A FAMILY who tried to sue Wagga Base Hospital for negligence after their son was born with brain damage from a premature birth has had their claims dismissed.
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James Phillip Coffey was born on the morning of January 19, 2004 at just 27 weeks gestation to parents Kathleen and Brian Coffey.
Now 15 years old, James suffers from a host of cognitive impairments that hinder his everyday speech and communication.
In a NSW Supreme Court ruling last week, Judge Ian Harrison ruled that the hospital complied with the medical practice standards at the time and that the proceedings brought by Ms Coffey did not meet the legislative timeframe.
Anthony Bartley SC, counsel for the Coffeys, argued that when Ms Coffey was admitted to hospital on January 4 and 5 in 2004, it should have been clear that she was likely to deliver before 32 weeks and that she should have been transferred to Canberra Hospital for specialist delivery treatment.
Mr Bartley argued that she had a provisional diagnosis of threatened premature labour. She was monitored and reviewed by doctors and given antibiotics until she was discharged on January 10.
She then presented herself to the hospital on January 19 with a history of mild tightenings. About 90 minutes later, she gave birth to James at less than 30 weeks gestation.
At delivery, James needed to be resuscitated almost immediately after an X-ray showed him having breathing difficulties.
He was then flown to Canberra where he also suffered anaemia of prematurity and was transfused twice.
Allegations of failure in care
The significant and overarching allegation against the Murrumbidgee Local Health District was that it failed to transfer Ms Coffey to Canberra Hospital for specialist treatment before James' delivery.
Mr Bartley also argued that a transfer should have taken place because Wagga hospital at the time was not accredited to deliver babies of less than 32 weeks gestation.
He argued that the hospital 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.
He argued that had Ms Coffey given birth at Canberra Hospital, proper resuscitation and medical specialists would have been available immediately and bleeding in the brain, which contributed or caused James' brain impairment, would not have happened.
Wagga Wagga Base Hospital acted in a manner that (at the time the service was provided) as widely accepted in Australia by peer professional opinion as competent professional practice.
- Dr Robert Lyneham
The MLHD conceded that Ms Coffey's pregnancy was high risk because of her obstetric history. The health district also admitted that at the time of James' birth, the Canberra Hospital was one of the referral centres that Wagga staff were able to seek advice from and that they did not do so.
Richard Cheney SC, counsel for the MLHD, argued that in the circumstances of the case, the decision not to transfer and the treatment of Ms Coffey during and after delivery conformed to competent professional practice.
The MLHD relied on evidence by various experts who reviewed the material about whether or not the treatment provided to Ms Coffey leading up to the birth met competent professional practice at the time.
Of the 11 who provided evidence, 10 found in favour of the hospital's medical practice. Dr Robert Lyneham said there were no indications of imminent delivery that required Ms Coffey to be transferred.
"Wagga Wagga Base Hospital acted in a manner that (at the time the service was provided) as widely accepted in Australia by peer professional opinion as competent professional practice," Dr Lyneham said.
Of the six obstetricians who gave evidence, an associate professor was the only one who said a transfer to Canberra Hospital was necessary.
The professor said that the risk of Ms Coffey delivering prematurely was close to 50 per cent.
The professor argued that Ms Coffey did fulfil the criteria for threatened pre-term labour and that her history of three previous pre-term births made her a high-risk patient.
"In such a high-risk patient with such a high-risk of pre-term birth occurring, one would always err on the side of overdiagnosis and overtreatment than under diagnosis and undertreatment," he said.
"Otherwise, you're taking unacceptable risks on behalf the patient".
MLHD argued that Ms Coffey's high-risk pregnancy "did not as a matter of practice, policy or medical necessity warrant" her transfer to Canberra before January 19.
It also argued that the only difference between Wagga and Canberra hospitals was the Neonatal Intensive Care Unit.
Judge in favour of hospital
In his remarks, Judge Ian Harrison said the hospital met the standards set by the experts and that his ruling in favour of the hospital was in relation to all allegations.
"The hospital does not incur a liability in negligence either to Ms Coffey or James Coffey," he said.
He said that the evidence "ultimately spoke with one voice" to show that the hospital met the standard of care required by professionals.
"There was no evidence from Ms Coffey to the contrary," Judge Harrison said.
The hospital also argued that Ms Coffey's legal proceedings started in March 2011, which were outside the statute of limitations.
Judge Harrison dismissed those claims. "I accept that dealing with the fact that her son had possibly been injured by the hospital would have been a terrible and frightening thing," he said.
"I am not satisfied that the effect of that realisation or appreciation substantially impeded Ms Coffey's management of the relevant affairs."
Kathleen Coffey and her lawyer had been contact but did not respond before publication deadline.
A spokesperson for the MLHD declined to comment.
