Shielnile Darlington v Saint Ann's Bay Hospital, North East Regional Health Authority and the Attorney General's Department

• Jurisdiction: Jamaica
• Judge: Stephane Jackson-Haisley, J
• Judgment Date: 25 January 2018
• Neutral Citation: [2018] JMSC Civ 53
• Docket Number: CLAIM NO. 2011 HCV 00898
• Court: Supreme Court (Jamaica)
• Date: 25 January 2018

[2018] JMSC Civ. 53

IN THE SUPREME COURT OF JUDICATURE OF JAMAICA

IN THE CIVIL DIVISION

Stephane Jackson-Haisley, J

CLAIM NO. 2011 HCV 00898

Between

Shielnile Darlington

Claimant

and

Saint Ann's Bay Hospital

1 ^st Defendant

and

North East Regional Health Authority

2 ^nd Defendant

and

The Attorney General's Department

3 ^rd Defendant

Mrs. Denise Senior-Smith and Ms. Olivia Derrett instructed by Oswest Senior Smith and Co. for the Claimant

Mrs. Donia Fuller-Barrett and Ms. Kimberley Morris instructed by the Director of State Proceedings for the Defendants

Medical Negligence - Whether the Defendants failed to ensure the safe delivery of the Claimant's baby — Whether the treatment of the Claimant and her baby fell below the standard expected of a reasonably competent hospital staff

IN OPEN COURT

BACKGROUND

1 The Claimant, Shielnile Darlington was 22 years of age when she lost her child, a child who could have been classified as a bouncing baby boy, had he survived. He weighed two ounces short of 9lbs. He was born on June 17, 2008 a few days past his expected date of delivery at the St Ann's Bay Hospital in the parish of St. Ann. During his delivery it was observed that the umbilical cord was wrapped tightly around his neck. When he was delivered at 2:10am on June 17, 2008 he was observed to be extremely “limb”. Resuscitative measures were carried out but proved to be unsuccessful. The baby's death resulted from asphyxiation. The account however, did not begin there. It began on Friday, June 13, 2008 when the then pregnant Claimant, having passed her due date reported to the St. Ann's Bay Hospital at about 7:15am and was admitted to the maternity ward at approximately 8am.

THE CLAIMANT'S CASE

2 It is the Claimant's case that after she was admitted on Friday, June 13, 2008, she was subjected to several tests. Further, that the nurses advised her that after the tests results came in they would decide whether or not a Caesarean section would be requested. She indicated that on the following day she was examined by a Doctor after which he advised her that she would more than likely have to do a Caesarean section but she would have to wait until Monday when the tests results were ready so that a final determination could be made.

3 On Monday, June 16, the Claimant was still awaiting the birth of her baby. At about 7pm that day she was taken to the delivery room where she was prepared to give birth naturally. She said she began to push and she recalled that the nurses said that they saw the baby's head at around 11pm. She indicated that she continued to push but nothing further happened. She was in labour and in pain and it was not until 2am that the nurses called Dr. Wolfe so that he could make a decision as to whether or not she should be taken to the operating theatre.

4 According to the Claimant by the time Dr. Wolfe arrived and did certain procedures, it was by then too late. The baby came out at about 2:10am and Dr. Wolfe advised her that the umbilical cord was tied too tightly around the baby's neck and the baby had started to urinate and defecate and some of it went down his throat. It was then that Dr. Wolfe told her the news that no mother would ever want to hear, that her baby had died.

5 It is no small wonder that she expressed that after the death of her baby she remembered that she was distraught. To use her words, she had to “split herself in two and separate the me that was scared and frightened and devastated to go throughout the days”. She was referred to a Dr. Denton Barnes for an assessment after which she saw Dr. Terrence Bernard, a psychiatrist who examined her and prepared a report containing his findings.

6 According to her, it was really hard to have to recount to people what happened especially because people would have seen her pregnant and then they did not see a baby afterwards. She indicated that she will never forget the day her baby died, that she usually calculates his date of birth and that when she sees little boys she would think to herself that her baby would be that age if he had lived. She also expressed that she imagines what he would look like and what he would be capable of doing.

7 On February 23, 2010 the Claimant filed a Claim Form accompanied by Particulars of Claim against the Defendants with the Saint Ann's Bay Hospital as the 1 ^st Defendant, the North East Regional Health Authority as the 2 ^nd Defendant and the Attorney General's Department as the 3 ^rd Defendant. The Claim Form and Particulars of Claim were amended twice resulting in a 2 ^nd Further Amended Claim Form and Particulars of Claim.

