“Freddie”, now 8 

Mistakes made by a community midwife caused Freddie to suffer a brain injury called kernicterus when he was a newborn baby. Freddie’s parents needed support with finding answers and securing compensation for their son so turned to JMW for advice. Freddie’s case was handled by leading kernicterus solicitor Eddie Jones, who was able to obtain all the specialist help he needs for the rest of his life. 

Jaundice errors

Freddie’s mother Yvonne had the same routine blood tests at the start of her pregnancy as other expectant women receiving NHS care. These showed that she had a rare blood type that could increase the risk of her baby developing severe jaundice after birth. However, the hospital laboratory that provided the results never communicated them to the midwifery team caring for Yvonne and Freddie. 

Yvonne’s labour with Freddie began when she was 37 weeks pregnant, and he was born in hospital in a very good condition and perfectly healthy. Yvonne chose to exclusively breast feed Freddie, as was recommended by the midwives providing her post-natal care. 

The morning after Freddie’s birth, while still in hospital, Yvonne noticed that his skin appeared yellow (jaundiced). While jaundice is often completely harmless for babies, when it appears in the first 24 hours of life, and particularly when there are risk factors, babies need prompt testing of their bilirubin levels and a referral to hospital for treatment. Bilirubin is the substance that causes yellowing of the skin and eyeballs and is able to cross the blood-brain barrier in babies and cause damage. Yvonne raised her concerns about the jaundice with a midwife but was told that it was nothing to worry about and was very common in babies. Later that afternoon Yvonne and Freddie were discharged home. 

The following morning, a community midwife visited Freddie and Yvonne at home to provide their follow-up post-natal care. Yvonne again raised the fact that Freddie was jaundiced. The midwife advised Yvonne that as Freddie was feeding well, this was of no cause for concern. Yvonne questioned at what point jaundice does become a concern, but the midwife failed to provide any clear guidance on the subject. 

The next day Freddie’s jaundice appeared worse. This time it was a midwife support worker who visited Freddie and Yvonne. She provided incorrect advice by telling Yvonne to put his Moses basket by the window to get some sunlight, action which would have no impact at all and is against guidance issued by the National Institute for Health and Care Excellence (NICE). 

Deterioration 

Early that evening, Yvonne tried to breastfeed Freddie and found that he was uninterested, which was a significant change as he had been feeding so well up to that point. Freddie was also very alert and had not slept that day. By 9.45pm that night Yvonne became concerned; it had been six hours since Freddie’s last feed and she called the maternity department at the hospital. The midwife Yvonne spoke to said this feeding behaviour was quite normal. She did not ask anything about Freddie’s jaundice and reassured Yvonne that he was fine. 

Shortly after this phone call Freddie began screaming in distress. Yvonne changed his nappy and found that it was relatively dry and what urine was present was bright orange. Freddie had also not opened his bowels for some time. Yvonne rang the maternity department again at 11.15 and reported all these worrying issues, as well as the fact that he was now making strange movements, including arching his back. The midwife again tried to reassure Yvonne and told her Freddie was probably hungry and to try to express come milk into his mouth. 

Freddie remained the same overnight and at 6am the following morning, Yvonne called the maternity team again and said she wanted to bring him to hospital. The midwife told her to try putting Freddie skin to skin, or in a warm bath, to try to calm him. If this didn’t work she was welcome to call back again. Yvonne did as advised but there was no change to Freddie’s condition so she took him to the children’s emergency department at the hospital, arriving just after 7.30am.

At hospital, Freddie’s bilirubin levels were found to be very high and in need of emergency treatment. He was given intensive phototherapy and a blood transfusion but the window of opportunity to successfully treat him had been missed and he tragically sustained kernicterus brain damage. 

JMW’s investigation

JMW’s Eddie Jones launched an investigation into Freddie’s care and how his condition had been able to deteriorate so terribly when his family had had regular contact with maternity staff. After analysing Freddie and Yvonne’s medical records, and due to his experience of dealing with other cases, Eddie was able to identify the key areas of concern. These were the failure of the hospital laboratory to make the midwifery team aware of Yvonne’s blood test results, which out Freddie at higher risk of severe jaundice, and the failure of the community midwives to arrange testing and treatment when early newborn jaundice was visible. 

Due to these glaring errors and tragic consequences, Eddie was able to write to the hospital trust at an early stage and invite them to admit their failings without the need for a longer legal process. Thankfully in this case, the hospital trust agreed that this was justified and made a full admission of negligence and that they should compensate Freddie so that he could access all the support he required. 

Kernicterus compensation

Eddie was able to obtain some amazing support for Freddie, including a new single storey house that could be adapted to his needs. Therapy and technology that could provide as much independence as possible were also factored into the compensation, as well as financial security for Freddie’s future given he would not be able to work. Across Freddie’s lifetime, this amounted to a total value of £13.4 million, but the impact of the case on the lives of Freddie and his family is priceless.