A Wagga family is suing the Murrumbidgee Local Health District for damages after their son suffered brain damage, which they say was a result of his premature birth at Wagga Base Hospital.
James Phillip Coffey was born on the morning of January 19, 2004 at just 27 weeks to local parents Kathleen and Brian Coffey.
Now 14 years old, James suffers from a host of cognitive impairments that hinder his everyday speech and communication, leaving him with severe anxiety issues.
On Monday in the Supreme Court in Sydney, counsel for the Coffeys Anthony Bartley SC argued those impairments are a direct result of James’s delivery at Wagga Base Hospital.
Mr Bartley said the hospital was not qualified to deliver a baby as premature as James, and instead should have transferred his mother to Canberra Hospital for specialist treatment.
“The defendant attempted to manage a birth at a stage in the term of the pregnancy for which it was not accredited, for which it did not have the appropriate personnel present,” Mr Bartley said.
“The delivery was the result of a pregnancy which, under a policy direction which was binding of the defendant, should have been referred to a tertiary centre with the neonatal expertise to manage a high-risk pregnancy.”
The MLHD is defending the claims, with Richard Cheney SC arguing Ms Coffey knew a transfer was possible if she wanted one.
The court heard James needed to be resuscitated almost immediately after he was born, and it was six minutes before medical staff were able to stabilise him.
He and his mother were airlifted to Canberra Hospital later that day, where they remained under specialist care for some months.
Mr Bartley said James has been left to grow up with receptive and expressive language difficulties ever since, including disorders relating to speech, sound, language, stuttering, and voice.
“He has symptoms consistent with an incompletely treated major depressive disorder with suicidality, likely anxiety, moderate intellectual disability, and severe language disorder,” Mr Bartley said.
“One of the unhappy periods of evidence that your Honour will hear is that, increasingly, as he gets older, the way he is able to express himself is through anger, threatened physical violence brought about not so much by his cognitive impairments, because the cognitive testing is relatively normal, but by sheer frustration.”
The court heard his parents now spend some 28 to 35 hours a week giving him particular care.
In 2004, Wagga Base Hospital was not accredited to attempt a birth at less than 32 weeks, and policy mandated that any high-risk pregnancy more premature than that had to be referred to a tertiary centre like Canberra Hospital, Mr Bartley said. He went on to say the hospital also breached its own policies by not having a paediatrician present at the delivery of a pregnancy that had already been identified as high-risk, which meant it was up to a midwife to begin resuscitating him.
“The hospital’s own internal protocols required that, in a high-risk patient such as this, a paediatrician be present at the birth,” he said.
“The paediatrician was not called until after the birth … so, almost everything that could have been done wrong by the Wagga Base Hospital was done wrong in this case.”
Further, James’s mother had spent six days as an inpatient at Wagga Base one week earlier, during which time Mr Bartley said the hospital was aware she had a history of pre-term labour.
The court heard that if James had been born at Canberra Hospital instead, he would have had the benefit of immediate treatment by a neonatologist, an anaesthetist, and an experienced obstetrician, all of whom might have been able to improve the outcome.
In his opening statement for the defence, Mr Cheney pointed out that Ms Coffey had been transferred to Sydney some years earlier in connection with the high-risk pregnancy of her first son.
According to Mr Cheney, that meant Ms Coffey knew transferring was possible, and it was not up to the hospital to force it upon her.
“The height of Kathleen Coffey's own evidence indicates that she was well aware of the fact that transfer was an option,” he said.
“Indeed, at some point she laments that she didn't press hard enough about it.”
Judge Ian Harrison asked if that was up to the patient.
“But she's not obliged to press,” Judge Harrison said.
However, Mr Cheney said his point was that the hospital could not force a transfer on someone.
“The allegation that there should have been a transfer of Kathleen is really an allegation that there was a failure to advise Kathleen that transfer was an option,” Mr Cheney said.
“The point is that we couldn't compel her transfer – at best, we could recommend it, advise it, and seek her consent, but we couldn't mandate that she be placed in a helicopter or plane and taken to Canberra … you can't physically throw her into the helicopter against her will.”
The hearing is expected to continue before Judge Harrison for the next three-and-a-half weeks in Sydney.
James’s parents are expected to give evidence about the difficulties he has suffered in his early life, while his grandmother will speak to the distress his ongoing health problems have caused the family.
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