Nadine Montgomery wins £5m from NHS Lanarkshire over brain damage to son

image source, BBC - handout
image captionNadine Montgomery has won a 16-year legal fight for damages for her son Sam

A Lanarkshire woman whose baby suffered brain damage during birth has won a 16-year fight for £5.25m compensation.

Nadine Montgomery, 40, claimed medics neglected to give her proper advice which may have led to her son Sam having a safer caesarean birth in 1999.

Her damages claim had been rejected on two previous occasions at the Court of Session in Edinburgh.

Judges at the Supreme Court in London have now upheld her major damages claim against NHS Lanarkshire.

Following the ruling, Mrs Montgomery said: "This judgment is an enormous relief after a very long legal fight.

'Best care'

"I believe that I had the right to know of all the risks surrounding Sam's birth - and I am pleased the Supreme Court has recognised that. I hope this means that other patients will not have to go through what I have gone through.

"The decision will allow me to ensure Sam receives the best possible care for the rest of his life."

Mrs Montgomery gave birth to her son in Bellshill Maternity Hospital on 1 October 1999.

As a result of complications during delivery, Sam was born with severe disabilities.

The case hinged on whether the health board went far enough in advising Mrs Montgomery, who is small and a Type 1 diabetic, of all the potential risks of giving birth to her son.

It is recognised that diabetic mothers can give birth to larger than average babies, putting them at risk of complications from traditional births, including shoulder dystocia, where the baby gets stuck.

In Mrs Montgomery's case, Sam's shoulder became stuck after the delivery of his head.

The staff performed appropriate manoeuvres to release the shoulder, but during the 12-minute delay, he suffered oxygen deprivation.

The need for resuscitation resulted in brain damage, leading to cerebral palsy and damage to the nerves which control shoulder, arm and hand movements.

Mrs Montgomery expressed concerns during pregnancy about her ability to deliver the baby safely.

Previous rejections

Her obstetrician was aware of the risks of shoulder dystocia, but made a decision not to discuss this with Mrs Montgomery - or to discuss caesarean section as an alternative.

Mrs Montgomery indicated that had she been advised of the risks, she would have elected for a caesarean section.

Her claim for damages from the health board was previously rejected by the Outer House of the Court of Session in Edinburgh.

The Inner House also rejected her appeal against this decision.

Those judgments have now been overturned by a panel of seven judges at the Supreme Court in London.

In their ruling, the judges said: "The only conclusion that we can reasonably reach is that, had she (the consultant) advised Mrs Montgomery of the risk of shoulder dystocia and discussed with her dispassionately the potential consequences, and the alternative of an elective caesarean section, Mrs Montgomery would probably have elected to be delivered of her baby by caesarean section.

"It is not in dispute that the baby would then have been born unharmed."

NHS Lanarkshire's medical director, Dr Iain Wallace, said that practices had "changed significantly" since Mrs Montgomery's son was born.

"Women are more fully informed and advised of the risks and complications of pregnancy and birth than was the case at that time," he said.

"We are disappointed in the Supreme Court's decision which has applied retrospectively to the law relating to informed consent and to this case.

'Very helpful'

"We have only just received this judgment and will need time to consider it fully. We understand, however, that it materially changes the law relating to consent and we along with other health boards in the UK will need to consider very carefully any potential implications for future service provision."

Mrs Montgomery's lawyer, Fred Tyler, from Balfour and Manson, said: "This is almost certainly the most significant medical negligence judgement in 30 years - a momentous decision which will affect the doctor-patient relationship throughout the UK.

"Doctors will have to discuss with their patients the options that exist in their treatment and advise them about the alternatives and any associated risks."

Niall Dickson, chief executive of the General Medical Council, described the judgment as "very helpful".

"We are pleased that the court has endorsed the approach advocated in our guidance on consent.," he said.

"'Good Medical Practice and Consent: patients and doctors making decisions together' makes it clear that doctors should provide person-centred care.

"They must work in partnership with their patients, listening to their views and giving them the information they want and need to make decisions."

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