NASSAU, Bahamas, CMC – A High Court has awarded US$3.6 million to the family of a child after a botched delivery 12 years ago left their newborn boy with lifelong brain injuries and near-total physical disability.
“I, therefore, find on a balance of probabilities that the defendant caused the injuries to the plaintiff by his successive failed attempts to deliver the baby before the arrival of Dr. Bloomfield and that the injuries were of a kind that fell within the scope of the defendant’s duty of care and were foreseeable,” Justice Loren Klein said in one of the country’s most significant medical negligence award.
Dr Gregory Carey, who has delivered more than 1,000 babies during his 30-year practice, denied negligence and blamed genetics for the child’s condition.
The 12-year-old boy is in a near-vegetative state, suffering from cerebral palsy, epilepsy, and other neurological impairments.
The High Court heard that Dr Carey never apologised for the outcome and, according to the child’s father, even joked it was his “most difficult delivery” and that “they were trying to mess up his record”.
The child’s injuries were traced to hypoxic-ischaemic encephalopathy (HIE), a brain injury caused by oxygen deprivation during delivery. The court found this was the result of prolonged and failed attempts at a vaginal delivery when a caesarean section should have been performed.
According to court documents, the child’s mother arrived at Princess Margaret Hospital around 4.15 am (local time) on August 5, 2012, and Dr Carey tried to deliver the baby using a vacuum extractor and later forceps, but both efforts failed.
After 30 minutes of unsuccessful attempts, another doctor, Dr Harold Bloomfield, the consultant gynecologist and obstetrician, was called and delivered the baby at 11.45 am using forceps. The child was born unconscious, not breathing, and with the umbilical cord around his neck. He was resuscitated and admitted to the Neonatal Intensive Care Unit.
In the weeks and years that followed, the child was diagnosed with a series of debilitating conditions, including West Syndrome, Lennox-Gastaut Syndrome, microcephaly, and permanent neurological impairment. Medical experts testified that he will require round-the-clock care for the rest of his life.
Dr. Carey denied wrongdoing, claiming he was thoroughly trained in the use of delivery instruments and that neither the vacuum nor the forceps was responsible for the injuries. He argued that developmental abnormalities or other unknown factors may have caused the damage.
Dr. Bloomfield testified that he didn’t see any signs that the baby was in distress. And that if he had, he would have proceeded to a caesarean section.
“During my involvement in the delivery of the plaintiff, I did not detect any signs of cuts or contusions to the baby or the mother’s vaginal area, which would have been evident if the forceps were used forcibly or improperly by the defendant,” he said.
But Dr. John Busowski, a specialist in the field of obstetrics and gynecology, testified that sequential use of vacuum and forceps had been tied to increased rates of brain injury.
“In this tragic case, the use of multiple instruments for her delivery resulted in trauma to the baby. These injuries were the direct cause of the child’s current and life-long condition,” Dr. Busowski said, adding he believed that if a cesarean section had been performed after the first failed attempt at assisted delivery, the outcome would have been prevented.
Dr. Ronald Davis, a specialist in neurology, testified that no evidence of structural abnormality implied a genetic abnormality in the plaintiff’s brain.
According to the judgment, after 25–30 minutes of attempts at spontaneous vaginal delivery, Dr. Carey decided operative assistance was required, and sequentially used a vacuum extractor and forceps to attempt delivery.
“At that point, attempts were made to deliver the baby, firstly by vacuum extractor, but the device was said to be malfunctioning and, therefore, forceps were used. After those efforts collectively failed to deliver the baby, the defendant had the nurse call a consultant obstetrician and gynecologist, Dr. Homer Bloomfield,” according to the judgment.
It said that Dr. Bloomfield arrived about 15 minutes after he was called and delivered the baby in five minutes with the use of forceps.
The Judge noted that no claim of negligence was made against Dr. Bloomfield, “perhaps for obvious reasons,” adding “the evidence was that Dr. Bloomfield was able to deliver the baby in about five minutes successfully and no issues were encountered applying the forceps.
“Whether this was because the baby’s head had rotated in an ideal position by the time Dr. Bloomfield had arrived, or because of his superior knowledge and experience, it matters not. “The fact is that he was able, with minimal effort, to deliver him with the same forceps Dr. Carey was unable to deliver him with,” the Judge said, noting also the absence of empirical evidence to support the defense that the infant never showed signs of distress.
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