Cerebral palsy and clinical negligence litigation—a cohort study

Abstract

We set out to compare the characteristics of children with cerebral palsy who have and have not been the subjects of clinical negligence legal claims. This involved a nested cohort study within a geographically defined cohort of a former Health Authority. Participants were singleton children with cerebral palsy born between 1984 and 1993, excluding cases with a recognised postnatal cause for cerebral palsy. The main outcome measures were the three ‘essential’ criteria defined by the International Cerebral Palsy Task Force which identify acute intrapartum hypoxia. One-fifth (27/138) of all singleton CP children were the subject of a legal claim. The presence of all three criteria was significantly more likely to lead to a legal claim (P < 0.01), but in 74% (20/27) of claims all three were not fulfilled and 36% (4/11) of those satisfying all three criteria did not claim. At least one of the three criteria was met in 82% (91/111) of the cases where there was no claim. Data on fetal or neonatal arterial blood gases were available in only 57% (78/138). Of the 27 claims, 12 were discontinued, eight were settled and in seven the legal process is still pending. The presence of the three essential criteria for acute intrapartum hypoxia did not increase the likelihood of a legal claim being settled.