8 The Claimant seeks Damages for Negligence in that whilst she was a maternity patient with the 1 ^st Defendant, she lost her child due to the negligence of the 1 ^st Defendant, its servants and/or agents in failing to use reasonable care and skill in the treatment and advice of the Claimant and her baby. The Particulars of Negligence pleaded are as follows:

• I. Failed to “properly” carry out proper and adequate pre-natal care to ensure the safe delivery of the Claimant's baby;

• II. Failed to conduct radiographic tests to ascertain the health of the baby since the Claimant had passed her overdue date;

• III. Failed to carry out steps to ascertain the health of the baby during the period she was in the hospital;

• IV. Failed to observe or act upon, monitor or investigate properly the status of the foetus or at all the steady, serious and obvious deterioration in the condition of the Claimant's baby whilst the Claimant was in their care.

• V. By reason of these matters, the Claimant's baby underwent pain and suffering which she would otherwise not have endured, her illness was greatly aggravated and the consequences thereof were prolonged and she suffered loss and damage. Further the Claimant suffered severe emotional trauma, stress and anxiety. severe emotional trauma, stress and anxiety.

9 The Claimant also seeks Special Damages in the sum of $176,000.00 which reflects expenses incurred consequent upon the death of her child.

10 At trial the Claimant's witness statement dated August 2, 2017 was allowed to stand as her evidence in chief save for portions which were struck out on the ground that they were in breach of the rule against hearsay. She was subject to cross-examination during which she insisted that the baby's weight was 9lbs and further indicated that she would be surprised to learn that he weighed less than 9lbs. She admitted that tests were done to her and the baby four or five times throughout each day except for the urine test which was only done once and that the tests included blood pressure tests and examination of the baby's heartbeat.

THE MEDICAL EVIDENCE

11 The Claimant's medical docket was tendered into evidence by the Claimant however it was also relied on by the Defendant. The docket contains a chronology of the treatment administered to the Claimant from her admission on June 13, 2008 to her discharge on June 18, 2008. I have summarized some of the notes made on June 17 ^th 2008 leading up to the delivery.

17/6/08

• — At 1am Dr Khan reviewed the patient

• — At 1:50am it was noted that there was poor maternal effort, the foetus appear big there was no progress, fetal heart rate was at 110 beats per minute and Dr. Khan was informed.

• — At 2:00am Dr. Wolfe arrived, reviewed the Claimant, an episiotomy was given after which the Claimant delivered a large male “neonate” with the assistance of forcepts.

• — At 2:15 am the apgar score was noted a 1-0 0/10 and the weight 4.14kg

• — At 2:15am paediatrician intern and resident present were resuscitating the neonate but same was unsuccessful.

THE DEFENCE'S CASE

12 The Defence's case is contained in the Amended Defence filed on June 2, 2007, the medical docket, and in the evidence of Dr. Locksley Wolfe, Doctor of Medicine and Gynaecology and Obstetrics and in his “Report on Perinatal Death”.

13 The Defendants deny the Particulars of Negligence pleaded and dispute the claim. They aver that they did not fail or refuse to properly and effectively treat the Claimant, nor did they cause the death of the Claimant's baby. Further, that the medical records reveal that at all material times both the Claimant and her baby were afforded all reasonable care in the circumstances and treated with the requisite skill and care required. They alleged further that despite this treatment, which included numerous tests to ascertain the health and status of the baby, when delivered, the baby came out in an occipito-posterior position with its umbilical cord wrapped tightly around its neck, despite previously being in a cephalic position due to no fault of the Defendants.

14 The Defendants made no admission in respect of the Claimant's assertion that she has suffered severe emotional trauma. They simply contend that she is not entitled to the reliefs claimed.

15 Dr. Locksley Wolfe was the only witness relied on by the Defendants. At the time he treated the Claimant he was a resident gynaecologist at the St Ann's Bay Hospital and the senior obstetrician on duty. Dr. Wolfe in his evidence paints a picture of what took place from the Claimant first presented at the Hospital to the time when she was discharged. According to him, upon the Claimant's admission to the Hospital investigations were done to determine whether the baby was macrosomic. He explained that a macrosomic baby is one whose weight ranges between 9lbs and 91/2 lbs. He went on to say that non stress tests were administered to ascertain the baby's heartbeat and that blood tests were done on the Claimant to determine whether she had gestational diabetes. He explained that the presence of gestational diabetes would mean that the baby would be bigger than normal and so the results would determine the appropriate mode of delivery.

16 According to Dr. Wolfe, the results of the...