claimant had suffered a brachial plexus injury but argued that it had resulted from the forces of labour rather than the actions of the clinicians involved. The key issue was therefore whether the injury had been caused by negligent management of the delivery.
The consequences for the Claimant were potentially lifelong. Expert evidence confirmed permanent impairment affecting the C5, C6 and C7 nerve roots, which contribute to movement and function in the shoulder and arm. The evidence also highlighted the importance of considering how the injury might affect the Claimant as they grew, including their rehabilitation requirements, functional abilities and need for ongoing specialist support.
Challenge
The case involved a fundamental dispute about what had happened during the delivery and what had caused the Claimant’s injury.
The Defendant filed a Defence denying both breach of duty and causation. It maintained that the attending midwife had acted reasonably and disputed the allegations of excessive traction and inappropriate technique, arguing that the injury had resulted from the forces of labour rather than the way the delivery had been managed.
Court proceedings were issued, factual witness statements were exchanged and the matter was listed for trial in November 2018. The parties also had to manage the timetable for expert evidence, with the original deadline for service extended from December 2017 into January 2018.
A further complication arose when the Defendant indicated that it had been unable to trace the midwife involved in the delivery. Enquiries with the Nursing and Midwifery Council (NMC) revealed that conditions had been imposed on the midwife’s practice. This information was brought to the Defendant’s attention.
The case therefore required a combination of detailed medical investigation, careful preparation for a contested trial and proactive enquiries to establish the relevant factual background. The central challenge remained proving the Claimant’s case on liability and causation while establishing the lifelong implications of the injury.
Solution
We obtained specialist evidence in obstetrics, midwifery and peripheral nerve injury, alongside detailed evidence concerning the Claimant’s care, rehabilitation and occupational therapy needs.
The medical evidence was updated as the Claimant grew, allowing the team to assess the longer-term consequences of the injury. A specialist peripheral nerve surgeon confirmed permanent impairment affecting at least three nerve roots and recommended ongoing physiotherapy, specialist monitoring and consideration of interventions that might improve the Claimant’s function.
Alongside the expert evidence, the team progressed the litigation, exchanged factual witness statements and prepared the case for trial.
Shortly after receiving information from the NMC, the Defendant invited the Claimant to engage in mediation. Given the disputed liability position and the potential need for a contested trial, mediation provided an opportunity to explore settlement while avoiding the uncertainty, cost and demands of a full trial.
The mediation was arranged at short notice and required close coordination between solicitor, Counsel, the Claimant’s Litigation Friend and the Mediator. Extensive communications took place in advance, with further contact involving the Defendant’s solicitors.
To ensure that the negotiations were informed by the latest assessment of the Claimant’s needs, we disclosed a draft care and occupational therapy report and a draft revised Schedule of Loss on a without prejudice basis late on the day before mediation. Before discussions commenced, the team reviewed the position with Counsel and the Litigation Friend. Counsel presented an annotated valuation setting out the proposed settlement figures and the minimum settlement position considered acceptable, allowing[DM1.1] the team and the Litigation Friend to discuss the advice and establish a clear negotiating position.
The mediation took place on 1 December 2017. The parties reached an agreement to settle the claim for £600,000 gross, plus reasonable costs, subject to Court approval.
Impact
The settlement brought the dispute to a conclusion without the need for the contested trial listed for November 2018.
Because the Claimant was a child, Court approval was required to ensure that the proposed settlement was in their best interests. The Court subsequently approved the settlement and granted an anonymity order protecting the Claimant’s identity.
The outcome followed a combination of specialist medical investigation, preparation for trial, independent factual enquiries and careful mediation preparation. Despite the Defendant’s denial of breach of duty and causation, we continued to develop the evidence, assess the Claimant’s long-term needs and prepare a detailed valuation to support settlement negotiations.
The updated care and occupational therapy evidence, together with the revised Schedule of Loss, helped ensure that the Claimant’s future needs were addressed in the settlement discussions. The agreed compensation provided financial resources to help meet the consequences of the permanent arm injury as the Claimant grew up, including potential rehabilitation, physiotherapy and other support.
The case demonstrates the importance of combining thorough preparation with a clear understanding of a child’s long-term needs. In serious birth injury claims, the work required extends beyond establishing the medical consequences of an injury: it also involves investigating disputed facts, preparing for litigation and ensuring that any proposed settlement properly considers the child’s future.
Taylor Rose’s clinical negligence team helps families pursue compensation following serious birth injuries. We work with specialist experts to understand how an injury may affect a child’s development, daily life and future independence, building the evidence needed to assess their individual needs and support informed settlement decisions.
