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Friday, October 15, 1999 Published at 03:44 GMT 04:44 UK


Palsy guidelines may cut court trauma

High Court rulings can lead to multi-million pound payouts

The number of groundless medical negligence claims making it to court could be dramatically cut with a new document drawing together evidence on the causes of cerebral palsy.

A number of High Court cases have hinged on the question of whether hospital staff were responsible for a child suffering cerebral palsy. One recent case produced a damages payout of £2.35m.

However, doctors' defence organisations say that many other cases have little merit and simply clog up the courts as well as distressing families - and medical staff.

Now doctors and midwives from around the world have published a consensus statement, defining the factors that cause the condition.

'No-one to blame'

It says that in most instances the condition develops in the womb and cannot be prevented.

It also gathers together the evidence on what factors at the time of labour and birth can be responsible for cerebral palsy.

[ image: Medical negligence claims are becoming more common]
Medical negligence claims are becoming more common
Julia Neild, of the Medical Defence Union, said it would be useful for reducing the number of unfounded cases going to court.

"A huge number of these cases are pursued, and anything that clarifies the issues makes litigants prepare their cases better," she told BBC News Online.

"There are so many unmerited cases - and they are the ones that drag along for years and years and cause so much stress," she said.

These would now be more likely to be resolved before making it to court.

"Also, those cases with merit should move along more quickly, which is good for everybody."

Useful definitions

The new document was especially good because it set out clear definitions in a complex area, she said.

[ image: Events at the time of birth are crucial in court cases]
Events at the time of birth are crucial in court cases
Debate in court would often centre on an interpretation of medical records, which may be incomplete, and - although this document would not end that - it would help guide the court more clearly.

"What is particularly valuable is that it is very wide ranging and has been put together by people from all the various disciplines that might be involved in determining what happened at a birth," she said.

"It's especially important to point out that many cases of cerebral palsy begin in the womb.

"It's been easier in the past to assume that if there were delays in the birth, then they were what caused it."

Consensus view

Professional organisations from around the world have endorsed the statement, which was published in the British Medical Journal.

Professor Leiv Bakketeig, from Odense University in Denmark, said in an editorial that research on the cause of cerebral palsy needs to look at what happens before birth.

"In most cases of cerebral palsy there will be nothing or nobody to blame," he said.

"Focus should therefore be on the provision of optimal care for infants with cerebral palsy and their families."

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