What is a medical intervention?
Essentially it is some positive action taken by a medical practitioner to avoid harm to a patient or to improve his or her physical or psychological function or well-being…and specifically in relation to a nursing intervention it is some action taken in accordance with a nursing plan, such as administering medication, turning a patient to avoid bedsores, giving treatment for the current condition.
Not all medical interventions are entirely necessary. Several common and repeated examples of such practices are as follows:
1. During labour/child birth – e.g. induction, often a response to pressure from anxious or excited parents as opposed to due to genuine clinical need; and caesarian section, the frequency of which has increased, again not always due to actual medical necessity, despite the seriousness of the procedure;
2. CT or MRI scans which are said to be over used and often ordered as a means of patient reassurance rather than diagnosis
3. Antibiotics – i.e. being too swiftly or unnecessarily prescribed
As stated above, there are a number of very obvious, and in most instances, understandable explanations for these:
1. Issues, guidance and motivations in the particular Trust or body;
2. Industry or media generated concerns influencing the process
3. Inadequate education or training, or awareness
4. Practicing “defensive medicine”
5. Self-referral (in the private sector),
6. Acceding to the wishes of the patient,
7. Availability of private health insurance and patients inappropriately exploiting this
This article is not intended to be prescriptive or comprehensive but merely a brief pointer or introduction to the topic.
Our own experience in dealing with clinical negligence cases is that of the aforesaid examples, the over-use of induction techniques, leading in many cases to C sections, in maternity departments by midwives and obstetric clinicians is the situation that most clients complain of and upon which we are asked to advise most frequently.
What is induction?
To be clear on what we are talking about, an induction is an artificial way of commencing labour.
It can be triggered by a number of methods, some more sophisticated sounding than others.
First, at seemingly the rudimentary end of the spectrum, the membrane or thin tissue around the head of the baby can be ruptured by the insertion of a finger or else a sterile hooked instrument into the cervix – this technique is commonly known as a “sweep”;
alternatively, a balloon like catheter or a prostaglandin gel (an artificial hormone which softens and thins the cervix, usually within 6 to 12 hours) can be inserted into the cervix;
thirdly, the expectant mother can be intravenously given a synthetic hormone such as syntocinon or pitocin to stimulate contractions.
In the vast majority of cases where any of the said induction methods have been utilized, usually (but not always) because there is some concern about the health of the baby or mother, contractions then result within a few hours thereafter and a normal birth ensues without complication, however this is tragically not always so.
Since induction is an intrinsically non-natural means of initiating labour (contrast, for example, “old wives’ tales that a very hot curry, vigorous sexual activity, or other process will do the trick) it is surely inevitable that problems will sometimes arise, if only because, for no sinister reason at all, the baby is genuinely not yet quite ready to come into the world.
Most clinicians would agree that unless there is a clear medical reason for induction, it is far more healthy and carries far less risk of complication for both mother and baby to allow the labour to begin on its own and without intervention or encouragement. Because induction creates a premature contraction process (premature because it is before the body itself has decided it is right to start) sufficient dilatation to facilitate normal vaginal delivery does not always follow, often despite contractions that have been intensified by the IV hormone. This can result in the mother and baby becoming distressed and resulting in the need for a caesarian section.
What is a Caesarian Section?
Basically a large surgical incision into the abdomen and uterus to enable the baby to be removed from the mother.
This is a major procedure that carries the normal risks of such surgery. It can be carried out under general anaesthetic if there is a particular reason for this but more customarily it will be performed after the mother has been given spinal epidural anaethesia, which carries less risk to both mother and baby.
There is no doubt that when there is an real threat to the life of either, such as the baby’s oxygen supply having been compromised or mother hemorrhaging, this can be a life-saving procedure.
But statistically most C sections are non-urgent but more often due to a protracted labour (sometimes because the labour had been induced when the baby was not ready, the labour can be very prolonged indeed, and not surprisingly exhaust the mother, making vaginal delivery beyond her; sometimes the baby may not be engaged in a head down position or in the breech or transverse position) and might not have been necessary had the labour not been artificially induced by the original intervention in the first place.
Although every parent we know would agree without hesitation that the relief and joy of a healthy child far outweighs the pain, stress and distress that accompanies induction and C section, and perhaps that relief and joy is more than enough, some clients are unhappy that they were not able to have a natural birth and have felt that the decision to induce and/or have a C section was taken without their full involvement, and without their full and clear appreciation of the risks and, in the case of the latter, the permanent scarring and other serious problems that might result.
What can we do?
Lloyd Green, Solicitors, have handled many cases where, for example, the surgeon’s incision was negligent and went beyond the uterus/abdomen and caused very severe harm.
We have considerable experience and expertise in these situations and will be more than happy to guide you through the process of making an initial complaint, if that is your preference, and/or formalizing the process by presenting a legal claim to the clinician or Hospital.
We work closely with independent medical practitioners and specialists, and will ensure that your claim is handled sensitively and swiftly, to secure you an explanation and apology, where possible, and ultimately thereafter fair and proper compensation for any errors that have occurred and have caused you injury.