Jayden Astley (A minor by his father and litigation friend Craig Astley) v Lancashire Teaching Hospitals NHS Foundation Trust

28 July 2023

[2023] EWHC 1921 (KB)

High Court

A baby suffered brain damage during birth because the midwife didn't notice his heart rate was dangerously low. The judge said the midwife was negligent, and the hospital had to pay damages.

Key Facts

•Jayden Astley suffered brain damage due to acute profound hypoxia-ischaemia (APH) during birth on July 22, 2012.
•The claim alleged negligence by Lancashire Teaching Hospitals NHS Foundation Trust in managing the mother's labor.
•A split trial focused on breach of duty and causation.
•Experts agreed that APH started 8 minutes before birth, and delivery 3 minutes earlier would have prevented brain damage.
•Midwife Kong's notes showed normal fetal heart rate (FHR) despite Jayden's asphyxiated condition at birth.
•The main allegations were inadequate attention to blood-stained liquor, inaccurate FHR monitoring, and failure to identify bradycardia.
•Expert evidence highlighted inconsistencies between recorded FHR and Jayden's condition.

Legal Principles

Standard of care for midwives in managing labor and monitoring fetal heart rate.

NICE guideline 55 on intrapartum care

Duty of care to provide competent intermittent auscultation and timely recognition of fetal bradycardia.

Expert midwifery and obstetric evidence

Outcomes

Judgment for the Claimant.

The court found breaches of duty in failing to accurately monitor FHR, identify bradycardia, and respond appropriately to blood-stained liquor. These failures directly caused Jayden's brain injury.

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