THE doctor-patient relationship will change forever after a ruling by the UK's highest court, according to the Scottish legal firm which represented the mother involved in the case.

 

Nadine Montgomery claimed that she had not been made fully aware of the specific risks of being a diabetic of small stature before giving birth to son Sam in Bellshill Maternity Hospital, Lanarkshire, in October 1999.

Sam, who has cerebral palsy, was asphyxiated during the birth after his shoulder became stuck. It took staff 12 minutes to free him, after which he had to be resuscitated - resulting in brain damage.

On Wednesday, seven UK Supreme Court judges found in favour of Mrs Montgomery in the landmark Montgomery v Lanarkshire Health Board case.

Mrs Montgomery, 40, will receive £5.25m as a result of the judgment.

Fred Tyler, a senior litigation partner with Edinburgh legal firm Balfour & Manson LLP, who represented Mrs Montgomery, said: "My primary wish has always been to secure a positive outcome for Mrs Montgomery and her son. The settlement will allow her to ensure Sam receives the best possible care for the rest of his life.

"In a wider context, this is almost certainly the most significant medical negligence judgment in 30 years - a momentous decision which will affect the doctor-patient relationship throughout the UK."

The case hinged on whether the Health Board went far enough in advising Mrs Montgomery - a Type 1 diabetic - of all the potential risks of giving birth to her son. It is recognised that diabetic mothers can give birth to larger than average babies, putting them at risk of complications from traditional births.

Mrs Montgomery expressed concerns during pregnancy about her ability to deliver the baby safely. Her obstetrician was aware of the risks of the baby's shoulder becoming stuck during the birth, but made a decision not to discuss this with Mrs Montgomery.

She indicated that had she been advised of the risks, she would have elected for a Caesarean section.

Mr Tyler added: "If she had been properly advised of the risks, she would have opted for Caesarean section - and her child would have been delivered uninjured."

Mrs Montgomery, who lost the initial case in the Court of Session in Edinburgh and also lost an appeal, said: "This judgment is an enormous relief after a very long legal fight. I believe that I had the right to know of all the risks surrounding Sam's birth - and I am pleased the Supreme Court has recognised that. I hope this means that other patients will not have to go through what I have gone through.

"The decision will allow me to ensure Sam receives the best possible care for the rest of his life."

Dr Iain Wallace, Medical Director at NHS Lanarkshire, said: "In the 15 years since this case practices have changed significantly. Women are more fully informed and advised of the risks and complications of pregnancy and birth than was the case at that time.
"We are disappointed in the Supreme Court's decision which has applied retrospectively to the law relating to informed consent and to this case.
"We have only just received this judgement and will need time to consider it fully. We understand however that it materially changes the law relating to consent and we along with other Health Boards in the UK will need to consider very carefully any potential implications for future service provision."