A hospital has apologised and agreed a lifetime settlement after 38 issues were found in the care of a baby born with brain damage. Lucas Whitehouse, now eight, suffers from cerebral palsy and development delay after being deprived of oxygen for nine minutes at North Middlesex University Hospital.
But months before then, mistakes were being made when his mum Rebecca, 42, was told he was no longer in the breech position but was denied a scan. And even at the birth when the recommendation was a caesarean as he was in a breech position, a consultant went against hospital policy and delivered Lucas naturally, when the catastrophic injuries occurred.
Following the case, Rebecca and Lucas's dad Dan, 41 have called for lessons too be learned. Lucas is non-verbal and communicates using signs and a communication device. He has cognitive problems and becomes frustrated when he can’t communicate quickly.
During an antenatal appointment at 34 weeks, Mrs Whitehouse was told that her baby was in the breech position, where the baby is lying feet first. At her 35-week appointment, Mrs Whitehouse was advised by midwifery staff that her baby was cephalic, meaning its head was facing down - the correct position for the birth.
At her final antenatal appointment at 37 weeks Mrs Whitehouse requested an ultrasound to confirm the position of the baby, but instead of arranging one, she was advised that she would have a consultation with an obstetrician three weeks later, who would decide whether a scan was necessary.
After Mrs Whitehouse's waters had broken, the midwives performed an examination and believed Lucas was in the normal birth position, even though he was in fact in the breech position. Mrs Whitehouse later had an ultrasound that confirmed that her son was going to be born feet first.
While she was initially consulted and prepared for a caesarean section, the consultant advised that a natural delivery would be the safest option. This advice went against the hospital policy and the Royal College of Gynaecology (RCOG) guidelines that state that a caesarean should have been carried out.
The guidelines also state that the caesarean should have been performed within 30 minutes of Mrs Whitehouse's arrival to the labour ward. Instead, Lucas was delivered an hour and 14 minutes after mum and baby arrived on the labour ward.
As a result of the natural birth, his head was delivered nine minutes after his body, during which time Lucas was starved of oxygen. He had to be resuscitated and after two failed attempts he was intubated after 11 minutes. Circulation was restored at 17 minutes and Lucas took his first breath after 29 minutes.
Despite being able to resuscitate the baby, the lack of oxygen he experienced permanently damaged his brain, resulting in cerebral palsy and global development delay. Mr Whitehouse said: “When Lucas was born he was taken away. We weren’t told anything for two hours and didn’t get to see him for three hours despite repeatedly asking. We knew immediately he was in a really serious condition.
"We had discussed names before he was born and had not yet decided, but we named him immediately after he was born as I was concerned that we may not see him alive again as between the time his body was delivered and his head was delivered his body had turned blue."
Ms Whitehouse said: "After I was told that Lucas was in the breech position I was concerned and raised this at follow up appointments, including at 37 weeks when I was told that I didn’t need a scan as Lucas was not in the breech position.
"After my waters broke medical staff reaffirmed that Lucas was not breech. I recall them saying that his head was engaged and it would not be long until he was born. Despite this I knew something wasn’t quite right and we raised this while I was having contractions.
"However, I put my trust in what I was being told. It was only after nearly four hours when I had the urge to push and nothing was happening that staff started to suspect that something wasn’t quite right.
“Finding out afterwards that Lucas’s injuries could have been avoided if the correct guidelines had been followed and staff were properly trained has been the hardest thing to accept. It’s difficult not to think that when Lucas needed help the most he was badly let down."
North Middlesex Hospital Trust has since admitted liability and subsequently apologised to the family and have agreed on a settlement which will fund the specialist lifetime care, therapies and support Lucas requires.
The Investigation Report by thel Trust found 38 issues and factors in the family’s care.
These included not sending Mrs Whitehouse for a scan to confirm her baby’s position at 37 weeks, a delay in diagnosing Lucas was breech, not following Trust and RCOG guidelines, as well as poor documentation of what happened by all staff.
Training was also highlighted as an area of concern. Mr Whitehouse said: “Natural deliveries of breech babies can happen safely with staff that are properly trained and do a great job.
"We just believe that mums should be aware of all of the pros and cons so they can make the most informed decision about what’s best them for in their particular circumstances and that training for breech births across the NHS needs to be made consistent."
Auriana Griffiths, the expert medical negligence lawyer at Irwin Mitchell representing the family, said: “This is a tragic case which resulted in Lucas suffering devastating but avoidable injuries which will affect him and his family for the rest of his life. The settlement has been carefully calculated and means Lucas will receive the lifetime care and support he requires because of his complex needs.
“While we welcome the Trust’s co-operation in this case and apology, the family would rather not be in this position. Lucas’s case is a stark reminder of the life-changing consequences families can be left to face because of maternity failings.
“Every second counts when delivering babies in distress and it’s vital that lessons are learned so other families don’t have to suffer the pain that Rebecca and Dan have had to endure. We’ll also continue to campaign for improvements in maternity safety nationally.”
Mrs Whitehouse has set up an Instagram account telling Lucas’s story and charting the things he enjoys but also the challenges he faces. The account @lucas_cpjourney also aims to provide help and support to other families experiencing the same issues.
Mrs Whitehouse said: “Despite everything he’s been through we’re so proud of Lucas. He’s an absolute fighter and we feel so blessed that he’s our son. Each day he amazes us with the courage and determination he shows to not be defined by his condition. His laughter would make anyone smile.
“All we want is for him to have the best life possible. Knowing that the support and care Lucas needs is guaranteed for the rest of his life is a huge relief. We just hope that by speaking out we can help prevent other families having to go through what we have.”
A North Middlesex University Hospital NHS Trust spokesperson said: “Our Trust apologised to Lucas’s family in 2015, and we reiterate this full apology today. No amount of money will ever compensate Lucas for his injuries. However, the settlement does ensure that Lucas’ care needs can be met. We wish Lucas and his family the very best for the future.
“After Lucas’ birth we conducted an extensive investigation and made significant changes to our maternity services that will reduce the likelihood of another family going through the same experience. We want to reassure our local communities that our maternity teams are committed to providing excellent care, and our service is rated Good by the Care Quality Commission.”
